A Weekend Away

I shall not be blogging over this weekend... and no that's not an early April fool. I am delighted to say that I'm attending the wedding of my cousin Julia, who is marrying Eldon. The wedding will take place in Newcastle Upon Tyne and I shall be there wishing them every happiness in their future together. Below is a short video from a couple who shared their first dance on youtube. I wish you all a restful weekend and I look forward to writing again next week.

What's it Worth?

My blog is worth $35,001.48.
How much is your blog worth?

If anyone is curious to find out how much their blog is worth, click here. It was good to know that my blog had a market value, but fortunately I’m just doing it for fun, so this shall remain cyber money.

Rumblings

I have seen talk of a suggestion that 'Modernising Medical Careers' (MMC), the name given to the changes in junior doctor training may be running into some legal difficulties. For obvious reasons, I do not intend to comment upon the legal merits one way or the other on a public blog. However, I thought you may all appreciate this photograph taken during the London march on the 17th March, when over 12,000 doctors and supporters took to the streets in protest to the centrally imposed government changes to doctor training and the reduced number of training posts.
Hopefully, things will not progress to the legal court rooms, and I remain hopeful that answers can be found swiftly and amicably. However, if solutions are not found, it may well be that Patricia Hewitt will need her HewBacca outfit afterall; a pun on the Chewbacca defence technique she offered when answering questions in the House of Commons on Monday 19th March
To support the junior doctors quest please join RemedyUK.

Sending Doctors to Outer Space

The fears of nearly qualified doctors have been quelled by Dr Who. He has kindly taken it upon himself to employ a young trainee doctor in the form of Martha, to accompany him on his travels. It all sounds very exciting and I'm certainly looking forward to watching the new Dr Who series. Perhaps this will also catch the attention of Patricia Hewitt (aka HewBacca) who having miscalculated trainee numbers by 8,000, may wish for a big black hole to appear.

The Big Toad

It has been reported today that a giant cane toad, the size of a small dog, has been captured in northern Australia. This giant toad, weighing almost two pounds, has been given the nickname ‘Toadzilla’.

Environmentalists have been trying to stop the spread of the poisonous creatures across the country's tropics. The toads were introduced from Hawaii in the 1930s in a failed attempt to control native cane beetles. However, they have had a more widespread effect on other animals, and have poisoned countless native animals, including crocodiles and small marsupials which have died after eating them.

Gold Blogging Thinking Award

Back on Friday 16th March JMB awarded me the honour of a ‘gold thinking blogger award’. Dr Dork who was also awarded this label at the same time, side-stepped the three step rule award requirements in the following way, which I replicate here:
"1. Post with links to 5 blogs that make you think.

2. Link to (*original source blog*) which contains advertisements and solicits "donations" to its author. Maybe not.

3. Variation on 2. Definitely not.”

So, in the spirit of linking to 5 blogs which make me think, I offer the following, which are in no particular order:

1) Ellee Seymour – always offering a topical issue with plenty of debate.
2) Walking Dreams - daily beautiful descriptions of the British countryside in all seasons.
3) The Barrister Blog – For cutting edge legal debate.
4) Prague Tory – a leader in the political blogosphere.
5) Or so I Thought – a freelance writer who has entered the blogosphere with a storm.

There are so many more which I would like to have listed, as there are many quality blogs out there. Hope you also enjoy the blogs named here.

Patricia Hewitt's new look (Hew-Bacca)

David Anthony has very kindly designed this picture of Patricia Hewitt dressed in her full ‘Chewbacca defence’ outfit… is it a good look? The ‘Chewbacca defence’ is a well known in America, and this may well be the technique she has imported to try and explain her reorganisation of NHS doctor training, which "just don't make sense". Now she has the costume to match. Please feel free to leave comments about her new look below.

Thought of the Week - NHS Doctor Training

Thought of week has to be dedicated again to the 33,000 doctors who are stuck in the centre of job application politics and an uncertain future.



The clip above shows David Cameron, leader of the Conservative Party, underlining the importance of doctor training; saying that if no better answer is found the Government will need to scrap the MMC/MTAS. Thankfully, he says he will be keeping up the pressure on the Government and will continue to treat doctors as "human beings".

To see Patricia Hewitt answer questions in the House of Commons click here. Also click here for her 'Chewbacca defence technique', she knows “it just does not make sense”; perhaps she is trying to hide behind confusion rather than face the consequences, or sort out the increasingly urgent implications. The clock is ticking, all junior doctors change jobs the first week in August…is time running out?

Patricia Hewitt's Review

The BMJ (24/03/2007) tries to offer some insight into the current review which the Government is undertaking about doctor training:
"..applicants for their third or fourth year or specialty training (ST3 and ST4) would be guaranteed an interview for their first or second choice of training post... Doctors applying for their first year of specialty training (ST1) who have not been shortlisted for any interview will have their application reviewed...Meanwhile, applicants for second year specialty training (ST2) who have not been short listed for interview will be offered a face to face review..."

The following clip perhaps illustrates Patricia Hewitt's chewbacca defense technique:

Taking the Pulse of a Relationship

To continue with the relationship blog topic from yesterday - Professor John Gottman has recently developed a radical theory for the secret to a successful union, based on 'the love map'. 'The love map' is the term for the part of your brain where you store all the relevant information about your partner's life.

Gottman's research showed that a powerful predictor of how long a relationship lasts is how many apparently trivial minutiae they knew about their partner; for example, what kind of sauce they liked with different food, which was their preferred coffee brand etc. Gottman's theory is that the small details seemed to be the best predictor of the relationship's health. He went onto suggest that 'the love map' acts as a protecting factor from big life upheavals as it's this kind of knowledge that keeps couples up-to-date and keeps them aware of what they are both thinking and feeling.

Obviously, the main criticism of Gottman's research is that it's chicken and egg. Maybe by the very fact that the relationship is strong, a detailed love map will naturally develop. However, perhaps the take home message from his research is that we can all sometimes underestimate just how upsetting it can be for others when we forget the small details as it can be perceived as uncaring.

Finding a Mate

If you want to find a partner who is likely to stay committed to you, recent psychological research suggests that it would be wise to choose someone whose face resembles your own, because they are more likely to find you attractive.

There are many theories behind this, one of them is the repeated exposure hypothesis. It is postulated that over the years an awful lot of time is spent looking at our own face - in the mirror, on photographs plus all sorts of documentation; what develops is a very comfortable feeling with your own particular look. Much research points to the fact that when people fall in love, although they may not consciously be aware of it, they may well be falling in love with the bit of that other person which reminds them of themselves.

Of course, there is one politician who just 'ain't boverred' by faces:

Questions and Questions about Doctor Training

Questions were raised in Parliament on Monday about the changes in doctor training which have since been published and made availablr via the House of Commons Hansard publications, extracts as blow:

"Ms Diane Abbott (Hackney, North and Stoke Newington) (Lab): The House accepts that the old system was unsatisfactory and... it has left junior doctors genuinely in uproar. Some of them contacted me this morning to ask me to put this to the Secretary of State: given that the implementation of the new system appears to be fatally flawed, is it right to continue to allocate jobs before the review gives its final report at the end of the month?

Ms Hewitt [The Secretary of State for Health ]: Whether round 1 should be delayed or scrapped was one of the first issues that the review group considered at its first meeting, and it has come back to it since. The review group has been clear that round 1 should continue, because otherwise the interviews of thousands of junior doctors would be completely disrupted and hospitals could well find themselves in August without the junior doctors they need in place to continue operating..."

"Mr. Crispin Blunt (Reigate Con): The Secretary of State began her review when the scale of the problem became known to her, but the scale of the problem was pretty clear on 13 October to the junior doctors committee representative from the BMA who, in my presence, made quite clear to junior doctors at East Surrey hospital the scale of the disaster that was about to happen and made it clear that the BMA’s junior doctors’ representatives were begging the Department of Health to postpone this process... Is the Secretary of State aware of this potential problem, and is she going to do anything to avert it before it happens?"

Ms Hewitt: "...We are looking at what will happen in August, but the immediate priority is to ensure that we sort out the changes that need to be made for round 1 and round 2 to ensure that this first year—which was bound to be a transitional year—of appointments to the new consultant training system continues in a way that will be fair to everyone and that restores the confidence of junior doctors."

Although, Ms Hewitt, did acknowledge that "the hon. Gentleman and other Members" were "complaining—perfectly reasonably—about problems". The questions still remain.

Doctor Jokes

I was sent this today and I thought I'd share it with you. It made me smile so I hope you also enjoy it.

Talk of the Hospital

Today every doctor seems to talking about the march. The feeling is that it has put the 'health' back in 'health professionals', by collective empowerment.

I wanted to dedicate this post to all the many doctors who were working hard in hospitals, on weekend duty, during that march. They were perhaps doing the most important job of all; continuing their dedication to the job by looking after patients. Their voice for the same cause should not go unrecognised and the march could not have happened without them. My thanks to you all.

Happy Medical Mothers Day

Today is the wonderful celebration of 'Mothering Sunday'. There are so many things to thank my own mother for that I couldn't possibly write them all here. However, the one thing we can collectively thank our mother's for, is mtDNA (mitochondrial DNA).

Whenever an egg cell is fertilized, nuclear chromosomes from a sperm cell combine with the egg's nuclear DNA, producing a mixture of both parents' genetic code. However, the mtDNA from the sperm cell is left behind outside of the egg cell. Hence, the fertilized egg contains a mixture of the father and mother's nuclear DNA and an exact copy of the mother's mtDNA, but none of the father's mtDNA.

The result is that mtDNA is only passed on along the maternal line. This means that all of the mtDNA in the cells of a person's body are copies of his or her mother's mtDNA, and all of the mother's mtDNA is a copy of her mother's, and so on. No matter how far back you go, mtDNA is always inherited only from the mother.

May I wish you all a Happy Mother's Day.

More From the Rally

Webcameron has posted this today. David Cameron addressed the doctors' march and added the weight of his support. He said it was time to recognise "that we are all human beings"... thankfully, he has treated us as such.

I am proud that so many people came and supported the march, and I would like to add my thanks to each and every person. The morale of doctors has recently been in a cycle of dispair; it's time to break that cycle.

A consultant's take on the MMC

Whilst on the march with thousands of doctors, it was great to see the support for the plight of junior doctors at every level, from consultants to students. This experienced consultant suggests a novel way of filling out the MTAS.

May I thank the thousands of doctors, friends and familes, who all came out to support junior doctors. Together let's hope we can make a change.

The White Coat March

The White Coat march took to the streets today. A wave of white coats, surgical scrubs and stethoscopes, lined the streets of London to protest again the hideous imposed governmental changes; not only changing eductaion, but also reducing the number of much needed doctors. It is expected that this march will change the direction of 'Modernising Medical Careers', and the politicians will let the experts in their own specialties train the future consultant generation.

Round Up, Round Up....The March is Tomorrow

As tomorrow history will be made by a medical march, this blog is dedicated to a brief round up about news regarding changes to medical training: In the BMJ (17/03/07) Professor Morris Brown, on behalf of 25 senior consultants, wrote a letter stating:
“This nightmare must stop…We need facts and action…It is time for the mass of consultants to find voice.”

The Herald printed a the words of Dr John D Mackenzie, NHS Consultant: "Ask any consultant working in our hospitals what they think of the junior doctors' dilemma and they overwhelmingly will tell you the same story: "It's simply dreadful."" And if that’s not enough then the words of a fellow blogger and junior doctor; the normally ‘Shiny Happy Person’ may bring tears to the eyes: “I can see no future, just a wasted life; no career, no home, nothing to show for years of determination and passion.”

The Royal College of Psychiatrists is extremely concerned about the “impact the chaos related that the Medical Application Service process is having on the mental health of trainee doctors.” I am especially glad they have added this to their College website, as the stress imposed by such an application process, is palpable in every hospital in the country. It is time to remember that carers also need to be cared for.

NHS Blog Doctor discusses remarks “The Royal Colleges were all expecting that behind the scenes, they would be able to weed out all international graduates, indeed, they thought this was the main purpose of MMC.” These comments have been subsequently removed from the Royal College of Obstetricians and Gynaecologists website and the retraction can be read in full on FrontPoint Systems Ltd

The Royal College of Surgeons have posted: “It is now up to the profession to put right the damage that has been done by this first round of selection. Every opportunity must be provided to offer the rejected trainees a better chance for selection in round two. This College will play its part to make sure this happens.”

As for the latest news, we know that 'The Review Team' led by Professor Neil Douglas, has met again today, partly by teleconference, and the outcome is eagerly awaited.

Until then, I very much continue my support for junior doctor training, and encourage everyone to join the March and show their Support. More details can be found on the website www.remedyuk.org.

Sleep impaired Judgment

I am sure the BBC news came as no surprise to any parent, as they reported that "lack of sleep can impair many functions, including concentration and memory." It was reported in the latest edition of the US sleep journal that researchers found soldiers struggled to make snap decisions in emotionally charged situations after being deprived of sleep for two nights. The authors suggest this could be important for other professions, including doctors, who have broken sleep and need to make quick decisions in a crisis.

The researchers studied 26 healthy soldiers to judge whether a given course of action would be "appropriate" or "inappropriate" in a range of test situations; from minor inconsequential ones to serious dilemmas where the decision could theoretically harm another person. In general, the soldiers found it harder to perform the task after they had been awake for 53 continuous hours. The longest stint ever recorded was a person who went 11.5 days without sleep, but they suffered psychiatric symptoms, such as, psychosis.

The report also raised concern regarding the trend towards a 24-hour society, with people burning the candle at both ends. I have added here are a few common sense tips about aiding a healthy body clock:

Sleep Hygiene

1. Getting Ready For Bed
a. Develop a routine before bedtime, so your body can learn that this process means it is time to relax and stop thinking about work or other worries. Perhaps drink a glass of milk.
b. Don’t take your worries to bed. Leave your worries about job and daily life behind as you get ready to go to bed. Some people find it useful to assign a "worry period" during the evening or late afternoon to deal with their issues.
c. Light snacks before bed. Warm milk and foods high in the amino acid tryptophan, such as bananas, may help you to sleep.
d. Practice relaxation techniques before bed.
e. Establish a pre-sleep ritual. Pre-sleep rituals, such as a warm bath or a few minutes of reading, can help you sleep. Don’t watch TV as this can be engaging and keep you awake.

2. Sleep Time
a. Routine - Fix a regular bedtime and awakening time. Do not allow bedtime and awakening time to drift, as the body "gets used" to falling asleep at a certain time.
b. Avoid alcohol 4-6 hours before bedtime. It is common to believe that alcohol helps with sleep. However, whilst alcohol has an immediate sleep-inducing effect, a few hours later as the alcohol levels in your blood start to fall with a resulting wake-up effect, leading to disrupted sleep.
c. Avoid caffeine 4-6 hours before bedtime. Caffeine acts as a stimulant and is contained in many foods, such as chocolate. Food and drinks containing caffeine should be avoided before bed.
d. Exercise - but not right before bed. Regular exercise, particularly in the afternoon, can help sleep. But don’t exercise within the two hours before bedtime as this can decrease the ability to fall asleep.

3. Sleeping Environment
a. Bedding. Make your bedding as comfortable as possible. Also find a comfortable temperature setting and keep the room ventilated.
b. Eliminate as much light as possible. This will help your brain understand it is night time and help with the sleep process
c. Block out all distracting noise This will reduce the chances of being disturbed
d. Reserve the bedroom. Never use the bedroom as an office or a place of work. Let your body "know" that the bedroom is associated with sleeping.

Older Women; Younger Men

I was tagged by Corporate Presenter to post about “younger women, older men”, but as others will have posted about this, I hope he doesn’t mind if I swap this round to discuss the growing list of women dating younger men. To name just a few, Demi Moore, Gwyneth Paltrow and Madonna.

Research published by the Office for National Statistics shows that these celebrities are just a part of a much wider movement. The trend in the UK is clear; the proportion of women marrying younger men has almost doubled over the past 25 years. To the extent that now in over a quarter of new marriages, the husband is the younger spouse.

There is speculation that this change is linked to the changing psychology of women. As women have developed more financial independence some theories suggest that women are focusing more on male appearance than on finances. Others suggest that as women have a longer life expectancy, it makes evolutionary sense to marry a younger man. Another theory is that women in advance years remain more fun-loving, and as the average age of marriage increases, women search for more youthful fun-loving husbands.

Therefore, on the day that reports the sad news about the divorce between Roman Abramovich and his wife, perhaps the Russian billionaire should look towards older women, if he wishes to marry for a third time.

A clip about Junior Doctor Training

This is a clip from the show on 18 Doughty Street last night talking about junior doctor training. The panel include:
Vicky Ford, Dr Phillip Lee, Dr Shazia Ovaisi, myself and Iain Dale.

A Guest Spot on the Blog - Owen

Blog by Owen, who wished for no further introduction other than writing a piece entitled 'Nuclear Psychology and Psychopathology'.

"I would like to thank to Dr Tempest for having me as the guest blogger today. I am writing about the government’s proposal of renewing UK’s nuclear arsenal; Trident system in 22 years time. The proposal will be voted in the commons this Wednesday, March 14th, 2007. The government will possibly be able to pass the motion only with the support of opposition, against the will of their backbenchers to my relief. I see this as a vital decision which would affect not only the future of UK but a very important issue for the whole world.

We all know that all living beings survive through inter and inner species competition. This includes even the plants, where a big chemical war goes between them for the preferred territory in our back gardens. For the animals –including humans- the well established survival strategy is to get faster, stronger, stealthier, and more reproductive and increase their ability to cooperate as a group. Fights and wars for territory between species and within the species is we can say the rule in nature. I have to note the inner species altruism is also a very important factor in survival but the competition and altruism are not mutually exclusive, or the altruism, in other words the cooperative loyalty, is often to the immediate group and for humans take the order of (according to priority) family-tribe/nation-humanity depending on where the threat comes from and to who. I believe human kind, thanks to their more developed intelligence, has been on the route to change wars from being a rule into an exception. As humans became more organised the trend has been from a continuous war state between families, later tribes, to gradually much less frequent wars with the emergence of states. It could be argued that the destructiveness of the wars have shown an opposite trend and wars have become more and more destructive.

In this survival struggle display of aggression plays an important role for protection of the species especially in terms inner species competition. Male competitors for prospective mates start their dominance struggle with display of aggression; gestures to give the impression of a greater body mass, display of teeth, or other weaponry such as antlers, horns, so size becomes an important issue. Often the disputes resolve and the dominance is established with little or no damage by ways of only the aggressive display or minor skirmish. Deaths during these do occur but rarely otherwise it would have threatened the existence of the whole species. In terms of interspecies competition, the display of aggression takes many forms; i.e. the bright colours of most venomous snakes, which advertise their dangerousness. So the idea is to be threatening in a very visible way and keeping the enemy as far as possible and to avoid even coincidental direct confrontation which carries risk of damage no matter how well the fighting ability of the species is. These displays often come at a cost; they attract attention of their predators with their bright colours. But their very existence in this colourful form is the proof that this strategy works. We can describe Trident project as a colourful display but also the venom itself. It is very expensive at a cost of about £70 billion –ideally could have been spent on health, innovation, education etc-, and carries the possibility that it can attract the attention of prospective enemies. But when it comes to survival one cannot experiment with concepts such as “Lets give up the venom and see if we will survive”, especially at this point of human history where full cooperation and altruism of the whole of the species is not formed for the whole of the humanity but still remains at a tribal level. Just try to imagine the post WW II history without the existence of nuclear weapons, which I believe have prevented a full scale war and paradoxically brought the cooperation of the enemy states. Skirmishes related to the dominance display continued; such as Korean War, Cuban conflict or Vietnam, but never reached to a full blown confrontation. People, perhaps the first time realised that war carries the risk of annihilation of the whole species, hence over came their altruism towards their nation/tribe as in the order I have mentioned above and placed it with the humanity instead. Unfortunately good will and wish do not make up for the realities of the aggressive side of nature and its bitter rules but knowledge and power does help to manage risks and reduce them. The priority chain described above in terms of altruism is unlikely to be broken unless there is a larger threat. It is a very simplistic and unrealistic mind-set to argue that if one is against nuclear weapons, one should argue to get rid of such weapons without paying attention to history, strategy, human psychology, sense of future and other nations’ intentions.

Unfortunately, we are living in a world of uncertainties, and this is not only a reference to terrorism. I do not believe that nuclear weapons can protect UK against the risk of a potential nuclear attack by terrorists but only to create a just world where democracy in-between states/nations is established. The Labour backbencher’s rebel on the subject at a time when the world’s energy resources are getting scarce and when China has successfully destroyed a satellite in space against the existing conventions, this way declaring their ambitions to develop advanced nuclear capabilities, and Russia’s increasing defence budget, seems to be displacement of their anger towards Tony Blair and an expression of their confusion about their identity as a party. How can such argument add up when one still has another nation’s nuclear weapons, star wars stations on their own soil which they have no control over, and yet try to get rid of a protection that belong to themselves, which they have the full control. Who can guarantee whether our current friends’ national structures will not change in the future? Who can guarantee one day US will not have a very extremist government which can change the whole nature of intergovernmental relationships in the world? Only equals can negotiate and when there is power discrepancy between nations one can only plead. I do believe UK is a significant power in keeping the world peace and should remain so independent of other nations and only in this role can work towards achieving a world wide nuclear disarmament…

A world where altruism for the whole humanity wins over the tribal one is I believe at heart what John Lennon described in the famous song. I do believe in his view and continue to imagine… "

Thanks Owen for posting me your views on such a topical and timely issue.

More Publicity for Doctors in Training

For those of you who are interested I shall be appearing on 18 Doughty Street TV on Monday 8-9pm, to discuss the issues about doctor training. It will be chaired by Iain Dale and other guests include: Dr Phillip Lee, Vicky Ford and Dr Shazia Ovaisi.

On the show I am happy to try and highlight specific issues/topics for junior doctors, so feel free to leave comments below and I’ll try and bring them into the discussion on Monday. Wish me luck!

Cartoon interviews...Are they on? Yes and No

The following offers a small round up of comments about the changes in medical training, from medical Royal Colleges and blogs:

“We are saddened to see that in some schemes only 6% of existing trainees have been short-listed, in spite of the fact that they had previously been interviewed and selected for the jobs they are doing.”

“The College can report instances where the technology for referees has not worked, despite repeated emails and calls to the helpdesk. For instance, referees have not been able to click answers which say ‘yes’ as to whether they would employ a particular trainee; they could only click ‘no’ in response to the question “would you employ this applicant?”.
Royal College of Psychiatrists

“Although many good doctors have been short-listed, we are dismayed to learn of the exposure of serious weaknesses in the Medical Training Application Service, through which doctors are now selected and placed for specialist training. We see a crisis of confidence in this critical element of the new system.”
Royal College of Surgeons

“The row over training of junior doctors intensifies as more senior consultants decide to boycott the interview panels.”
The Telegraph

An email was sent to Dr Crippen from a senior consultant anaesthetist:
"We were very concerned at the many irregularities of procedure and process that took place during shortlisting.…We are therefore decided that we should no longer continue with the present round of interviewing for anaesthetics…There have been a series of serious procedural errors during the process: 90 applications were ‘lost’ from the original boxes, due either to a Deanery error or an MTAS ‘black-hole’…Most of us had 48 hours in which to carry out shortlisting of up to 650 applications.”
For the full e mail see Dr Crippen, NHS Blog Doctor

"We have a monopoly employer which decides that all junior doctors should cancel their lives for a couple of months (and if they don't, tough sh*t, game over) and they tell us we're making a choice. Can it get much more ridiculous? Yes, I'm sure it can, and will."

Hospital Phoenix

So, in summary, some places are going ahead with round one interviews, but not in others. Round two interviews will be going ahead, but with a more traditional meritocratic CV application and with "significant" changes. To all those enduring the interview process; you may have an interview, it may or may not be going ahead, and there is always round two to look forward to... good luck to all.

Breaking News

The review undertaken by the Government about junior doctor training has concluded that round one of the interviews will go ahead. However, round two of the interviews will have "significant" changes, allowing applicants to provide CVs and portfolios to support their applications, in contrast to the first round when doctors could only complete a computer application form. In addition, there will be changes to the application form, the scoring system, and support plus feedback will be included for candidates.

The DoH said: "The Department has accepted the need for change and the revised approach will now be tested with junior doctors, selectors, deanery recruitment teams and employers."

The full report is awaited at the end of the month and lets hope this will answer some remaining questions, such as, will there still be a reduction in training posts? Can doctors who were successful in round one still take part in round two if they did not get the job they wished for? The questions continue and I'm sure more will be added in the comments section. But for now, at least, this is a small step in the right direction.

David Cameron's Response to the Changes in Doctor Training

Early Day Motion

There is a second Early day Motion about the changes in medical training which reads:
That this House notes the decision of the Department of Health to carry out a review of the operation of the Medical Training Application Service following the widely reported chaos relating to the shortlisting and selection of junior doctors for interview for medical postgraduate specialty training; further notes that concerns have been expressed over several months by the British Medical Association about the new on-line system which was not piloted prior to introduction; further notes that the IT system has been blighted with technical problems, with the website crashing repeatedly, and that there have been delays and confusion over the application process; further notes that there is substantial evidence of significant numbers of highly qualified, able candidates not being shortlisted for any interviews whilst some others have been selected for interview for posts for which they have not applied, and that the process cannot therefore be fair and meritocratic, and is causing dismay and despair amongst junior doctors, resulting in many considering applying for jobs abroad; and calls on the Government to act on the recommendation of the British Medical Association to suspend the process until it can be demonstrated that it is fair and transparent and that appointments will be genuinely based on merit.
To find out if your MP has signed this, click here.

Has your MP signed?

The wave of feeling within the NHS about the changes to medical training is almost palpable. I am delighted to hear that the Government has announced a review of the system and I don’t think there is any shame in admitting that a mistake has been made. The Government enforcing changes in all medical specialty training has spun the system into chaos. It has been the role of the Royal College to decide how to train their juniors, so why change the goal posts now?

To discuss the changes in doctors training an ‘Early Day Motion’ has been tabled stating:
That this House shares the concerns of Remedy UK that poor workforce planning may result in more than 6,000 experienced junior doctors being unemployed in August; deplores the rushed implementation of the Modernising Medical Careers programme, which is resulting in anxiety and disillusionment in the medical community; and calls for an urgent review of the division of training posts to ensure that £1.5 billion worth of medical training is not lost to the NHS.
To find out if you MP signed this motion click here.

A Guest Blog

A friend of mine (Dr OandG) asked me to post this for her today:

"I have always wanted to be a doctor and I’ve worked hard all my life to fulfil that dream. I studied hard to get a place at medical school and my family made sacrifices to ensure that I could pursue that goal. As a pre-registration doctor, I worked long hours, I was not paid for the extra time I spent; money has never been my driving factor. I spent time in an apprenticeship, learning the knowledge, craft, techniques and procedures from my trusted seniors.

Following that I joined the Obstetrics and Gynaecology training scheme. I continued to work incredibly hard to care for patients on top of passing my membership exams. I have sacrificed much of my personal time to achieve this; I have worked more weekends than I’d like to count and I have had to muster every last ounce of physical stamina for my long busy nights. Saying that, I have thoroughly enjoyed looking after patients of all ages, plus, I have had the privilege to bring new life into this world using both surgical and medical skills.

Of course, the day of birth is the most dangerous day in life. Many new parents have described holding their new baby as the happiest moment imaginable and some babies have even been named after me!

However, this is where my story may come to an end. I have not been offered a job to continue my dream, I have no interview and I did not get picked from the computer MTAS lottery system. I have dedicated my life to the service of others and I have done my utmost to deliver the best care I can. I have never asked for anything in return... "

For the latest action about the MMC, The Telegraph covered it on their front page. The morale amongst hospitals is at an all time low and I for one hope for justice in this matter. I am proud to call Dr O and G my friend.

The Prime Minister's Office response.

An e petition to stop 'Modernising Medical Careers' was sent to the Government in January 2007 having been signed by 2,712 people. The Government have since responsed to the petition as below:

"The Government are aware of the calls to defer implementation of the new specialty training programmes. However, the view of the four UK Health Departments is that, as we are on target to deliver, this would not be helpful and would actually cause greater uncertainty for trainees.
The petition suggests that there will be a lack of specialty training posts....Of course, as entry is competitive not every trainee can be guaranteed a post and not everyone will be able to get into the specialty they want in the location they want, but this has always been the case. However, the number of training places announced represents a significant increase in training opportunities.
It is inevitable that reform on this scale will prompt some concern but we hope this response goes some way to reassuring you about these important changes."

It is unclear was meant by 'a signifcant increase in training opportunites' and I am aware of many doctors who seem to have missed out on further training posts. In a letter in the Independent newspaper today, Dr Liz Tate (SHO psychiatrist) wrote:

"When the results [from the MMC] were in, the scale of the disaster became apparent...Junior doctors have suddenly seen how little they are valued by the Government. Doctors with homes, partners and families are now faced with the choice of becoming unemployed or relocating their entire household to take up a job they don't even want.

Contrary to what the public are sometimes led to believe, most doctors want to work, enjoy their job and are committed to their specialities and their patients. This new system of job allocation favours no one. At best, the Government will create a generation of demoralised and demotivated doctors, doing jobs they hate in areas miles from their families and friends. At worst, doctors will leave the country for the open-armed invitations of Australia and New Zealand, or leave medicine altogether."

I continue to fully support the junior doctors and I very much value their hard work and dedicated commitment.

Save The White Coats!

‘Thought of this week’ has to be awarded to doctors. As a psychiatrist I often have the job of being an advocate, and this week my advocacy skills have been an essential part of supporting my own colleagues. Junior doctors are the engine of every hospital and without them the NHS would grind to a halt. However, this week they have all been subjected to a job application procedure under Modernising Medical Careers (MMC), that many have called an ‘unethical double blind trial’.

To give a brief summary, all doctors in training were asked to re-apply for their jobs via a computer system. Some have since been offered interviews, but about 5,000 plus doctors who have not, now face unemployment. I have seen at first hand some extremely talented and dedicated doctors not being offered a job interview, yet absolutely no explanation has been given as to why not. Others have been offered jobs in other parts of the country and are now facing up-rooting their entire family to relocate to another district. The unaccountable application system is being challenged by Remedy UK and I have offered them my support.

If you would like to also support these doctors there are several things you could do:
1) Join ‘the white coat March in March’ on the 17th March, which will start at 11am at the Royal College of Physicians.
2) Sign the Early Day Motion 737 (Junior Doctors Training)

3) Pass on this information and please do post a comment of support – I know many doctors this week who are in need of support.

Who can you Trust?

It was reported today that a city business man was jailed for just two years (instead of a possible ten years) for spiking the drink of a female banker. The offence was noted by an eagle eyed waiter who spotted the banker's slight of hand into her drink whilst the female banker had gone to the ladies; she was thankfully alerted as to what had happened.

This is an extreme criminal case, but just how good are we generally at spotting deception? Research would suggest that people are not as good at spotting deception as they would like to think they are. Indeed studies show that people can detect lies in others at a rate of only 44%. This is actually lower than the success rate you would get if you tossed a coin! Even professionals who are meant to have a lot of specific experience in this area, like police officers and customs officials, perform no better at lie detection than at the level of chance.

In one famous experiment police officers were exposed to videotapes of people who were asking the general public for help in finding their missing relatives. Some of these people had been found guilty of crimes against their relatives, but police officers didn’t know this. What was found was that none of them performed any better at spotting deceit at the press conference than could be expected by chance. The psychologist Professor Aldert Vrij from the University of Portsmouth, who conducted the experiment found that the only professionals more adept at spotting deception than the general public were officers who worked for the US Secret Service – but then again they tended to trust no one at all!

One explanation as to why professionals are no better at detecting lies than the general public is that they are burdened with the same false beliefs about how liars behave. For example, it is commonly assumed that liars have key non-verbal behaviours, such as gaze aversion. This preconception remains, despite psychological research which has established that this is not a reliable indicator of deception. In fact, the opposite may hold sway, because liars have to manufacture reality, and this usually requires a lot more intellectual effort than simply reporting the truth. As well as watching their words, liars tend to closely monitor how their story is coming over, hence liars tend to watch the listeners closely rather than look away. Therefore, perhaps someone who maintains more eye contact than usual, is the person to be concerned about. Also, good liars tend to make fewer gestures to try and ensure that they don’t ‘leak’ body language clues.

It is said that a useful tip is that liars experience three main emotions during lying: fear of being caught, excitement at the opportunity of fooling someone (‘duping delight’) and guilt. Hence by being vigilant for these emotions, you are supposedly more likely to spot them in the form of ‘micro’ expressions – facial movements that appear for short periods of time and betray these emotions. Unfortunately, these expressions are usually barely perceptible.

So, beware of preconceived ideas as to who is telling the truth, and always be aware of the dangers of leaving your drink unattended in a public place.

Sleeping....zzzz

This week the New Scientist discussed the old wives' tale about 'sleeping on a problem' reporting the research which showed that sleep 'helps us extract themes and rules from the masses of information we soak up during the day'.

But how much sleep is needed?
According to Maas, the prehistoric genetic blueprint for sleep has not evolved fast enough to keep up with the pace of twenty-first century living. Humans are more likely to need an average of ten hours sleep a night rather than the four hours on which Margaret Thatcher was famously able to get by. Maas also claims that everyone maintains a personal sleep bank account, and as a rule of thumb for every two waking hours incurs a sleep debt of around one hour is incurred. Maas and others argue that modern society is a sleep-deprived society and notes that over the past twenty years an extra month of working hours has been added to the annual working and commuting time. In fact, the British work longer hours than any other nation in Europe, and sleep one-and-a-half hours less per night than two generations ago. This is not to say that everyone needs ten hours of sleep a night, or that people cannot survive on much less. However, it does raise the question that you may not have addressed, as to whether you are getting too little sleep for your own body.

...In the words of Samuel Pepys "And so to bed."