Twelve-month PRHO training posts in medicine, surgery, and a third specialty
Editor - To qualify for full GMC registration the Pre-registration House Officer must complete a training period of 12 months with a minimum of four months' experience in General Medicine and four months in Surgery.1 These requirements have given universities the opportunity to design accredited PRHO posts involving a third specialty, such as general practice.2
I particularly enjoyed psychiatry as a medical student and was keen to gain further clinical experience in this field without the lifetime career commitment. My PRHO post in Nottingham included four months in psychiatry with useful exposure to the presentation and management of affective, psychotic, neurotic, personality disorders, and drug abuse. The houseman duties were divided between an acute general psychiatry ward and the low-security forensic unit for Derbyshire. It involved the risk assessment and management of violent psychiatric patients, including Home Office admissions from Her Majesty's Prison in Leicester. I attended weekly court tribunals and hearings with my consultant, gained a good understanding of the 1983 Mental Health Act, participated in clinical research, and ran my own electroconvulsive treatment sessions.
Despite our clinical experiences as medical students, the houseman year has a strong influence on the career path we choose to take. Final year medical students should not commit themselves to the traditional six-month PRHO posts without careful consideration of these specialty rotations (see Table). At present, few rotating posts exist and they are still a relatively new concept in some institutions. Most rotate through general practice only. There is a need to increase the number of these specialist posts, extend the range of specialties currently available, and further assess their overall value in the general professional training of junior doctors.
PRHO posts with a third specialty
Advantages
- Diverse range of clinical experience in the PRHO year
- Improvement of clinical, diagnostic,and management skills
- Better teaching and clinical supervision than in the mainstream specialties
- Self-directed learning
- Opportunity to learn new practical procedures
- Flexible on-call commitments if the houseman plays a supernumerary role
- Assists in making a more informed career choice
Disadvantages
- Less experience in hospital medicine and surgery than PRHO colleagues
(an issue that may be addressed by consultants when applying for Senior House Officer posts)
- Transport/travelling expenses
- Isolation from fellow PRHOs
Michael A Gonzalez, Senior House Officer In Cardiology, The John Radcliffe Hospital Oxford OX3 9DU
Email: email
studentBMJ 2000;08:217-258 July ISSN 0966-6494
- General Medical Council. The New Doctor. London: GMC,1997.
- Williams C, Cantillon P, Cochrane M. PRHO rotations incorporating general practice. studentBMJ 2000;?:???. (May.)
