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I am a third year medical student. A tutor has offered me a doctorate studentship. Should I do the doctorate now or wait until I have finished medical school?
The main consideration should be whether you have a great desire to do the doctorate on offer. If the area really interests and excites you then pursue it now. If you are thinking about doing a doctorate just to get the qualification, then you should wait until you have done a bit more medicine to be able to decide which area you want to study in depth. Also, you will leave your classmates and you will remain as a student (with all of the financial implications) for a few more years. Often if you are a postgraduate you can more easily get funding for a doctorate. One other advantage of doing it now is that if you are older (and wiser) when you return to clinical medicine you often get more out of it.
Brian Angus, clinical tutor, University of Oxford
Is there an age limit for house officer posts?
No. The provisionally registered house officer year is compulsory for all doctors qualifying in the United Kingdom who wish to fully register with the General Medical Council. There is no age limit (and it can be done part time with good reason and deanery approval).
Simon Eccles, chair, BMA Junior Doctors Committee
I will be one of the first foundation programme intake (August 2005-7).
I will gain full General Medical Council registration at the end of year 1 (31 July 2006). I am also studying for the USMLE exams with the intention of joining the US residency programme at the end of my preregistration house officer year, but the calendar in the United States starts 1 July. If I gain a residency place to start 1 July 2007, I will have full General Medical Council registration, but how would I stand at leaving my foundation programme one month before it ends?
The General Medical Council is still considering when full registration will be given but it is likely to be at the end of foundation year 1. The foundation programmes will be competency assessed and if you achieve the competencies by 1 July 2007 then it is likely that you will have been deemed to have completed the foundation programme. However, the detail of the assessments is still to be decided and therefore no guarantees can be given at this stage.
Your contract would be for two years and if you want to leave early you should discuss this with your employer. It is also possible you may not have achieved the competencies by the time you are hoping to leave.
Annie Hastie, director of postgraduate general practice education, London Deanery
I have taken a foundation year after year 2. Are these not training posts, and will they not be recognised. Will taking up this post affect my future career plans?
Foundation 2 posts are training posts. They may not be recognised towards subsequent training in all specialties. In anaesthetics, for example, no foundation posts will be recognised because they will not be using these posts to try to train future anaesthetists. Instead they will provide a range of skills and competencies useful in any subsequent career.
A foundation post may, at worst, delay you by one year. That said it should give you a rather broader base that will prove more useful and aid your getting the next rotation. Many specialties seek someone who has a good broad start (for example, including four months in general practice) even if this is not directly relevant to the next stage.
Simon Eccles, chair, BMA Junior Doctors Committee
What routes are there are into counselling and what different types are there?
Counselling has different forms, which affect the route you are likely to take in training. Rather than giving you a detailed answer, look at the website of the British Association of Counselling and Psychotherapies (www.bacp.co.uk). Then site gives a lot of information on training and accreditation. They cover different schools of counselling, and are an umbrella organisation looking to maintain standards.
What form you are likely to practise will really be dependent on your interests and the context you are hoping to work in. The ways of working include person centered practice and psychodynamic counselling among others. A substantial grey area between psychotherapy and counselling exists, and the importance of the therapeutic alliance is core in both.
Philip Crockett, specialist registrar in psychotherapy and general adult psychiatry, Grampian Primary Care
What is community gynaecology?
Community gynaecology is a sub-speciality of obstetrics and gynaecology. It has recently been re-named sexual and reproductive health by the Specialist Training Authority (STA). The discipline combines one to one patient care and allows you to significantly influence public health and service delivery.
The typical specialist in sexual and reproductive health care which was formerly known as community gynaecology - may work in a primary care trust, community trust or an acute trust possibly with two or three other consultants in the same speciality. Most units have developed from family planning services and offer an expanded clinical service and undertake a significant strategic and public health advisory role. Increasingly these units are working alongside or merging with genitourinary medicine departments.
Clinical services which a consultant may deliver or lead include:
- contraception and well women
- STI screening and treatment
- menopausal services
- termination of pregnancy services
- psychosexual counselling
- colposcopy
- sexual health promotion and screening
- medical gynaecology
- ultrasound
- youth clinics
- sexual abuse/sexual assault
In summary, a consultant in sexual and reproductive health (formerly known as community gynaecology) is a clinician, manager, public health doctor and educator. The non-clinical roles resume greater importance than in a typical hospital speciality and make this a challenging and rewarding speciality in which to work.
There are currently about eighty consultants in the UK and a significant expansion is expected.
Alison Bigrigg, consultant in sexual and reproductive health, Glasgow
studentBMJ 2004;12:309-348 September ISSN 0966-6494
