Practical skills UK

[gattasultetto]

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I'm trying to improve my practical skills and I'd like to make a comparison with UK graduates. What practical skills do UK doctors have right after medical school, before F1 year?

- suturing
- central venous lines insertion
- peripheral line insertion
- urinary catheter insertion
- ABG (arterial blood gases) (doing and reading)
- intubation
- laparoscopy course
- EKG reading
- chest drain insertion
- drugs administration
- fluid/ electrolytes balance and fluid therapy


Just say yes or no. In my hospital it's not easy to be able to do every skill I mentioned (for instance intubation). Please feel free to add any other skill that you assume a junior doctor shuold have...

 

[bambi]

I'm trying to improve my practical skills and I'd like to make a comparison with UK graduates. What practical skills do UK doctors have right after medical school, before F1 year?

- suturing
- central venous lines insertion
- peripheral line insertion
- urinary catheter insertion
- ABG (arterial blood gases) (doing and reading)
- intubation
- laparoscopy course
- EKG reading
- chest drain insertion
- drugs administration
- fluid/ electrolytes balance and fluid therapy


Just say yes or no. In my hospital it's not easy to be able to do every skill I mentioned (for instance intubation). Please feel free to add any other skill that you assume a junior doctor shuold have...

- suturing - Yes
- central venous lines insertion - No
- peripheral line insertion - Yes
- urinary catheter insertion - Yes
- ABG (arterial blood gases) (doing and reading) - Yes
- intubation - Yes - you should certainly know how and be able to at least try to do it if asked but you probably wont have actually done it
- laparoscopy course - no
- EKG reading - ECG! Yes
- chest drain insertion - No - Know roughly how but wouldn't have done it
- drugs administration - Yes - nurses tend to actually give the drugs
- fluid/ electrolytes balance and fluid therapy - Yes

The things I have said yes to you should be really good at by the time you start F1, not just done it a couple of times. In fact you should be really good at these things as a student. This sort of stuff is the majority of your job and you really shouldn't need help doing any of it. Courses, like laparoscopy are things you might do during foundation depending on what specialty you want to go into.

As well as the above we are obviously meant to be able to do a full exam of everything, both full system exams and focused exams on adults and kids. As well as the obvious stuff (cardio, resp, neuro, gastro) you should be able to do peripheral vascular exams, examine any joint, pregnant abdo, all the intimate exams- breast, testicular, rectal, vaginal. General derm/lesion exam, newborn check, neck exam, ENT exam, diabetic foot exam, assess fluid status...probably a load more I can't think of right now.

You should also be able to -
-Confirm death and write a death certificate
-Scrub for theatre - we have to do our own gown and gloves by the way
-Blood cultures
-Prescribe (prescription stuff is a big deal here, including prescribing fluids)
-Be able to deal with at least the basic ABC stuff for any emergency
-CPR
-General wound care
-Actually do the ECG, not just read it
-Scan interpretation and presentation- mostly CXR but others too
-Smear tests and swabs
-Administer a blood transfusion (incl doing all the checks)
-Urinalysis
-Set up a nebuliser
-Pulmonary function tests- some schools expect you to be able to perform it, all should expect you to be able to interpret the results
-LP - you should know how to do it and will have done it on a model but not on a real person


That's all I can think of for now

 

[gattasultetto]

Thank you. So this is what an AVERAGE UK junior doctor is able to do? And what about the two foundation years? What are the skills you can learn in this two years? I'm asking you because I read you're a resident.

 

[bambi]

Thank you. So this is what an AVERAGE UK junior doctor is able to do? And what about the two foundation years? What are the skills you can learn in this two years? I'm asking you because I read you're a resident.

Yes, this is what an average or even a below average junior can do. We are heavily tested clinically, you wouldn't pass finals if you couldn't do this stuff. There might be very slight variations depending on the school but all this stuff is listed in our handbooks and any of it could come up in our finals and a lot of it comes up in 3rd and 4th year exams too. We are also tested on our ability to break bad news and explain clinical conditions, tests etc in lay terms. I am just starting work so I don't know how good you are at the end of foundation really, I imagine I will be told soon! Exactly what you do will probably depend on your placements - central lines, stuff like that in terms of practical skills if you do the right placements. Foundation years are about improving knowledge just as much as skill and just getting good at being really organised and efficient and seeing as much stuff as possible.

 

[Chest Cutter]

Thank you. So this is what an AVERAGE UK junior doctor is able to do? And what about the two foundation years? What are the skills you can learn in this two years? I'm asking you because I read you're a resident.

Depends on your placements. I was surgically themed so did chest drains, central lines, ect.... but never did an LP as I had minimal time in IM. Would be opposite for someone who was medically themed. And the people who wanted to do psych generally did nothing. haha

 

[franceschino]

I agree on what type of rotations you applied for.

I am currently an f1 and started on ICU.

By the end of the 4 months I was able to put cvc and arterial lines, intubate, traches, ascitic and pleural taps. But never had the chance of doing an LP or chest drain.

However I have friends who have done the largest two but none of the other stuff.


Bottom line it depends on what jobs you apply for during your foundation years.