Monday, 14 January 2008

PMETB- beyond a joke

PMETB (Postgraduate Medical Education and Training Board) have the unique position of being able to question junior doctors in training on a yearly basis. This is an opportunity that should not be missed, it should be a time when the views of trainees can be taken on board to work out where things are going wrong, problems could then be addressed and training could then be improved. Unfortunately PMETB wastes this opportunity on a yearly basis by ignoring many of the key issues behind training and subjecting junior doctors to completely useless questions that would be better left in 'psychobabbler's monthly'. Listed below are some of the questions that trainees were asked this year:

Have you had formal teaching since leaving medical school in any of the following?
Patient safety The political creation 'patient safety' is slipped in here. Everything that a junior doctor learns is aimed at making them a better doctor, and is linked up with patient safety, so what the hell would a 'patient safety' teaching session comprise of? Words fail me.

In this post how often do you have the opportunity to learn together with other healthcare professionals (e.g. nurses, physios etc)?

Why are they asking this? Doctors should not be taught with nurses and physios, as they are being trained to be doctors, not nurses and physios. Again this question shows how PMETB are trying to hint towards the 'skills escalator' with their survey, their politically driven questions are designed to give them ammunition for yet another politically driven agenda.

In the last month, have you made a serious medical error?

Is anyone really going to say yes to this one? The PMETB survey is meant to be anonymous, but in reality it would be easy to work out who filled each form in from the basic questions at the beginning which include speciality, year and university of graduation and more give away details.

I'm always willing to admit it when I make a mistake.

No matter who I'm talking to, I'm always a good listener.

I sometimes feel resentful when I don't get my way.

(Describes me-very wellfairly wellfairly poorlyvery badly)

Now the questions are nothing other than a joke. It is turning into a psychological questionnaire, one wonders what the relevance of this is to medical training?

How often do you feel:







( A littleModerately Quite a bit Extremely)

The psychobabbling rubbish continues, I find it amazing that so many questions are wasted on such vague nonsense. It is more amazing when seen in context of what has not been asked my PMETB.

They ask nothing about competency based training, nothing about the excessive paperwork that trainees have been bombarded with. There is also no mention of the European Working Time Directive (EWTD) and its impact on training, as arguably EWTD is massively reducing exposure and hence experience levels, how can this be continually ignored? Maybe it's because they want to replace experience and an apprenticeship with black and white competency based assessments, a disingenuous tactic in my eyes.

Even though PMETB are fishing to find out whether junior doctors are being taught with other HCPs, there are no questions as to whether trainees feel that their training is being damaged by the introduction of more and more HCPs doing jobs that used to be a valuable part of a junior doctor's training. There was also no mention of study budgets and whether trainees were still having to fund their own training with minimal help from the government?

There is no mention of MTAS or MMC, and what trainees think of these failed policies. There are strangely no questions about the role of PMETB and how well trainees think PMETB is doing its job. There is also an ominous lack of questions asking about the quality of Foundation training, I suppose any questions on this topic may well scupper the politicians' claims that Foundation training is such a great success, they think by saying it over and over enough times it will magically become a reality, I think not.

I could go on, there were many other rather important issues that PMETB whitewashed over with its 'unique' set of questions. One question that does not need to be answered is what trainees think of the Tooke review's seventh reccommendation:

"PMETB should be merged within GMC to facilitate economies of scale, a common approach, linkage of accreditation with registration and the sharing of quality enhancement expertise."

The haphazard and disorganised regulation of medical training should not be allowed to continue. Organisations like PMETB are happy to tell people what to do, but are never happy to take any responsibility for their actions or roles. PMETB's state of denial during MTAS 2007 summed up this rather glaring lack of accountability.

If anyone from PMETB is listening then I would like to express the state of my emotions regarding PMETB's handling of medical training. I am not at all inspired by PMETB's actions, very scared that PMETB are given such responsibility, afraid of how badly things are going wrong at the moment and very determined that trainees should have much more of a role in leading medical training out of its current crisis. Listen up PMETB, trainees are frustrated with your incompetence and we want to be listened to.

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