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Is Medical Training Inefficient?

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davebro | 20:22 Thu 31st Oct 2019 | Body & Soul
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Does a specialist doing say eye surgery or hip replacements really need to go through years of general medical training? Couldn't they be trained in their specialism more quickly & more effectively?
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I'd have thought that were a good grounding unnecessary then it would have been abandoned decades ago.
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Because that's how it's always been done?
With all the expense ? Unlikely surely.
It might be very tricky putting together a different plan for each speciality, as there must be a number of common modules which vary in their relevance. And many are unlikely to pick a speciality until full training has given them experience. Worth exploring by the profession nevertheless.
I've often thought that myself, Davebro.

For example it seems daft that someone who spends their life performing cataract surgery has first had to learn about identifying and treating a vast range of diseases, as well as understanding the rudiments of pharmacy and knowing how to perform a tracheotomy.

We accept that someone whose work will be confined to the mouths of patients (i.e. as a dentist) doesn't need to know about other areas of medicine, so why can't we adopt the same approach in relation to other parts of the body?
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No - resistance from the profession!
If you are rushed into hospital you'd want someone treating you who had a very good idea of things beyond their speciality. Believe me!

Anyway...don't you watch Casualty?
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"Anyway...don't you watch Casualty?"

No - but I do watch 24 hours in A&E and if they need a specialist they call the appropriate department.
Maybe the majority of .trainee doctors don't start out with a clear specialism in mind- perhaps the preference emerges as they go through their training. It's a bit like degrees- you could argue that degrees in things like History or Maths or PPE should be replaced by Accountancy or Teaching- but most students have little idea at 18
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Fair point FF - but with a looming crisis in medical staffing wouldn't a fast track approach for those who want it be beneficial?
Yes, they call the appropriate specialist. Someone has to know who to call though.
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"Someone has to know who to call though."

That's the someone who had full training specialising in A&E!
I think the straight answer is "yes, it is inefficient" - but the issue is would more efficiency introduce possibly perilous pitfalls.
It could be worth looking at- although I think the fear of being seen as running down/privatising/commodotising the NHS will deter anyone from pursuing it
To me it seems essential that one should have a basic knowledge of all aspects of medicine and have a qualifying examination at the end of six years to assess their expertise to be called a doctor of medicine and Surgery, so if called in any situation could offer qualified expertise.
At that stage you probably haven't made up your mind as to what branch of medicine that you want to follow...surgery, medicine, obstetrics, general practice etc and in doing so then a particular pot graduate path needs to be traversed.
An eye surgeon needs to know the ophthalmic manifestations of no eye conditions e.g rheumatoid arthritis, metabolic disorders, diabetes etc and so on and so an for ALL specialties, medical and surgical. The principles and practice of surgery, medicine, dermatology.
If you had a heart attack on a flight, there might not be a Cardiologist aboard, but you might like to know a Dermatologist or an Obstetrician might help.....OR better still an ABer with or without Internet connection ;-).

No.....I cannot see need for change.
Apparently,according to my wife of 40 years experience, Mid wives had to be fully trained as nurses first and then went on to specialise in midwifery . That is no longer the case and it appears to work.Midwives go direct to their specialist training.
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Squad - let me through. I'm an AROMATHERAPIST!
davebro....LOL.....done.
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"possibly perilous pitfalls"

I love alliteration!
Dave...Sqad said the point I was trying to make.

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