Newsbites

Doctors need a single united voice

UK hospitals should only take students from GMC accredited schools

Hospitals in the United Kingdom have been advised to make sure that clinical placements are offered to students from schools accredited by the General Medical Council only. The issuance of this guidance by the GMC follows a BBC Five Live investigation that raised doubts regarding the validity of some degrees. Some private medical colleges based in the UK rely on NHS hospitals for training but award degrees from foreign institutions. The GMC said that there are currently 27 medical schools whose medical education is in line with the curriculum that it advocates (http://news.bbc.co.uk).

Closing on-call rooms is dangerous, BMA warns

Closing hospital on-call rooms will put patients at risk, the BMA’s Junior Doctors Committee has warned. Andrew Rowland, the joint deputy chairman of the committee, said that junior doctors needed to be able to rest when working on call at night to keep them alert for when they were needed. Junior doctors use on-call rooms with beds and showers to catch up on rest during quiet periods in overnight shifts, but hospital trusts have been closing many of them, the BMA said. “Sleepiness is known to be associated with memory deficit and impaired performance,” Dr Rowland said. “Sustained wakefulness results in a decline in performance similar to breaching the legal blood alcohol limit for driving in the UK” (http: //news.bbc.co.uk).

Overseas doctors suffer discrimination

Overseas doctors in the UK suffer from widespread discrimination at the hands of hospital trusts through employment in non-standard posts with lower pay and lack access to training, the BMA said.

“This state of affairs cannot be allowed to continue. I hope that this will be rectified by a national fair contract that recognises the enormous contribution staff and associate specialist doctors make to the NHS,” said the BMA’s chairman, James Johnson. The UK has around 12 500 staff and associate specialist doctors, most of whom are from overseas (www.bma.org.uk).

UK medical schools may close because of shortage of academics

The falling number of academic clinicians could force medical schools to reduce the number of places available, unless they are able to train more academic clinicians, concluded a recent BMA conference—“Delivering Academic Medicine.” Although medical student numbers have risen by 40% since 2000, clinical lecturer posts have declined. In just one year, 2003-4, for instance, 17% of posts have been lost. Peter Dangerfield, the deputy head of the BMA’s Medical Academic Staff Committee, said, “We may reach the stage where we have to curb the number of medical undergraduate courses. There is plenty of scientific staff but they don’t have the same clinical training as doctors and this is crucial. If academics are lacking, then NHS staff might have to step in; this isn’t their role (Times Higher Educational Supplement 2005 Dec 9: 9).

Irish consultants want to limit non-EU students

Ireland should restrict the number of medical school places going to high paying non-European Union students to 25% of the total, to make sure that enough Irish doctors are trained, the Irish Hospital Consultants Association told the Irish government in a prebudget submission. The group noted that non-EU students paid a €33 000 (£22 400; $39 600) fee while home students brought only an €8000 grant. “There is a profound shortage of Irish doctors. As long as we continue with the present structure of underfunding medical schools, we will be unable to meet the home demand for medical school places, or more importantly, doctors. Besides increasing the student intake, this Association would like to see a 25% cap on the number of non-EU students,” the consultants’ association said (www.ihca.ie).

On-call hours count, EU court rules

The European Court of Justice has upheld rules that count junior doctors’ time on call towards the maximum working hours limit. The court, considering the case of a French teacher, ruled that being on call at work is not the same as resting at home. The weekly working limit for British junior doctors was this summer cut to 58 hours to comply with European Union directives restricting working time, and the government plans to further reduce this to 48 hours a week by 2009. Most countries had previously considered the hours medical staff spent on call as working time only for the hours actually worked (www.ft.com).

Patients are at the heart of new medical professionalism

A report on medical professionalism highlights a “serious failure” in doctors’ leadership and calls for a central forum to give the profession a single united voice. The report from the Royal College of Physicians also proposes a new definition of medical professionalism that focuses on partnership with patients and with other disciplines and discards the concepts of autonomy, privilege, and self regulation. The wide ranging working party report, Doctors in Society: Medical Professionalism in a Changing World, comes at a time when the profession is under unprecedented scrutiny as a result of medical controversies, changing working practices, and increased public expectations. The report says that medical professionalism lies at the heart of being a good doctor. But today’s healthcare environment, which focuses on setting targets and regulation, puts this at risk. The working party redefines medical professionalism as “a set of values, behaviours and relationships that underpins the trust the public has in doctors” and lists the qualities doctors should strive for as integrity, compassion, altruism, continuous improvement, excellence, and multidisciplinary working (http: //bmj.com).

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Bed shortage affects doctors

Romanian orphanages closed without overseas adoption

Romania claims to have removed one of the main obstacles to its entry to the European Union in 2007 after closing down a large number of its huge children’s homes without resorting to overseas adoptions. Its policy of returning abandoned youngsters to their natural families has meant that dozens of the state run institutions have closed their doors, and Romania is pledging to continue the programme, despite pressure from countries such as Israel and the United States that wanted overseas adoptions to be restarted. The country’s problems with large numbers of unwanted children began when the then dictator Nicolae Ceauçescu decided to increase the country’s population. He banned sex education, contraception, and abortion and offered financial incentives to parents to produce large families. The national birth rate doubled as a result, but many of the children were unwanted and later abandoned, forcing the state to build institutions to house them (http://bmj.com).

studentBMJ 2006;14:1-44 January ISSN 0966-6494