My immediate reaction to the news that Health Education England is planning an apprenticeship programme for would-be doctors is to wonder if I could take the Alan Sugar role in the inevitable TV reality show.
Others are responding more apoplectically – some with indignant froth about the potential dumbing-down of our beloved profession, and others with paranoid conspiracy theories about cheap and second-rate plugging of workforce gaps. To which I’d reply: ‘You don’t need to speculate on this vision of Hell. It has arrived already, and if you don’t believe me, I’ll get you an appointment with the mocktor/phoctor/noctor’.
Besides, we’re missing a trick here. Supporting the apprenticeship programme enables us to confirm general practice as the most important specialty of all. The rest, with their in-depth but very restricted knowledge and job-specific technical skills are more like trades than professions and therefore lend themselves to apprenticeships.
Don’t believe me? Look, everyone knows that surgeons evolved from barbers. As for the rest, orthopods are simply carpenters, neurologists electricians, plastics exterior decorators, cardiologists mechanics, urologists plumbers and so on.
Whereas we GPs, of course, have to know about absolutely everything and are therefore in a different professional league to all the rest. Because of us, the lesser specialties don’t have to worry their pretty little heads about issues outside their restricted area of expertise – they can rely on us to bale them out. Surgeons, for example – they don’t need to understand the niceties of renal function, if they ever did, which is presumably why those post discharge U&Es are always delegated to us. Or, to put it another way, that ‘GP to do’ list is short for, ‘GP, we don’t have a clue what to do’.
So fast-track those apprentices, by all means, to qualification and beyond. But not to general practice. You can’t reach the apotheosis of the medical profession via any route but the traditional, arduous, degree-based one. And for any orthopod reading this who thinks that ‘apotheosis’ is an insertion point for a tendon or ligament: with respect, you’re fired.
Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield
READERS' COMMENTS [5]
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Agree with many of the comments doubting the appropriateness of the proposed apprenticeship model ‘widening access’ to become doctors.
The best way forward is surely more medical school places and financial support.
6 years full time intensive study to be equalled by what exactly, in this ‘earn as you learn’ model? These poor (in all senses of the word) to be dogsbodies for nhs low level tasks while they grapple with pharmacology, physiology, etc etc burning midnight oil? In order to pass rigorous exams, Or will they be a ‘second class’ of ‘doctor?’
We already have the apprenticeship model in GP training, and looking after ST 1. 2 and 3 in GP takes up a lot of GP time. Who is going to “supervise’ these entrants “largely to be trained in primary care” ?? From a presumed lower starting point?
The models have been sketchy, to say the least, for supervising physiotherapists, pharmacists, though already proving valuable in GP settings, have required GP input.
So instead of second class doctors on the cheap, do something about the many well qualified 18 year olds who have been well suited to a career in medicine but failed to gain a place due to supply and demand and selection process favouring better off articulate private school coached applicants.
‘..selection process favouring better off articulate private school coached applicants….’
…will direct their pupils to respected and better paid professions…
To be fair to the orthopods, they are getting some crap too. Its a good 10+ years ago now, but on a hospital job as a GPST I was chatting to an ortho reg in our mess (do they even still exist?). He told me that they had a new group of “clinicians” assisting in theatre and stopping the traditional consultant/reg model and “freeing up” the reg to do countless out patient clinics and ward rounds. I’ve realised this is a major issue being a doctor- all the interesting and easy stuff is being pinched by noctors and we’re left to deal with anything problematic….. and complaints.
Enough with the “noctor” slurs. Maybe you don’t work with ANPs or PAs, perhaps you should. And if you do perhaps you shouldn’t be slagging them off so. It isn’t “hell” and that they’re valued colleagues, in fact it would be 10x more stressful where i’m working if not for them. Whatever these proposals turn out to be sounds like you have a few prejudices to overcome
To be fair I’ve had a complete mixed bag with from lifesaving to soul destroying ANPs but why can’t we have a joke word for them? It’s not offensive, and it’s part of being in a team. When we work together it can work well. But it doesn’t change the fact that outsourcing parts of what was traditionally the doctors role can leave only the hard, multi morbid, no longer fits in the clinical pathway heartsink patients as your full clinic to be dealt with in 10 minutes which is making some careers, especially general practice, unsustainable. If the recruitment of more ANPs meant 20 minute appointments and 5pm finishes I’d be all for it.