Friday, 6 November 2009

So you want to be a doctor.

Professor Rubin is desperately trying to be a man of the people. The problem is he isn't being very successful. He recently did a interview for the Guardian on encouraging doctors from the lower socioecomic classes. Strangely, the lower socioeconomic class hardly read the Guardian. They have more exciting papers to read. To having targeted the affluent intellectuals in the form of Guardianistas, Rubin expects to encourage poverty stricken teenagers into medicine. Rubin is dubbed The Count for obvious reasons. Having destroyed good doctors through the GMC, he seeks to find more new blood. His fangs are certainly out for the next innocent desperate poverty stricken teenager who is desperate enough to sacrifice themselves to the world of the GMC.

The GMC Register once had 300,000 doctors. It has now dwindled down to 185,000 practicing doctors. So a mere 185,000 doctors now try and help a population of 61.4 million. Doctors are unhappy with the General Medical Council. The option of revalidation otherwise dubbed the "harassment" of doctors isn't going down well. Given this shortage of doctors in general, Rubin is trying to persuade the lower social classes into entering the esteemed medical profession. Is it esteemed anymore? Or is it an imprisonment of genuine people who would otherwise be free? Rubin tells the world that he was from a atypical background. He flaunts his father's personal history to tell us all " if I can do it, you can". The point here is this :- do we really want to be like Prof Rubin? Does any spotty teenager want to be a bald man with large ears who knows nothing about the real world.

"Research by the British Medical Association (BMA), the doctors' trade union, shows that just one in ten medical students comes from the three lowest socio-economic groups, far less than the 30% from such backgrounds in higher education overall. It estimates that by next year the average debt incurred by a graduate of a five or six-year medical degrees will rise to an average of £37,000 by next year, with those in London paying as much as £67,000"

So instead of campaigning for a change in culture ie less judgmental medical school staff, Prof Rubin asks that richer students pay more tuition than poorer students. Rubin assumes this to be "equal opportunities". Rubin makes the assumption that all rich students are funded well by their parents. In reality, not every parent funds their child. This view will create discord and resentment between the two groups. Rubin fails to understand that the entire system of university education should be changed. The whole system is encouraging those from a higher social class into education. We are becoming a generation where education is only given to those who can afford it - a system that was in place in the 18th Century. It isn't just medicine that is in trouble, all students are in dire straits. There is no such thing as equal opportunities. It is time to scrap tuition fees, reinstate the full grants and ensure students from their GCSE years are provided with support and additional funding [ topped up EMAs] in order to work towards their aspirations. Each student should be judged equally - grades should not be lowered for poorer students nor should they be funded by their richer counterparts. The system in the UK used to believe in education for all. It certainly doesn't anymore. Rubin therefore fails to understand the that this issue is a global problem in UK education. The solution isn't to insult poorer students by offering them beggar funds. The solution is to equalise opportunity by ensuring all students are able to study - whether they are rich or poor. If the basic grants were of a decent amount, no one would need extra funds.

One of the GMC blessed programmes encouraging those from a so called "lower social class" is the Extended Medical Degree Programme. This extended medical degree programme has recently been criticised by its students. The programme has been accused of being insulting to minority students by implying they are in some way a special needs section of medical school. Students were given psychometric tests to show if the experiments in social mobility were working.

Medical Students were subjected to the draconian processes as implemented by the General Medical Council. Again, Prof Rubin believes that any person in their right mind would opt to choose a profession where every segment of you is scrutinised.

What to expect from the GMC.

This is what he says about Revalidation

"Rubin will certainly leave a major footprint in the sand of UK healthcare. His top priority is implementing the revalidation of all those 185,000 doctors. Although he describes it as "the biggest change to medical regulation since the GMC was established in 1858", revalidation has so far generated little controversy outside specialist medical publications - despite significant suspicion towards it among doctors. It will involve every doctor undergoing an annual 360-degree appraisal - with input from colleagues and patients - to prove their skills are up to scratch, and having to acquire, every five years, a fresh licence proving that they are fit to practice"
This is what the Telegraph said about GMC Style hearings for medical students.

The issue was highlighted at the British Medical Association's annual representatives meeting after student Drew Kinmond said the numbers graduating with black marks against their name has increased from three per cent in 2006/7 to one in ten last year.

He told the conference in Liverpool: "Students are not doctors, we are still in training. There has to be a period of time where students can be students and learn what it takes to be a doctor. There has to be a period of time where we can make some mistakes.

"That is why students are not in charge of patient safety."

He said he supported disciplinary action in serious cases such as assaulting a patient or dealing drugs, but urged the rules to remain in proportion.

The General Medical Council has issued guidance on disciplinary matters at medical school in an attempt to standardise rules that apply to behaviour before graduation.

The guidance states: "Students must be aware that unprofessional behaviour during their medical course, or serious health issues that affect their fitness to practise, may result in the GMC refusing provisional registration.This is the case even if the circumstance in question occurred before or early on in medical school."

The medical schools can set their own rules and hold hearings when they are breached.

Students have been warned they face action for skipping bus fares, setting off fire alarms, damaging carpets and floors, playing loud music, being impolite, not filling out forms on teacher feedback, parking violations, and attendance.

Of course, Rubin fails to inform the general public about the oppression that exists in medicine.You could successfully get into medicine and one night out may end your career. There are very few good things to say about medicine. Rubin implies that doctors earn a great deal. For the hours they do, they earn practically nothing. By the time you pay your student loans off and living expenses, MPS fees, GMC fees etc you will probably have as much in your pocket per week as someone working at the checkout in ASDA.

Professor Rubin also misses out the fact that hundreds of doctors are prevented from working due to the GMC's draconian Interim Order Panel. Having got rid of the usual good doctors in the NHS, Rubin wants to get in new blood. Well, one cannot expect any less from the man referred to as Count Rubin.


Anonymous said...

all tyrannical organisations eventually implode - the Roman empire, the British Empire, Inca civilisation ...... it's only a matter of time.

Anonymous said...

Such a pity, students are not given this article to read before they join the medical college. Medicine is no longer a prestige profession - ruined by the media and the profession itself. Well done doctors - keep going and we will be a rare breed.

Anonymous said...

Count Rubin in this weeks' BMJ:

"I want to make clear that any doctor who wants to report genuine concerns will have nothing to fear from the GMC."

That paraphrases s43 of GMP but at s46: You must treat your colleagues fairly and with respect.
s47: You must not make malicious and unfounded criticisms of colleagues

There is everything to fear from mendacious and malicious colleagues/managers that eject you from your job and dump you in the GMC.

The literal mis-application of these clauses undermine the jurisdiction of the GMC, and, will undermine 360 degree feedback in revalidation.

As Sir David Carter, CMO Scotland, observed revalidation simply sets one half of the profession against the other. It is exactly what Milburn and Blair had in mind when they set out on this path with the Bristol inquiry.

Let us hope there is a substantial win in Hickey v GMC and Colman v GMC on 23 and 24th November 2009 in the High Court. The GMC is looking a "totalitarian" organisation in the hands of Count Rubin.

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