? about postgrad residency programs in UK

[PsychMD]

Do UK postgrad residency programs have a national body of accreditation like the ACGME, or each specialty college is individually "responsible" for accreditation of residency programs for each specialty?

Is there a comprehensive site like the Freida for the UK?

Is there a UK equivalent of the "match"?

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[Miklos]

Do UK postgrad residency programs have a national body of accreditation like the ACGME, or each specialty college is individually "responsible" for accreditation of residency programs for each specialty?

Just briefly, as I'm sure that UK students/grads will help fill in the gaps...

The individual colleges set the requirements and the post-graduate deaneries
http://www.copmed.org.uk/ ensure that the individual trusts implement them and thereby also approve the specific training.

Is there a comprehensive site like the Freida for the UK?

Not that I know of. For general registration issues, you can see www.gmc-uk.org

Is there a UK equivalent of the "match"?

No. Students/grads individually apply to programs/positions. See for instance http://www.bmjcareers.com/ for listings.

Miklos

 

[PsychMD]

Thanks, Miklos.

I was really surprised, in fact, to find out they don't have some sort of distribution match! Or at least some sort of exam- or grade- based distribution of some sort. (I think they have something like that in France for example.) I also saw some numbers from the BMJ re. competition for various entry-into-training positions...which is pretty fierce, across the board! So UK Med. School grads have to really compete in a market-place sort of way for getting access even to further training! I wonder if the salaries are even worth it, at least!

This really begs the question...what happens to the UK grads who don't find a post in ANY specialty? How do they earn a living at least while they get some entry into some basic house officer jobs? And how in the world do they guard against possible corruption or nepotism? And how is the "system" able to plan or measure anything re. long-term needs of the health-care system? Maybe indeed this is why they have such a frightful imbalance in between the real NEED for specialists and the inevitable bottle-necks limiting the entry into specialty training!

Is this the same in other EU countries? Or...to each his own?

 

[johnny_blaze]

In the U.K you are accepted into programs based on previous experience in that field and most importantly… research! Consultants here don’t really care about USMLE scores. Gaining entry into a registrar post is very tough! Some people spend loads of time in basic medical/surgical training before getting into a higher one. I think this becomes feasible because med students start and finish at a younger age here. (start around 18, finish around 22-23) and don’t really need to support a family. Also, UK students only pay like 1k/year or something for their tuition, so student loan debts aren’t as high.

I’m currently in med school in England and I’m definitely not looking forward to doing postgrad training here. I’m probably gonna go off to the U.S/Can because I want to avoid the whole “bottleneck” situation. I know too many doctors who have been affected by this (i.e. training for such a long time in a field and having to revert to something else because no higher training spots/consultant posts) I don’t really know why this is. I think it might have something to do with pushing more people into becoming GP’s. All I know is that there are too many med students in my year… and not enough training spots for all of us here.

 

[PsychMD]

Thanks for the reply. Just curious, since you're "closer" to Europe than we will probably ever be...do you happen to know if the situation (with the bottle-necks and barriers to entry into specialty training) is replicated in a similar manner across other EU countries, or is the UK in a league of its own?

It still seems to me extraordinarily hard to get any accurate direct information re. various systems of postgrad training in other parts of the world, compared to the US, which seems so "streamlined", and pretty straightforward, and "out there" for everyone to see! (And I doubt that it's for lack of or delay in technological interest and/or know-how in developing websites.)

It sometimes seems to me that the US info-sites are almost very well positioned at this point in time for full-stream recruitment of masses of English-speaking (and who isn't?) EU med. school graduates into our residency training programs here! Is this the near future (re. medical training) I sometimes wonder: the US absorbing larger and larger numbers from a highly-educated work-force from the EU over the next couple of decades?

 

[tonypowerful]

Psychmed,
I'm agree with u about what u said, but don't forget that for us (EU med students) we need the Usmle step 1,2 and 2cs, to complete that u need at least 18months ... how r u gonna live waiting for the results?
In my case for example,I'll graduate from Spain in 2 months,I was planning to go to the US , but as i told u before,how can maintain myself during those 18months studying for the exams|? that's why I decided to shift to UK since EU student graduated from EU don't need to to pass any kind of exams to get the Full registration in the GMC. I know it wont be easy to pass from the neck of the bottle but what can we do? as french say : c'est la vie!

Regards to all
Antoine

 

[DrIng]

The bottleneck also depends on the post you're interested in. For example psychiatry has less bottleneck than other fields. You can also get around it by doing things like going to the Caribean or Australia for 6 months/1 year to get extra registrar training to get aroudn the bottleneck, there are ways...

 

[tonypowerful]

4

 

[PsychMD]

Thanks guys, I didn't mean to sound as if I was criticizing. I was curious and somewhat surprised by the system, as I am only now trying to understand it. I have already completed my 4 year residency training here in Psych here in the US, but lately, I've been thinking about doing something like the equivalent of a fellowship (post-residency further training in a subspecialty like Geropsych or especially something like Geropsych combined with further exposure to Consultation-Liaison Pych.) in the EU, and it just looks like I might have to jump through lots of hoops. For the UK, I guess I could try to have to find a superior year SHO or even a SpR position? I don't even know myself where I stand...because the standards and lengths of training are so different, that I'm only now starting to figure things out!

 

[Miklos]

Thanks guys, I didn't mean to sound as if I was criticizing. I was curious and somewhat surprised by the system, as I am only now trying to understand it. I have already completed my 4 year residency training here in Psych here in the US, but lately, I've been thinking about doing something like the equivalent of a fellowship (post-residency further training in a subspecialty like Geropsych or especially something like Geropsych combined with further exposure to Consultation-Liaison Pych.) in the EU, and it just looks like I might have to jump through lots of hoops. For the UK, I guess I could try to have to find a superior year SHO or even a SpR position? I don't even know myself where I stand...because the standards and lengths of training are so different, that I'm only now starting to figure things out!

I think that depends on part on how much experience you have. You may wish to start by checking out the Specialist Training Authority http://www.sta-mrc.org.uk/

 

[PsychMD]

Thanks, Miklos! If you don't mind...you seem to be so well aware of various educational systems in Europe...how do you manage to keep up with all of this info, especially as it seems to be almost in constant flux, changing/evolving, especially over the last few years, as I perceive it, I guess?

Also, I'm getting this weird picture that in the EU, docs seem to be on the constant move, from one country to another, almost like in a merry-go-round (Med school in one country, training in another one, preparing at the same time for the USMLE's to come here, etc.). Plus many of the EU countries sites have, indeed, quite a bit of info for "foreign grads" as well, which furthermore reinforces my perception that the demand there is great, but the competition is also pretty fierce, and the road so...convoluted. Are so many docs just moving like that constantly all over the world in our day and age, roaming "road warriors"? What is going on? I'm getting dizzy...

I thought I was one of only few people who were curious re. moving, and now, as I'm looking more into it I just find HORDES of forums and sites just talking about "DOCS ON THE MOVE". Are so many highly trained professional people REALLY moving like that, at massive national levels? Or is it just a skewed perception due to the Net and increased interaction/communication abilities, etc., and most people are just staying in their home countries? I don't think it's bad....the more, the merrier! ...I just find it DIZZYING! Plus I read the scary stuff about the PLAB (even though it's not probably applicable in my case)...and my heart goes out to those colleagues, fellow docs, regardless of where they come from, who are just getting stuck into this MAZE.

 

[Miklos]

Thanks, Miklos! If you don't mind...you seem to be so well aware of various educational systems in Europe...how do you manage to keep up with all of this info, especially as it seems to be almost in constant flux, changing/evolving, especially over the last few years, as I perceive it, I guess?

Also, I'm getting this weird picture that in the EU, docs seem to be on the constant move, from one country to another, almost like in a merry-go-round (Med school in one country, training in another one, preparing at the same time for the USMLE's to come here, etc.). Plus many of the EU countries sites have, indeed, quite a bit of info for "foreign grads" as well, which furthermore reinforces my perception that the demand there is great, but the competition is also pretty fierce, and the road so...convoluted. Are so many docs just moving like that constantly all over the world in our day and age, roaming "road warriors"? What is going on? I'm getting dizzy...

I thought I was one of only few people who were curious re. moving, and now, as I'm looking more into it I just find HORDES of forums and sites just talking about "DOCS ON THE MOVE". Are so many highly trained professional people REALLY moving like that, at massive national levels? Or is it just a skewed perception due to the Net and increased interaction/communication abilities, etc., and most people are just staying in their home countries? I don't think it's bad....the more, the merrier! ...I just find it DIZZYING! Plus I read the scary stuff about the PLAB (even though it's not probably applicable in my case)...and my heart goes out to those colleagues, fellow docs, regardless of where they come from, who are just getting stuck into this MAZE.

I think that there are a number of factors in play. First, there appears to be (I use this phrase carefully for various reasons) a shortage of physicians in many developed countries (take for instance the US, UK, Canada, and Scandinavian nations). As far as reasons for this shortage go, these maybe in part demographic (e.g. often an aging population) combined with a related increased demand for services. Whether this has lead to the changes in the marketplace described below is a question for someone else.

IMO, one of the (rare) successes of the EU has been the technical regulation and liberalization of professional services such as physicians (other professions have not fared so well, yet). This has provided opportunities for physicians throughout the EU to find training opportunities and positions outside their home countries (cf. tonypowerful above). It is not unlike that enjoyed in US interstate commerce. (NB One thing both systems have in common is that they both discriminate against IMGs to one degree or another.)

As to why I looked into this? I came to realize that I would likely have only one opportunity to complete post-graduate training, especially if my plans included the US. Who wants to do scutwork twice?

NB For those that don't know, generally speaking only residencies completed in the US or Canada will allow someone to practice in the US. This is not completely true conversely. At the moment, it is possible to go from the US to Europe postresidency, IMO as long as there is a shortage of physicians in a given field/country. (UK-Canada or vice-versa is not a problem at all).

Miklos

 

[DrIng]

You might be interested in the link I posted below in the PLAB warning post. Basically it's a comment from the colleges in the UK saying that there are an incredible number of applicants for each spot- 300 applications for one position is not uncommon and that nearly 1/3 of people who have taken the PLAB (anyone gradauting from outside the EU regardless of citizenshp) is still unemployed 6 months alter. Combine this with the fact that unlike in Canada/US/AUstralia where you follow a set pattern i.e. 5 - 6 years of residency and you graduat ea consultant in the UK you have to apply for posts at each level. To use my example of psychaitry I could apply for a senior hosue officer post in psychiatry beat the oterh 200+ people for the job and then spend 4 years rather than the 2 outlined on the college website before I get a registrar position and then spend longer again in that before I can get a consultant postion. Now this could be a distorted position but this is how things appear to me and it makes the prospest of going to the UK less attractive. it's particularly interesting given that Australia has a net excess of 500 training places over doctors... Now there are difficulties with getting in to Australia in terms of visas and exmas etc if you're not an Australian graduate but at least you know you'll be a consultant in a set period of time, and our weather is better...