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[anxietypeaker]

can someone tell me what the route for specialties in medicine/surgery in the UK? After the modernizing thing/change im confused...what the heck is the point of the Basic Medical Training of 2 years? Theyve already done the Foundation years. Do any people choose to stop after the BMT? What specialty are they then?

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[john182]

The new UK system is a two year Foundation programme basically like 24 months of internship. The old UK system was 12 months, and in most EU countries it is 18 months.

Following that, you start a 6 year speciality training programme. At the ned of that, they will make you a junior consultant*.

The current system, is 12 months internship, then basic specialist training (2-3 years), do some research/kiss ass/sell your body, then hopefully get picked for a 5 year SpR programme, and then be made a full consultant**.

* they haven't specifically mentioned this yet, but it's what actually will happen.

** earn too much money and have political clout, so need to be destroyed (from the NHS's point of view).

 

[ThatKidMike]

The new UK system is a two year Foundation programme basically like 24 months of internship. The old UK system was 12 months, and in most EU countries it is 18 months.

Following that, you start a 6 year speciality training programme. At the ned of that, they will make you a junior consultant*.

The current system, is 12 months internship, then basic specialist training (2-3 years), do some research/kiss ass/sell your body, then hopefully get picked for a 5 year SpR programme, and then be made a full consultant**.

* they haven't specifically mentioned this yet, but it's what actually will happen.

** earn too much money and have political clout, so need to be destroyed (from the NHS's point of view).

sounds like a crapload of years, US med school sounds like a better deal then that with all the training they require

 

[BlondeCookie]

The new UK system is a two year Foundation programme basically like 24 months of internship. The old UK system was 12 months, and in most EU countries it is 18 months.

Following that, you start a 6 year speciality training programme. At the ned of that, they will make you a junior consultant*.

The current system, is 12 months internship, then basic specialist training (2-3 years), do some research/kiss ass/sell your body, then hopefully get picked for a 5 year SpR programme, and then be made a full consultant**.

* they haven't specifically mentioned this yet, but it's what actually will happen.

** earn too much money and have political clout, so need to be destroyed (from the NHS's point of view).

When does the new system of post-graduate training take effect? How does this work for graduates that will commence with the current system if the new system replaces the current system whilst they are still doing their internship or residency?

 

[Waiting4Ganong]

The new system started last year.

Common for all (first intake was 2005):

PGY1 = F1 - intern (including 3mos of med, surg and up to two other fields)
PGY2 = F2 - rotational year (eg: Four months of EM/Neurosurg/Radiology)

Followed by (first entry starts 2007):

3yrs for General Practice
5-6yrs Med (w/subspeciality trained)
6-7 Yrs Surgery


Hours are <<60/wk, pay is 2X US pay, you are a doctor from day 1. More gradual, progressive system. You have a life and train.

 

[anxietypeaker]

In the US if you want to do cardio...you do 3 years IM, 3 years cardio fellowship. IN the UK, you do 2 years foundation, 2 years basic medical training, then some number of years for higher specialty training in cardio.

1) in the US if you dont get cardio fellowship, you just stay with IM (primary care). What happens in the UK..if you dont get cardio can you stop after your 2 years of basic medical training? If you do what are you considered? (a gp? even though you did only 2 years after foundation, when gps do 3 years?)

2) Are there any specialties in the UK where you have to complete a general certificate prior? for example, gen psych certificate, then forensic? Or is it in the UK you pick gen psy or forensic from the beginning.

 

[Waiting4Ganong]

If you finish foundation years (F1 and F2) and basic medical training (ST1,ST2 also known as BMT1 and BMT2) and then can't get cards you do either:

A) Another 2-3yrs (ie: 6-7yrs total) and become a Consultant in General Medicine
B) You switch to another subspeciality
C) You switch to GP track (BMT may give you a years credit towards this).

A UK Consultant in Medicine is not equal to a US internist with only 3yrs training. They would be closer to associate prof status in a US teaching hospital. They manage a team of Junior Doctors at various stages of training (anywhere from 0yrs to 7yrs+).

You couldn't drop out of internal medicine training and just become a GP. GP in UK requires you to do 6mos rotations in some or all of: Emergency Medicine, Obs-Gyn, Medicine, Paediatrics, Psychiatry before doing a one year GP Registrar year (where you practice as a GP but under close supervision with a mentor).

GPs play a MUCH bigger role in delivery of medicine than they do in America. They are primary doctors to all. As a patient, you can't just go see the specialist you think you need willy-nilly.... you have to first see your GP who will assess you and discuss the options for further, subspecialist, treatment.
GPs are paid well in UK (170-200K dollars/yr) and have great hours (no nights or weekends, <50hrs/wk).

 

[anxietypeaker]

1) what do you mean consultant in medicine? What role do they play when a GP already calls on cardio for heart/path for disease/etc?

2) the "4-5 (6-7) total years" means what? im assuming that its 4-5 years of something like BMT? COnsultants dont do any HST...correct?

3) you didnt answer #2 in my last post

 

[Waiting4Ganong]

http://www.mmc.nhs.uk/pages/home

 

[anxietypeaker]

I've seen that site. Its kind of hard to decipher because im not familiar with the UK-only terms

 

[john182]

When does the new system of post-graduate training take effect? How does this work for graduates that will commence with the current system if the new system replaces the current system whilst they are still doing their internship or residency?

AFAIK the first intake to the MMC (Modernising Medical Careers - the management term for the new system) system is SUmmer 2007, following the end of the F2 years for those who started F1 in summer 2005.

As an aside:
1. The F1/F2 thing apparently has been carnage for the newly qualified doctors. Lots of very junior people are getting screwed by it, and the different deaneries and trusts haven't really planned everything out for everyone. Essentially, it maintains "feet on the ground" at lower salaries and more limited training exposure - at least, this is what I have gathered from people I know in the system. I am in Ireland, but as my training is closely linked to the UK system we need to know what goes on there to watch how it plays out here as many people go to the UK for SpR training.

2. You do have far less hours as mentioned above, and have much more potential income as a junior in the system, so it is possible to have a (very) good life outside of the hospital. There is less of a focus that you are a doctor only when done training (like the US perhaps) as the training is so goddamn long!

 

[john182]

2) Are there any specialties in the UK where you have to complete a general certificate prior? for example, gen psych certificate, then forensic? Or is it in the UK you pick gen psy or forensic from the beginning.

Psychiatry (my field) is dividied into BST and HST - Basic Specialist Training and Higher Specialist Training. BST is currently the 30 months minimum for the Royal College of Psychiatrists Memberships (therefore it's really 3 years as you can't sit the final part until you have completed 30 months). After that you specialise in an area, for example General Adult/Child & Adolescent/Forensic/Learning Disability.

The speciality training is also 3 years (this is the SpR training). Although you may do for example, a General Adult SpR, you can do a year in say Forenics and finish as a General Adult Psychiatrist with a "Special Interest". This holds for any other subspeciality as well.

The 3 years BST rotates you through General Adult, Old-Age, Child, Forensic, LD and so on in 6 month blocks. You must do 6 months of Child or LD to get the Membership exams.

 

[john182]

1) what do you mean consultant in medicine? What role do they play when a GP already calls on cardio for heart/path for disease/etc?

Consultants in medicine are like say, the new Hospitalist speciality in the US. They have most likely longer training, and although might be a general physician they would have a special interest. This is more in the rural areas. In big cities, there would of course be loads of speicalists in cardio/gastro in big hospitals, which may be inaccesible as the access depends on where you live as it is a nationalised system.

If you were going to work in the UK, GP would probably be the nicest balance of work/life/money. Specialist training seems to take a decade+longer in say surgical subspecalities.

 

[Waiting4Ganong]

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