Chaotic training system for new doctors in the NHS
An EU ruling that limits the amount of time junior doctors spend on wards during the day has led to almost a quarter dropping out of NHS training after two years. And of those trainee doctors who do continue their training, more than a fifth are now turned down because they lack sufficient skills or experience.
The findings come from first survey into doctors’ training since the chaotic introduction of a European directive which has put a cap on the working hours of junior doctors. Under the Working Time Directive, which was fully implemented in the NHS last August, junior doctors are now limited to a maximum 48-hour working week.
The aim of the ruling was to prevent them working while they were tired but, as a result of the more rigid system, junior doctors are now increasingly relied upon to cover ward shifts at nights and weekends – which means they spend far less time during the day learning from consultants.
According to figures shown to the Medical Programme Board, which oversees doctors’ training in England, 1,380 out of 6,000 trainee doctors completing their ‘foundation’ years in the NHS have either quit or have taken a break rather than applying for the next stage of core training.
Of those who did apply to continue, 22 per cent were not accepted by NHS trusts, the suggestion being that they lack the skills and experience necessary to hold the positions. A further 7 per cent declined the posts they were offered.
The figures are outrageously high, according to campaign groups, who point out that many doctors trained in the UK are now choosing to work abroad in Australia, New Zealand or the United States, where working hours are longer but more flexible. The British Medical Association said that in the last year alone it had advised at least 800 doctors to go to Australia to seek work.
There are currently record numbers of doctors in training in England. With it costing up to £250,000 to train each doctor, it is suggested that more than £340 million of investment could be at stake if the absconding trainees remain abroad.
More than 75 per cent of junior doctors say the quality of training has deteriorated since the introduction of the EU directive, surveys suggest. Around two-thirds also believe that the quality of patient care has also suffered – as a result of gaps in rotas and problems that occur when inexperienced doctors change shifts.
Top UK medical colleges have also criticised the ruling which has cut the working day for junior doctors from 56 hours to 48 a week. Remedy UK, the junior doctors’ pressure group, said the directive had resulted in a generation of graduates receiving ‘minimal and sketchy exposure to ‘real medicine’.
Richard Marks, Remedy’s Head of Policy and a consultant anaesthetist in London, told the Times: ‘Word on the ground is that doctors are taking a gap year — often abroad — and many will have no intention of coming back.’
The Department of Health said the Medical Programme Board was investigating the high drop-out rate but insisted there was ‘no evidence that the [directive] has any bearing’ on the figures.
A spokesman said: ‘We are doing more work with the Royal colleges to get a better picture of the different elements that influence a trainee’s decision not to apply for training posts or why they aren’t successful. Following that we will be able to decide what further support trainee doctors need.’
Why not brushing your teeth can kill you
But only if you have bleeding gums. The assumption seems to be that toothpaste is bacteriocidal or that brushing hardens your gums. I am not sure that either is true. Brushing tends to make my gums bleed, which is why I gave it up long ago. I have had no gum bleeding ever since — and no decay either. I would think that the findings below were an argument AGAINST brushing. A couple of glasses of gin and water before bedtime is my recipe for oral health.
I have corrected some deplorable spelling below. It must be a sign of modern education that writers and copy editors at a prestigious British newspaper think that “bacteria” is singular
A link between poor oral hygiene and increased risk of heart attack has long been suspected. But until now nobody has been able to figure out exactly why not brushing regularly might bring one on. Now a Bristol University dental scientist has discovered that a common bacterium responsible for tooth decay and gum disease can break out into the bloodstream and help blood clots to form. In turn these can cause heart attacks and strokes, which together cause more than 200,000 deaths in Britain every year.
Most of them time Streptococcus bacteria are confined to the mouth, but when someone has bleeding gums they can get into the blood. There the bacteria use a protein on their surface, called PadA, to force blood platelets to bind together to give themselves a protective shield.
Howard Jenkinson, professor of oral microbiology, said: “What we have done is whittled down to a single protein molecule on the surface of bacteria that can activate platelet formation. “It is the first time that a mechanism from a single bacterium has been shown to activate platelets and make them spread.”
Describing the mechanism, he said: “When the platelets clump together they completely encase the bacterium. This provides a protective cover not only from the immune system, but also from antibiotics that might be used to treat infection.
“Unfortunately, as well as helping out the bacteria, platelet clumping can cause small blood clots, growths on the heart valves or inflammation of blood vessels that can block the blood supply to the heart and brain.”
The study provides evidence for yet one more reason to brush one’s teeth and – ideally – floss. “People need to be aware that as well keeping a check on their diet, blood pressure, cholesterol and fitness levels, they also need to maintain good dental hygiene to minimise their risk of heart problems,” said the scientist.
But the research should also speed up the development of drugs which could prevent potentially deadly blood clots from forming in the first place.
Prof Jenkinson described the discovery of the key protein as a “new tool” on which to test drugs which might stop it from clotting blood. He is working with Dr Steve Kerrigan of the Royal College of Surgeons in Ireland to see how the protein’s platelet-causing function can be blocked. “This could eventually lead to new treatments for cardiovascular disease which is the biggest killer in the developed world,” said Prof Jenkinson.
He is presenting the research today (MON) at the Society for General Microbiology’s autumn conference.
British bureaucrats oppose crackdown on “Mickey Mouse” degrees
Civil servants who allocate billions of pounds to university teaching are secretly opposing moves which would ban spending on “Mickey Mouse” degree courses.
A far cry from the conventional humanities and sciences, a modern university education can involve studying subjects like pop music, puppetry, or the unorthodox combination of “waste management with dance”.
An analysis of courses available through the university clearing system has disclosed that while most traditional courses are now full up, there are empty places in scores of “eccentric” degree courses. Education experts said it was unfortunate that such courses appeared to be proliferating at a time when school-leavers with good grades could not get places in core academic subjects.
The Sunday Telegraph has learned that officials who allocate billions of pounds to university teaching are secretly opposing moves which would allow spending on such courses to be cut back.
Civil servants at the Higher Education Funding Council for England (HEFCE) want to avoid a debate over whether to change laws which currently prohibit ministers from instructing them to award money for “particular courses of study”.
When approached by this newspaper with questions about unconventional degree courses, the agency accidentally released copies of internal emails which had been exchanged between its officials as they discussed how to respond to the questions.
An email from Toby West-Taylor, the agency’s head of funding, which was intended only for colleagues, said: “The risk in highlighting this to a journalist at a time when a new HE [higher education] Bill could be on the horizon, is that it might prompt a lobby for there to be change to such sound legislation.”
The funding agency even referred to the questionable degree subjects in a derogative way, with one of the accidentally-released emails carrying the subject heading “Response to The Sunday Telegraph on Mickey Mouse courses.” This newspaper did not use that phrase when posing the questions.
Following the revelations, David Willetts, the universities minister, predicted the end of “odd” courses as students face up to the new economic climate.
The clearing system, by which candidates who failed to get into their chosen university or college try and get places on other undersubscribed courses, began more than a fortnight ago. Yet despite record demand for places at top universities, hundreds of places are still available in less well known higher education institutions, many of them offering unconventional courses.
Northampton University initially had 250 places available through the clearing system, including such courses as Third World Development with Pop Music, Dance with Equine Studies and joint honours in Waste Management and Dance.
The clearing web-site also invites school-leavers to consider a Tournament Golf foundation degree at Duchy College in Camborne, Cornwall. The two-year course offers students the chance to “improve your tournament golf skills”, and its admissions requirements indicate: “No handicap is definitive but the guide parameters are +5 to 3.”
A spokeswoman for the college said: “The innovative programme gives young talented golfers the opportunity to chase their dreams whilst having the safety net of a UK university qualification to fall back on.”
Glyndwr University, in Wrexham, still had 15 places available on its BSc (Hons) in Equestrian Psychology, which “investigates the unique partnership between horse and rider”.
Subjects which were on offer through clearing at the start of last week, but which filled up during the week, included a degree course in Australian Studies, a joint honours degree in Criminology and Pop Music Production, and another combining Geology and Popular Culture.
Nick Seaton, chairman of the Campaign for Real Education, said: “It seems that many universities are going for the lowest common denominator just to get bums on seats and maximise their funding. “It seems crazy that youngsters are getting good grades in serious subjects at A-level and then being denied places, while these sort of courses are proliferating.” He added: “The Secretary of State is the person democratically responsible and should be able to change things if necessary, and the law should be changed to allow him to do that.”
Unprecedented demand for university and college degrees this year has left an estimated 150,000 students without a place.
Mr Willetts said: “In tough times I suspect some of these more eccentric courses, which date from the excesses of the dying days of the Labour government, will disappear because students see they are not a route into a well-paid career. “Some of them sound like very odd courses indeed.
“I think the way forward is providing students with better information about the employment outcomes from individual course at individual universities.”
Farnborough College of Technology still had places available last week on its two-year foundation degree in Holistic Therapies. But if applicants find that course to be full they could turn to Warwickshire College which is offering Beauty Therapies Management, Hairdressing Management and Spa Management courses.
Writtle College in Chelmsford, Essex, offers a foundation degree in Professional Floristry which covers the “practical and theoretical aspects of floral design”. There is still one place available on a three-year degree in Theatre Practice: Puppetry at London’s Central School of Speech and Drama.
Jessica Bowles, the course tutor, said: “The major leads in War Horse [the successful West End play] are all from Central’s Puppetry course. This leads to very concrete career opportunities.”
A spokesman for the HEFCE, which allocates £4.6 billion a year for university teaching and £1.6 billion for research, said: “Universities have the discretion to spend the money according to their own priorities. “We don’t stipulate which subjects universities should teach and which they should not teach. That is a matter for them. They have to make their own decisions on their own mission and their own goals.”
Although the HEFCE has introduced priority funding for subjects such as sciences and modern languages, the freedom granted to universities meant that less-conventional degrees still receive funding even at a time of budget cutbacks.
When Northampton’s Dance with Equine Studies was pointed out to the funding council spokesman, he said: “You are talking about some pretty out-lying courses. “They are regulated through the Quality Assurance Agency and what we can do is try to steer the sector into offering subjects that employers might value more than others.
“We do not count unfilled places in our funding allocations. If institutions cannot fill places in clearing they have the flexibility to provide additional places on other courses provided they keep within the funding agreements with us.”
Asked about the use of the “Mickey Mouse” phrase, the HEFCE spokesman said: “Our use of ‘Mickey Mouse’ is pretty indefensible. I think the use of that phrase was a mistake, but it’s a fair cop.”
No comment on hesitant women drivers wasting fuel, apparently
Men waste more than $3,000 in fuel costs because they refuse to ask for directions when lost, according to a British study released as motorists across the U.S. prepare to load up their cars for the long Labor Day weekend.
The research, commissioned by British insurance company Sheila’s Wheels, revealed that male drivers travel 276 unnecessary miles each year because they stubbornly reject help when lost.
In what might not be shocking news for female passengers, the survey found that more than a quarter of men polled said they would wait at least half an hour before asking for directions when lost. One in 10 male drivers refuses to ask a stranger for help at all, the survey found.
The survey suggested that “lost drive time could cost as much as 2,000 pounds [just over $3,000 at current exchange rates]” in gas in a driver’s lifetime.
The survey results also found that three-quarters of women polled had no problem with asking for directions. “Men aren’t quite as confident behind the wheel as they make out when it comes to navigation,” said Jacky Brown, a Sheila’s Wheels representative.
There is a big new lot of postings by Chris Brand just up — on his usual vastly “incorrect” themes of race, genes, IQ etc.