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Too many doctors?

Discussion in 'Mature Students' started by matscar, Feb 2, 2004.

  1. matscar

    matscar New Member

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    This weekend I was chatting to a friend I haven't seen in a while, who - when I mentioned that I was applying for medical school - said something like "Oh, you'll get in - they are crying out for doctors at the moment". Obviously I then had to explain that it is actually quite competitive to get a place and so on, but it made me think: in four or five years time, will there still be such a demand for doctors? It seems that more and more people are applying each year - especially mature students, so does anyone think that this might lead to a surplus of newly qualified doctors in a few years time? I may be completely wrong, but would be interested to hear other people's point of view on this.

    It reminds me of the rapid increase in people doing subjects like Computer Science and IT when I was at uni (1997-2000), many of whom struggled to get jobs in the end because they entered a market saturated with graduates.

    Anyway - just wondered if anyone has any thoughts (may be under the wrong topic, but thought I would ask matures mainly)

    Matt
     
  2. spk76

    spk76 New Member

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    Med student numbers are prescribed by the government, which has complicated ways of predicting the future requirements of the NHS. There is a very real concern that GPs in particular are retiring at a faster rate than new doctor's are coming on stream. In addition to this, something like 10% of qualified doctors are no longer practising within 10 years of graduating. Those are some of the reasons why there has been such a drive to recruit med students, even though competition is still extremely high. Many people think that graduates have the experience and maturity to make an informed decision about their future career and are more likely to stick at it until retirement than some 18 year old with good A levels. This has certainly been born out in Australia and the States.
     
  3. Watalapum

    Watalapum New Member

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    I don't think the comparision with IT holds, as most IT provision is at the mercy of market forces and needs to be justified in that hard light, whereas most docs I guess are employed by NHS as public servants..unless of course they outsource doctors too!
     
  4. ira222

    ira222 New Member

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    I think the fact that it is so hard to gain entrance into MedSchool, despite the apparent lack of doctors shows that the GMC/government are not prepaired to A) jeopardise the quality of doctors by allowing all universities to start their own MBBS program and B) to have an uncontrolled influx of graduates in a discipline that cannot sacrifice a thoroughly carried out education for the current demands of the job market.

    Thus, I wouldn't worry too much about a sudden flood of newly qualified docs, albeit that it would increase my chances of getting one of the soo desired places in MedSchool :mrgreen:
     
  5. matscar

    matscar New Member

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    Thanks for the comments - I thought it would be a simpler case of supply and demand, as I guessed there must be an optimum number of doctors that the NHS requires, and I thought there may be a surplus of new doctors. However, you guys seem to know a lot more about what drives the number of /requirement for qualified doctors than I do, which is good to learn about.

    The last thing I need after 4/5 years of getting myself into huge debt, is to struggle to find a job!
     
  6. Jools

    Jools New Member

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    Also don't forget changes in working practices can only mean that more doctors are needed. For example, the European Working Time Directive, GP and consultant contracts, increase in the number of docs working part time (work-life balance, allowing involvement in academic/research etc pursuits), move towards a more patient centred approach (more time for consultations) and so on.


    Jools
     
  7. kul_p

    kul_p New Member

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    There will always be a need for doctors, regardless of how much medicine technology advances. Furthermore, the problem is not people applying, but how many places are actually available for medical students. I believe now that junior doctors are to be restricted to 48 hours/week to bring UK hours into line with Europe and this can only means that more doctors will be required. I'm not sure how more medical places can be made available, but that has to be the solution to produce more home-grown doctors in the future.
     
  8. Fizzwizz

    Fizzwizz Technical Administrator

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    The main issue is one of money ... we may need doctors but we cant afford them.
    This was one of the motives behind practising/prescribing nurses. It is an attempt to lower the cost of medical care by replacing doctors with cheaper to train nurses. There is huge debate, however, as to whether prescribing nurses are better (financial) value than doctors. Personally I can see arguements for both sides. You should read some of the comments I read recently on the BMJ web site (dunno the link) some of the comments made by some doctors were very bigotted ... it made amusing reading 8)
     
  9. kul_p

    kul_p New Member

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    Hey there Fizzwizz

    You make some perfectly valid points about the roles of prescribing nurses, indeed as a practising pharmacist, I can tell you that prescribing pharmacists are also something you will see in the not-too-distant future, and it is an option I would consider if I can't get on to a medicine course. However, prescribing nurses/pharmacists can only carry out so much of a doctor's workload and ultimately need from time to time a physician's opinion before starting/continuing therapy.
    I think if the two options, more prescribing/practising nurses/pharmacists and more doctors can be harmonised, then that would be to everyone's benefit. But as you rightly point out, it is all about money at the end of the day.
     
  10. Fizzwizz

    Fizzwizz Technical Administrator

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    Yes ... It's important to realise that prescribing nurses/pharmacists etc aren't replacing doctors .. they are just taking over some of the duties that can be covered by their own skillsets (with some additional training)
     
  11. kul_p

    kul_p New Member

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    And with nurses/pharmacists prescribing, maybe it will be easier to read prescriptions!!!
     
  12. FrankNFurter

    FrankNFurter New Member

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    <matscar says "they are crying out for doctors at the moment">

    It is understood that there is a shortage of doctors overall, but does anyone know if there are greater shortages in certain areas over others. I hear the most stories about GPs leaving/retiring etc. Is the same true for the surgical specialities?

    I suppose that I am especially interested, as a 36 year-old considering going to med school, that certain disciplines may be unobtainable by the time I get there.

    Does anyone know whether career paths are narrower, or strictly prescribed, for mature entrants?

    It seems from a lot of the threads that getting into med school is the biggest issue ( and of course I agree) but I am very grateful to matscar for identifying the point about career after med school.
     
  13. Fizzwizz

    Fizzwizz Technical Administrator

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    Hi Frank
    I am 37 soon and I haven't seen any obstacles to me attaining any medical career goal.

    It takes about 13 - 14 years from med school entry to become a consultant if you take that path. That gives you a 15 year margin just incase you get sidetracked :)
     
  14. spk76

    spk76 New Member

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    I understand it to be the case that if you're in your forties by the time you finish med school, it can prove difficult to gain certain positions, in comparison to kids who went straight from school to college, especially in some of the areas requiring long training, such as neurosurgery. General practice, with its shorter training time is probably a more realistic option for those who are getting on in years.
     
  15. Solitaire

    Solitaire New Member

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    I think that if our hearts are in the right places that we should be HOPING for a day when the supply of doctors eqiuals the demand for them (therefore skewing the the power of choice towards the consumer).

    I very much hope that over time the supply/ demand dynamic for doctors becomes similar to that of, for example, teachers, ie, that this is a profession where the primary focus of most of those chosing to serve in the role is to make a positive contribution in an intellectually stimulating and emotionally satisfying job (and, by extension, where those hoping to practice need to have top class intellectual, communication and other skills). The extreme anthesis is a focus on financial reward, status or absolute security.

    I'm not suggesting that most people attending this forum are driven by the latter but I do feel that an excess of demand for places versus the availability of places drives some pretty unacceptable behaviour by certain of those at the gateway of the profession. I also suspect that the nature of demand for places would change significantly if the level of financial security associated with this profession was less guaranteed. And I don't necessarily think that that would be to the detriment of quality of future doctors.

    I know this may sound aggressive and inviting critisim but unless the profession becomes significantly more accessible then it asks upon itself a meaningful chance failing in what should be one of its primary aims
     
  16. kul_p

    kul_p New Member

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    I entirely agree that the prime objective of becoming a doctor, in layman terms, is to make ill people better, and that this should be uppermost in every doctor and doctor-to-be's thought process. And I do agree that medicine should be less exclusive in its selection process ie why does a seasoned nurse practitioner with 10 years medical 'hands on' experience have to fight tooth-and-nail to secure a place on a medical degree (this is a hypothetical situation, but there are plenty of people with lots of experience in relevant fields who could become good doctors but get excluded because they did not get three A's at A level or a 1st when they got their degree - but I guess there will always be a drive for quality, and this should not be sacrificed within the medical profession)
    But what I cannot agree with your point on the financial status of doctors. Pre-reg house officers are not all that well paid (apparently less than 20000 pounds/year), and to reach the 'big bucks' you need to reach at least registrar level, which may be 3-5 years down the road.
     
  17. Fizzwizz

    Fizzwizz Technical Administrator

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    Personally I feel that selection techniques have much to be desired but are improving.
    There is more to being a good doctor than academic ability and institutions are slowly starting to come around to that mode of thought.
    I know many doctors practising at the moment who were AAA academics that were scary as doctors. It's a more known fact now that some academics can be considered "Book Smart" but are absolutely useless at applying knowledge to real life situations. And as for crisis management .... forget it!
    Some people, however, have an aptitude for applying knowledge and thinking on their feet. This is my mind (second only to empathy and equity) should be the quality tested for.

    I remember during my degree my friend and study buddy (*cringe) often commented how the students on target for a first seemed to spend all their time studying, while we were happy with our 2:1s and casual aproach to studying.
    Richard and I gravitated towards one another as we weren't the typical "Theoretical Physics" students. Our point was brought home after an exam called "Techniques of Problem Solving" where you are tested on your ability to apply all the knowledge of your degree to problems asked. It cant be studied for, it is designed to test your abilyty to solve problems as a physicist. Strangely myself and Richard were the only students to get a first in this exam. I think that says something.
    I feel doctors should be tested on this ability rather than academic qualifications. Personally, problem solving and crisis management are my strongest skills and I hope that selection teams start to favour these qualities.
    I'm rambling now so I'll take a breather :)
     
  18. Admin

    Admin Administrator
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    Another point to make would be that different types of doctors require different personality types.

    For example and A&E doc or an anaesthetist needs to be able to think quickly on their feet, apply their knowledge accurately and keep calm while everyone else is panicking.

    A pathologist or radiologist has more time to study the problem in front of them a come up with a logical and reasoned decision but does not need to have particular empathy with the subject matter.

    A psychiatrist also has time to think but has to have skills to interact with patients in an empathic and sensitive way.

    However all these specialties require a couple of years at least in which you work on the wards and cover emergencies. Even if you want to work in a no-patient-contact field you'll need to be able to survive working as a JHO and SHO to get there.

    Now, what's my point... oh yes - medical school admissions have to take all this into account. They don't want to deny the NHS a great academic radiologist because he doesn't show much patient empathy at interviews but they also have to train him to get through his house jobs. And you need to do house jobs in order to become a radiologist so that they understand first hand the clinical implications and indications of the x-ray they are reviewing.

    I think this is why you find such a diverse range of people at medical school. They should all have the basics to get them through house jobs but also have different personality types that the admissions people feel is required of different specialties.

    I don't think the inequality in supply and demand of doctors has anything to do with med schools though. The government set them a quota based on how many doctors the public purse can afford and the med schools choose the required number of students. I can't see the public ever allowing a government to get away with training MORE doctors than we actually need - I think taxation would need to be about 90%...
     
  19. Fizzwizz

    Fizzwizz Technical Administrator

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    I think Admin touches on a very important point ... that of diversity. A diverse range of medical students is a good thing but I think this is something that is fairly new, 20 years ago Doctors seemed to be quite a homogenous bunch but today there seems to be far more variety (which is after all the spice of life :) )
     
  20. pretoria

    pretoria New Member

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    I'm sure age will only get in the way if you let it. Being denied training in a specialty because of your age is inappropriate discrimination, just as unacceptable on the grounds of age, as it is on the grounds of gender, race or religion for example.

    We shouldn't become GPs because it is the easier option, but because it is an active choice. If you want to be a consultant neurosurgeon, go for it, otherwise you'll only be helping the ageists.
     

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