Pre-registration House Officer Posts Research Articles

Pre-registration house officer training in psychiatry: the London experience

AIMS AND METHOD To evaluate whether new pre-registration house officer posts in psychiatry deliver training leading to increased confidence in target skills, based on General Medical Council requirements, and to evaluate trainees9 satisfaction with these posts. A structured questionnaire was filled out by the first nine incumbents of the PRHO posts before and after the placements. RESULTS Trainees9 confidence improved in all the target skills and the posts were all rated as good or excellent. The posts attracted trainees who were potentially interested in a career in psychiatry or general practice. CLINICAL IMPLICATIONS PRHO posts in psychiatry deliver training that meets General Medical Council objectives, and trainees9 confidence with core psychiatric skills improves after undertaking the placements.

Foundation doctors in Anaesthesia: should they be taught to administer an anaesthetic?

BackgroundAnaesthetic pre-registration house officer posts have been available since 1997. With the change to postgraduate medical training introduced in 2005, these posts have become vital building blocks for Foundation Programmes.DiscussionWe debate the skills that new Foundation Programme doctors in such posts should be taught, particularly whether administration of an anaesthetic holds an important place. The opinion of college tutors prior to the institution of the foundation programme is included. These were obtained from a postal questionnaire.SummaryWe maintain that teaching how to administer an anaesthetic remains an important learning objective and something that should be actively pursued.

Re-training refugee and other overseas doctors: re-qualification through the United Examining Board examination

The Professional and Linguistic Assessments Board test is well suited to overseas doctors who have migrated for reasons of career development but less so for groups such as refugees who have not had time to prepare for migration and may not speak English. We describe a 12-month structured clinical course leading to re-qualification, for 70 refugee and other overseas doctors. Between 1996 and 2003, 69 of the 70 overseas doctors on the course (27 of whom were refugees) re-qualified through the examination of the United Examining Board. We report on early and later outcomes of these 69 doctors who, by achieving provisional registration, were entitled to pre-registration house officer posts. Of the 69, 33 are now principals in general practice or GPs in training; a further 32 are in NHS hospital posts. Opportunities for disadvantaged overseas doctors to re-train are severely lacking; yet in the UK there are significant numbers who warrant special help. A very modest investment of resources could help them re-qualify and contribute to the health and economy of the nation.

I am a doctor from India. I came here after finishing my preregistration house officer posts and have passed the PLAB (Professional and Linguistic Assessments Board) tests. I want to work in genitourinary medicine; how do I progress and where should I apply?

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I am a doctor from India. I came here after finishing my preregistration house officer posts and have passed the PLAB (Professional and Linguistic Assessments Board) tests. I want to work in genitourinary medicine; how do I progress and where should I apply?

Have a career or related problem that needs answering? Can9t find the right person to point you in the right direction? Log on to the Advice Zone for reliable medical careers advice. You can post a question or see if one of our 300 advisers has already answered a similar question. Here is a selection of questions and answers posted on the site. <b>www.bmjcareers.com/advicezone</b>

Pre-registration house officer training in psychiatry

I was struck by Rebecca Mason's claim ( Psychiatric Bulletin , October 2003, 27 , 394-395) that, in 1981, she was involved in one of the first pre-registration house officer posts in psychiatry in this country. In fact, in 1960, at the Sefton General Hospital in Liverpool, I held the post of pre-

Pre-registration house officer training in psychiatry: the London experience

Aims and MethodTo evaluate whether new pre-registration house officer posts in psychiatry deliver training leading to increased confidence in target skills, based on General Medical Council requirements, and to evaluate trainees' satisfaction with these posts. A structured questionnaire was filled out by the first nine incumbents of the PRHO posts before and after the placements.ResultsTrainees' confidence improved in all the target skills and the posts were all rated as good or excellent. The posts attracted trainees who were potentially interested in a career in psychiatry or general practice.Clinical ImplicationsPRHO posts in psychiatry deliver training that meets General Medical Council objectives, and trainees' confidence with core psychiatric skills improves after undertaking the placements.

Pre-registration house officer training in psychiatry: the London experience

Aims and MethodTo evaluate whether new pre-registration house officer posts in psychiatry deliver training leading to increased confidence in target skills, based on General Medical Council requirements, and to evaluate trainees' satisfaction with these posts. A structured questionnaire was filled out by the first nine incumbents of the PRHO posts before and after the placements.ResultsTrainees' confidence improved in all the target skills and the posts were all rated as good or excellent. The posts attracted trainees who were potentially interested in a career in psychiatry or general practice.Clinical ImplicationsPRHO posts in psychiatry deliver training that meets General Medical Council objectives, and trainees' confidence with core psychiatric skills improves after undertaking the placements.

How consultants, hospitals, trusts and deaneries affect pre-registration house officer posts: a multilevel model.

To examine variation in reported quality and working conditions of pre-registration house officer (PRHO) posts. To use multilevel modelling to determine how much of the variation was due to the effects of consultant firms, hospitals, trusts and deaneries, as well as variation at the level of the individual doctor. Questionnaire survey of national sample of PRHOs at the end of the pre-registration year. Multilevel modelling was carried out using MLwiN. PRHOs working in UK approved medical and surgical posts in NHS hospitals from August 1996 to January 1999. One thousand, four-hundred and thirty-five PRHOs who had previously been part of an extended cohort study of medical student selection and training. They reported on a total of 4926 posts, on 2721 identifiable consultant firms, in 336 hospitals, in 264 trusts and in 17 deaneries. PRHOs' perceptions of the overall quality of all PRHO posts they had worked in, and working conditions in the current post. Twenty percent of PRHO posts were described as excellent and 34% as very good, through to 6% reported as not very good, poor or bad. The overall rating of the post showed highly significant variation at the level of hospital/trust, and consultant firm. Other aspects of posts, such as working conditions showed variation at the level of deanery, trust, hospital and firms, with different patterns for the different measures. Assessments of stress in PRHOs (GHQ, burnout, response to uncertainty), and a desire to leave medicine, showed no variation at the level of deanery, trust, hospital or firm. Some aspects of a PRHO post, in particular overall rated quality, but also many aspects of working conditions, show substantial variation at the level of hospital, trust and consultant firm, suggesting that differences reflect local variation in working practices and treatment of PRHOs, with the possibility of change and improvement. The lack of any variation at the level of deanery, trust, hospital or firm in stress of PRHOs suggests that these responses are idiosyncratic, individual responses by doctors themselves, rather than a general characteristic of posts, hospitals, trusts or deaneries.

Intensive care training and non anaesthetists.

It is almost certainly correct (Banerjee & O'Dea. Anaesthesia 2000; 55: 288) that anaesthetists will continue to play a major role in the management of UK intensive care, but the UK's currently highly restricted route to becoming an intensive care specialist makes their conclusion a foregone one. It is hardly surprising that they found that ‘only anaesthetists stated any desire to specialise in ICM’ at the time of their application, since very few applicants from other specialities have any notion of what such specialisation involves. Perhaps they should be surprised (and concerned) that only 28% (12/42) of anaesthetic trainees expressed any desire to specialise in ICM, since presumably this cohort might be expected to represent the trainees who may become the future's ICM specialists. To an extent this mirrors previous findings from the USA [1] where only 32% of trainees in anaesthesiology were interested in a career in ICM and where an accompanying editorial [2] suggested that ‘it is no longer appropriate to think that the anaesthesiologist will always have a management role in the ICU …’ Despite some early progress by the Intercollegiate Board for training in Intensive Care Medicine that might eventually have begun to open up career opportunities for nonanaesthetists hoping to specialise in ICM, recent developments appear to have seriously undermined such prospects. Trainees from specialities other than anaesthesia seeking to become specialists in ICM face a phenomenal obstacle course (lack of funding, lack of numbered posts, difficulties with training recognition, etc.); at the end of which they will have great difficulty finding a job because very few hospitals appear to be able to offer ICU consultant posts to nonanaesthetists. Our own experience suggests that the pattern for nonanaesthetic trainees may be rather different from that of Banerjee and O'Dea. We recently surveyed 35 trainees from differing clinical backgrounds who completed either 6- or 12-month training posts in our department. Forty-one per cent seriously considered a career change to specialise in ICM, and 19% did so. Of those who considered a change but did not undertake it, the most frequently cited reason was the prospect of having to ‘start again’ in anaesthesia. In addition to anaesthetic trainees who had not previously envisaged a career in ICM, trainees who have changed career intention include those from general medicine, emergency medicine and general surgery. Most accepted that they had no alternative but to undertake re-training in anaesthesia. One physician trainee attempted to arrange ICM training from within their respiratory medicine programme, but was eventually forced to concede defeat and apply for SHO posts in anaesthesia. We have other evidence that there is no shortage of interest from nonanaesthetists for intensive care training posts in the UK. Of 94 applications for the latest round of SHO posts in our Intensive Care Unit, 27 (28%) planned a career as an anaesthetist, 24 (25%) as a physician, 17 (18%) as a surgeon, 15 (16%) as an A & E specialist and one (1%) an obstetrician. Seven out of 24 (29%) of the medical, but only 5/27 (18%) of the anaesthetic, trainees declared an intention to specialise in ICM. Ten applicants had undertaken only preregistration house officer posts. Our experience suggests that there is potentially a bright future for ICM in the UK, with many interested and capable candidates for future posts. However, such interest and abilities cannot be harnessed by the present system. Perhaps it is time for NHS Trusts and those anaesthetists working within intensive care units to acknowledge that intensive care specialists can come from any background, and to ensure that training and consultant posts in ICM are open to doctors from all disciplines.

House officers must not be exploited, say deans

Postgraduate deans in the United Kingdom will not approve preregistration house officer (PRHO) posts that exploit and do not educate young doctors. A consensus statement produced this week by the Committee of Postgraduate Deans (COPMED) says that “In recent years the intensity of work of PRHOs has increased enormously…and the PRHO has less support than formerly as there are fewer doctors on call.” Professor Richard West, medical postgraduate dean of Bristol University, said: “Postgraduate deans now hold 50% of the budget for junior doctors' posts, and this gives us a lot of clout if we have to …

Allocating pre-registration house officer posts

Allocating pre-registration house officer posts

Preregistration house-officer posts

Preregistration house-officer posts

The allocation of pre-registration house officer posts in the four Thames regions: a survey of house officer opinion

The satisfaction of pre-registration house officers with the operation of, and outcome of participation in, their medical school's allocation scheme for house officer posts was investigated by postal questionnaire. Satisfaction with outcome was generally high. Significant differences are reported between medical schools in participation rates in allocation schemes and in satisfaction with the operation of the schemes. The operation of the ranking schemes used at Guy's and St Bartholomew's Hospitals is shown to be significantly less satisfactory. Reasons for these findings are examined.

Pre-registration posts in general practice.

Though the UK Medical Act of 1978 made the creation of pre-registration house officer posts in general practice in the UK a serious proposition there have been few attempts to explore the possibility. The absence of agreed educational objectives for the year makes it impossible to conduct the properly evaluated experiments that might assuage existing doubts about the appropriateness of introducing general practice as a setting in an objective way. Experience so far shows that carefully designed schemes are both feasible and worthwhile in the opinion of those involved. The implications for general practice are explored, the need for new educational thinking is discussed and suggestions about criteria for the approval of practices are put forward.

Educational objectives of the pre-registration year.

This paper has attempted to develop criteria for the evaluation and assessment of pre-registration house officer posts. In addition, it has listed the general aims and objectives of the pre-registration year. It is hoped that this will provide a focus for the discussion of this important period of postgraduate training.

Monitoring pre-registration house officer posts.

The method of monitoring and assessing the house officer posts in the North Western Health Authority Region so as to ensure that they provide the required educational experience is described. This is done by annual visits to meet the housemen and subsequently to have discussions with the responsible consultants.

Pre-registration house officer posts in psychiatry

Pre-registration house officer posts in psychiatry

Pre-registration house officer posts in psychiatry

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Pre-registration house officer posts in psychiatry

An abstract is not available for this content so a preview has been provided. As you have access to this content, a full PDF is available via the ‘Save PDF’ action button.