domingo, agosto 19, 2007

Fancy becoming another one of those overpaid GPs?

Many people think doctors are paid too much and have it easy. Alex Thomas suggests they have a go at taking up the job themselves

The constant analysis of GPs' salaries is really starting to irritate me. If the public think it is such an easy ride being a GP, why aren't there more of them applying for the job themselves?
You need to be able to get into medical school, of course. To even be considered, you need eight to 12 good GCSEs, By "good", I mean "excellent". Many universities stipulate six of these must be at grade A or above, so many of those who really want to be doctors start their hard work at the age of 14 when their GCSE courses begin.
After that you need at least three "good" (ie excellent) A-levels. A number of medical schools are moving away from the traditional three-science approach and demanding applicants have a range of skills. So in addition to A grades in chemistry and biology, applicants may have to be able to discuss Proust or be almost fluent in Spanish or be able to quote extensively from Chaucer, in the original Middle English.
Does this sound easy so far?
Assuming that applicants overcome social barriers on the way and achieve their three top grades, there is an entrance exam designed to level the playing field. Despite imposing these rigorous requirements upon applicants, many medical schools secretly do not think this a good enough measure of applicants' aptitude.
If you get through the demanding exam, you need to have had several months' work experience, which can be hard to find as many clinical environments do not welcome those under the age of 18.
If you are very lucky, you may be selected for an interview. But do not bank on this; at many schools, this is a random selection process and statistics usually quote that only one in 10 applicants is selected.
Then you actually do the interview. A panel of up to six eminently qualified medical professionals fire questions at you in no particular order for up to 30 minutes. You need to be tough not to crack under the pressure. You also need to have done your homework as questions can range from the mundane "Why do you want to be a doctor?" to the more demanding "What would you do if your incompetence killed somebody?" to the bizarre "What organelle do macrolides act upon?".
I do not think I knew the answers to any of these questions when I applied to medical school but I am sure you lot do. After all, this is an easy ride, remember?
If you get into medical school, you can expect to be examined every six weeks for the next five years; you will need to become au fait with clinical skills very early on; you will exist under phenomenal pressure. I used to work in the City of London and never have I known pressure like medical school.
Depression, anxiety and eating disorders are relatively common, alcohol and narcotics abuse is widespread, complete nervous breakdowns and suicides are not unheard of.
Does this still sound like an easy ride?
When you graduate, you become a junior doctor in an NHS that is crumbling around your ears. You do your one-year compulsory training with a team of doctors supervising and watching your every move. You are not allowed to prescribe alone, admit or discharge patients, but everyone around you seems to think you can.
At the end of that, you might start work in a GP's surgery on the lowest rung of the ladder. Or you might continue in a hospital in a specialism relevant to family medicine such as obstetrics or gynaecology. That is if you get the choice; increasingly, that choice is not your own to make.
With either option you will start work in a full-time job often with antisocial hours. In your spare time, you will start working for the hardest exams of your life, your membership exams. These will cost you around £600 just to enter and you will probably fail at the first or second attempt.
After you have passed these, and only then, will you start on the 15-20 year career path that will eventually lead you to being a senior partner in a practice and earning around £100,000 a year.
So let's not have any more nonsense about unrealistic salaries for GPs. This money is hard earned by exceptionally well qualified doctors at the peak of their profession. Of course, if you still think it is an easy ride, you know what you have to do to join in the fun yourself.
Alex Thomas, guardian 17.08.07