The actual paper is a must read.
Complicated by design
Medical training used to be an apprenticeship. Learning by observing, self directed knowledge acquisition, doing and most importantly taking responsibility.
Once out of medical school, you were meant to be responsible for your own knowledge and practice advancement.
Now, post-graduate education in England has deteriorated to the extent that it feels like primary school education. CBDs, Mini-CEXs, DOPs – the list of acronyms is growing day by day. Instead of assessing doctors holistically, training and assessment is broken down into number of assessments completed and matching these to a “cheatsheat”.
Is this leading to better doctors? I have not seen any evidence that it is.
If this is the best way of training doctors, then are we trying to say that doctors who are working in senior positions at present, which includes most consultants in post for more than 10 years, are poorly trained?
Does training in this fashion improve long term patient outcomes? Again, I am not aware of any concrete evidence to support this. And once more, are patients treated by existing senior consultants being given a raw deal as their doctors did not go through this complicated and bureaucratic training system?
In old fashioned medical training, the onus for learning was with the trainee doctor. The learning was seen as self accomplishment and a way to gain recognition of senior clinicians that were respected. Now, it is seen as a way to get a satisfactory progression in the ARCP.
The new system has also led to unnecessary power being vested in few hands. One person can devastate a trainees career by marking them down in their ARCP. There is an appeals process, but as every appeals process, it is made to be unwieldy. The very fact of taking a case to appeal is a source of stress.
Why have we moved to this new system? I have no real answer. Maybe it was to do with Shipman and the obsession to document every minute of training with a view to reducing the risk of another errant doctor. Maybe, it is the product of minds that have too much time to devise complicated and convoluted acronyms and forms for others to completed.
I have been a consultant in the NHS for more than 10 years. I struggle to understand the rationale behind this new health education system and how it leads to better doctors. I am pretty sure I am not alone.
Ever tried connecting to a European wireless network running on WiFi Channel 13 using a MacBook Pro running OSX 10.9 (Mavericks)…well you can’t. The MacBook doesn’t see the network. Turning stuff off and on doesn’t help.
If you want to, you need to be able to drop your channel to 11 then connect and cross your fingers that it holds the connection when you bump up the channel to 13!
If you are in a hotel where you cannot change the router’s channel, you are screwed.
I really don’t understand this. Apple’s website doesn’t show any means of sorting this out.
I could not access any network adapter setting that would enable me to change the adapter’s channel.
I am assuming that Apple thinks that anyone buying a new MacBook Pro, lives and works in the United States and has a 2nd computer to carry around with them when they travel abroad. How crap is that?!