I can't get my head around pharmacology

Last Wednesday (27/11/13) was Birmingham Medical Leadership Society’s second lecture in its autumn series on why healthcare professionals should become involved in management and leadership. Firstly, a really big thank you to Mr Smart for travelling all the way to Birmingham for free (!) to speak to us. It was a brilliant event and certainly sparked some debate. A second big thank you to Michelle and Angie – the University of Birmingham Alumni and marketing team who helped organise this event and recorded it – a video will hopefully be available online soon. Mr Tim Smart is the CEO of King’s NHS Foundation Trust and has been for the last few years – a period in which King’s has had some of the most successive hospital statistics in the UK. Is there a secret to managing such a successful hospital? “It’s a people business. Patients are what we are here for and we must never forget that” Mr Smart doesn’t enjoy giving lectures, so instead he had an “intimate chat” covering his personal philosophy of why we as medical students and junior doctors should consider a career in management at some point. Good managers should be people persons. Doctors are selected for being good at talking to and listening to people – these are directly translatable skills. Good managers should be team leaders. Medicine is becoming more and more a team occupation, we are all trained to work, think and act as a team and especially doctors are expected to know how to lead this team. Again, a directly transferable skill. Good managers need to know how to make decisions based on incomplete knowledge and basic statistics. Doctors make life-altering clinical decisions every day based statistics and incomplete knowledge. A very important directly transferable skill. Good managers get out of their offices, meet the staff and walk around their empires. Doctors, whether surgeons, GP’s or radiologists have to walk around the hospitals on their routine business and have to deal with a huge variety of staff from every level. To be a great doctor you need to know how to get the best out of the staff around you, to get the tasks done that your patients’ need. Directly transferable skills. Good managers are quick on the up-take and are always looking for new ways to improve their departments. Doctors have to stay on top of the literature and are committed to a life-time of learning new and complex topics. Directly transferable. Good managers are honest and put in place systems that try to prevent bad situations occurring again. Good doctors are honest and own up when they make a mistake, they then try to ensure that that mistake isn’t made again. Directly Transferable. Even good managers sometimes have difficulties getting doctors to do what they want – because the managers are not doctors. Doctors that become managers still have the professional reputation of a doctor. A very transferable asset that can be used to encourage their colleagues to do what should be done. A good manager values their staff – especially the nurses. A good doctor knows just how important the nurses, ODP, physio’s and other healthcare professionals and hospital staff are. This is one of the best reasons why doctors should get involved with management. We understand the front line. We know the troops. We know the problems. We are more than capable of thinking of some of the solutions! “Project management isn’t magic” “Everything done within a hospital should be to benefit patients – therefore everything in the hospital should be answerable to patients, including the hospital shop!” “Reward excellence, otherwise you get mediocrity” At the present The University of Birmingham Students Medical Leadership Society is in contact with the FMLM and other similar groups at the Universities of Bristol, Barts and Oxford. We are looking to get in contact with every other society in the country. If you are a new or old MLS then please do get in touch, we would love to hear from you and are happy to help your societies in any way we can – we would also love to attend your events so please do send us an invite. Email us at med.leadership.soc.uob@gmail.com Follow us on Twitter @UoBMedLeaders Find us on Facebook @ https://www.facebook.com/groups/676838225676202/ Come along to our up coming events… Thursday 5th December LT3 Medical School, 6pm ‘Why should doctors get involved in management’ By Dr Mark Newbold, CEO of BHH NHS Trust Wednesday 22nd January 2014 LT3 Medical School, 6pm ‘Has the NHS lost the ability to care?’ – responding to the Mid Staffs inquiry’ By Prof Jon Glasby, Director of the Health Services Management Centre , UoB Thursday 20th February LT3 Medical School, 6pm ‘Creating a Major Trauma Unit at the UHB Trust’ By Sir Prof Keith Porter, Professor of Traumatology, UHB Saturday 8th March LT3 Medical School, 1pm ‘Applying the Theory of Constraints to Healthcare By Mr A Dinham and J Nieboer ,QFI Consulting  

As part as my paediatrics attachment, I was having peripheral nervous system bed side teaching. We had spoken over the examination and I was first up to practice on 4 year old Jake. One consultant and 3 other medical students looked on as I worked my way through the examination. My general inspection and impression of the child got approving nods from my colleagues. Phew! Next up was actual exam “two people can’t resist…” I recalled in my head. First up, tone. I assessed this correctly and nothing had gone majorly wrong yet. Relief. Power was next. “ok, so put out your arms up like this and resist me…ok, no, not like that..erm..oh god…I don’t know how to explain it”. My colleagues looked on. The consultant chipped in “tell him to touch his shoulders”. It did the trick and I was able to get through the rest of the examination without too many hiccups. When we had finished, in classic med school fashion I had to reflect on what had just happened and then say something I did good and something I could have done better. My good thing was “I got through it..I mean I remembered everything”. My bad thing was “I wasn’t good at explaining power to him”. My feedback wasn’t the same as my bad thing though. My feedback was “be more confident. You did everything correctly and didn't forget anything. I think it’s a girl thing. You doubt yourselves more than the boys”. Next up was a male medical student’s turn. He did the examination just fine but there were things that I could pick out that he could have done better and being totally objective my examination was better. But there was a major difference. His confidence. He seemed like he knew what he was doing and when he went wrong or missed something out, he just added it to the end of his examination. If I were his examiner, I would have found it difficult to fault him. He appeared confident and as a patient that inspires confidence and a happy patient makes for a happy examiner and good marks. After the session, I got to thinking: am I really incompetent or am I just underestimating my own ability which is making me lack confidence? The fact that a paediatric consultant and all my colleagues told me that my examination was fine, good even, answers the first part. I am not incompetent. So I must be underestimating my own ability. And if I am, is that something that is unique to me? Or are other medical students doing that too? And more interestingly to me, is this something that the female medical students are doing more than their male colleagues?  

Does spending more time on the wards as medical students actually produce more competent junior doctors?  

The Health Service Journal have announced this week that medical students could be given a license to practice medicine in the NHS as soon as they graduate. What do we know? The proposal comes from Health Education England. Students would qualify by taking an additional exam when applying for the Foundation Programme. The aim is to improve the standard of medics joining the NHS. Another driving force is to reduce the rising number of med students applying for the two-year Foundation Programme (currently the only way for junior doctors to achieve a full license to practice). Last year there were 297 more applicants than places. If approved the plan would require changes to the Medical Act. Statement from the BMA Dr Andrew Collier, Co-Chair of the BMA’s Junior Doctor Committee said: “We do not feel the case has yet been made for a wholesale change in foundation programme selection process, especially as the system was significantly overhauled and implemented only one year ago. There is little evidence that another new national exam over and above current medical school assessment methods will add any benefit either for graduating students or the NHS as a whole. It is also unlikely to solve the ongoing oversubscription to the foundation programme which will only be addressed by well thought out workforce planning.” Will it work? This proposal has certainly come as a surprise to me so soon after recent changes to the Foundation Programme selection process. I would love to know what you think about it. Do you agree with Dr Collier’s statement? If the plan goes ahead do you think it will be effective in achieving the desired outcomes? Please post your comments and thoughts. Nicole Read more: http://www.hsj.co.uk/news/exclusive-medical-students-face-new-nhs-entry-exam/5066640.article#.UrbyS2RdVaE