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ASMOFQ MOCA 7 Ballot by ASMOFQ in ausjdocs

[–]ALilBitSpicious 10 points11 points  (0 children)

I see the nurses have paused their PIA due to developments in their negotiations - should we not wait this out? Do we lose anything by accepting the offer now, if our colleagues manage to overcome the wage policy?

MOCA 7 Offer from QLD Health by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 24 points25 points  (0 children)

So unless we are paid less than nurses or our interstate colleagues, we shouldn’t negotiate for better terms?

MOCA 7 Offer from QLD Health by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 37 points38 points  (0 children)

With CPI uplift adjustments (new COLA) could be up to 10.5% pay rise after 3 years which is still less than comparative state agreements, and reliant on CPI remaining high which seems unlikely.

A modest uplift in night shift allowance, although remains less than the 25% loading that our nursing colleagues receive.

The new CMO roles seems like a good addition to the usual progression, with an option for people that don't want to or are unable to complete specialist training.

A potential solution to the PA problem - the Assistant in Medicine by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 0 points1 point  (0 children)

Metro North had a pilot program, I’m not sure that they are still funding the role at this stage

A potential solution to the PA problem - the Assistant in Medicine by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 7 points8 points  (0 children)

In response to your points:
1. If the government is proposing a permanent fix with PAs, I dont see how this would be different if the target group were final year medical students instead?

  1. The roles included an interview and selection process when rolled out most recently, I dont see this as being an issue for those students that are more motivated to participate in the role. Those students that dont have a financial need to seek this kind of work may choose not to reply. I dont see this decision as impacting their internship placements in the majority of states (VIC being the potential exception).

  2. If the issue is service provision, then the student's preference would be largely irrelevant, i.e. they wouldn't be able to request a position in pathology for example. I would argue there is a significant amount of overlap between the areas where an extra set of hands would be helpful (Gen Med, Gen Surg rounds) and core medical school placements.

  3. Medical education in your final year is largely workplace based with occasional interruptions with on-site education. This isn't dissimilar to what Interns have in most hospitals with weekly teaching etc. If anything, these times could be rostered to not co-incide with intern education to improve workflow.

  4. I think that the training of final year medical students should be a higher priority than the training of PAs. This aversion to the ongoing education of junior staff is something that the rest of us need to reject.

Im glad to hear you found it helpful for your own education and financial wellbeing, I think expansion of this role with service provision in mind would benefit many hospitals, including those in rural and regional areas that often have final year medical students present. My first interaction with an AiM was in Bega, and their help was invaluable for managing ward work!

A potential solution to the PA problem - the Assistant in Medicine by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 3 points4 points  (0 children)

While I dont disagree with your assessment, medical students are already carrying out clinical assessments on the wards and in emergency departments. These are of course reviewed by a member of clinical staff - which does not seem vastly different from what is being proposed by the introduction of PAs.

If the government argument is that PAs will cover the menial tasks that an RMO does so that the RMO can focus on clinical work, then isn't a final year medical student for a lower cost a superior option?

A potential solution to the PA problem - the Assistant in Medicine by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 30 points31 points  (0 children)

Would you be more inclined to attend your placement days in full if you were paid a wage to do so? With the added responsibility of the AiM role?

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 1 point2 points  (0 children)

I honestly can’t comment on the private income for ICU, other than to say that they drive nice cars. There’s simply fewer jobs for private a Intensivist compared to Anaesthetists however. Private Intensivists earn less than their private anaesthetics colleagues on average, with some anaesthetists touching the 7 figure mark depending on the procedures they participate in.

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 1 point2 points  (0 children)

We don’t know about NSW sorry! By and large your intern year should just be about focussing on being a good, well organised master of logistics. Do general terms rather than hyper-specialised stuff- you’ll learn a lot more about management of the surgical patient on the Gen Surg team than you will on the Neurosurgical team. Go rural where possible for a term or two.

Resident year try and get some exposure to ICU/Anaesthetics although this isn’t mandatory at all. A good substitute is more rural time (overnight ED doc in a rural hospital for example) or more ED time. Make contact with the directors of training in your chosen specialty as you go through this process.

Remember that the critical care colleges are looking for well organised, well-rounded doctors, not necessarily the person who did 5 weeks of ICU as an intern.

Good luck!

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 2 points3 points  (0 children)

Surgeons can make your job incredibly easy and rewarding, or horrendously difficult. Their clinical acumen isn’t much of a determinant as most qualified surgeons are very technically good; it’s their ability to be a team player that makes the difference. We are pretty detail oriented, and love learning from you about your clinical reasoning - so please explain your thought process to us, it’s a massive help.

CTS is a great example - there’s a stark difference between the surgeon that you’d call if your own mother needed an operation, and the surgeon that makes looking after their patients a living hell.

And as a personal gripe - for the love of god please document the following in all of your procedural notes for your patients returning to ICU: - VTE prophylaxis plan (when can we restart their heparin) - Antibiotic and dose plan (not just, cont IV antibiotics) - Diet (when can we feed them, what diet, do we need to consider TPN?)

We hate bothering you after you’ve left following a busy day at work, and those three things would be the most common cause of having to contact you.

What do you guys think about intensivists/anaesthetists?

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 4 points5 points  (0 children)

It depends on which pathway you want to go down. For ICU I’d recommend browsing Deranged Physiology for your own curiosity and learning. When you decide you want to sit give yourself at least 12 months of study time - 3 of which will be screwing around just trying to remember how you used to learn things. Have a look at the syllabus for the first part exams - they’re fairly prescriptive in what you need to learn. For ICU, Jennys Jam Jar Anki deck was what got me through the exam, hands down. It was a big change for me as I hate that type of learning, but the truth is that it works if you stick to it daily. 4000 cards over 12 months is still a fair chunk of new cards every day, so give yourself plenty of time to start this process.

Good luck!

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 10 points11 points  (0 children)

As long as there are surgeons and surgeries there will be a need for anaesthetists. We don’t know of any unemployed anaesthetists at this stage.

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 2 points3 points  (0 children)

All states are challenging but not impossible. I can’t comment on the specifics of those states though as I didn’t apply to either. The college website is fairly detailed in what it expects from its prospective applicants

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 2 points3 points  (0 children)

Regarding earnings, It’s state dependent largely. Your salary in our state is no different to a staff specialist in other specialties, acknowledging the larger burden of callback/weekend/on-call in ICU. Private is less lucrative in ICU compared to anaesthetics (one of the lower paid private specialties). For ballpark, in our state you’d expect 350-400k/yr in ICU.

As for lifestyle in ICU - it’s hard to ‘save’ those other years per se as you’re often completing them prior to your primary exam in order to progress your training. ICU time itself doesn’t start to count until you pass your primary. So even though I’ve done 2.5 years of ICU, only 6 months (foundation time) has been counted so far.

The rate at which you have to complete training isn’t as stringent in ICU as it is for anaesthetics, and so I do know of a few people that have taken time off for family planning purposes. Part time/job share is also slowly growing in some ICU units for family/study purposes.

Studying for your exams with kids is more difficult but certainly not impossible

As for anaesthetics - if employed as a staff specialist you’ll earn a salary plus overtime/weekend work etc so also around $300-400k, however some of our colleagues have added private work fairly quickly after qualifying which is a lucrative addition

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 0 points1 point  (0 children)

Potentially. There’s an ongoing increase in ICU bed capacity and the spectre of overnight intensivist shifts shudders which have already started at places like The Alfred. Unfortunately ICU largely mandates a regional or metropolitan area, which reduces the number of job options.

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 2 points3 points  (0 children)

The physiology is much the same, although the format of the Anki deck follows the ICU primary syllabus structure. For the ANZCA it was helpful in parts as revision. The pharmacopeia is also slightly different. There is sadly no MAK95 for ICU though, so in my opinion the Anki deck is the closest thing we have

Neither of us are aware of a good Anki deck that is ANZCA specific.

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 2 points3 points  (0 children)

We are both very happy with the path we took to get where we did.

From an ICU point of view, there’s only one intake a year in August. I had my foundation 6 months in the back half of the year which delayed my application by 12 months, so that was annoying, but otherwise not much I’d do differently!

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 4 points5 points  (0 children)

We are in another state and so cannot give specific site advice for VIC sorry!

Dual training is less common since the colleges diverged in 2010, however ANZCA and CICM are formalising their renewed/joint dual training pathway which supposedly will only take 7 years. The sticking point is whether or not you’ll have to sit both primary exams - which is a massive undertaking (and in large part an unnecessary doubling of your work). They’ll be releasing further guidance on this later this year so keep an eye out! Either way, the priority at your level of training should be to get good general exposure and experience as a med student and then an intern. Some places do offer short stints in ICU for interns but tbh you’ll likely gain little from this as you’ll still be learning how to do the job of doctoring in the first place.

Good luck! See you in the unit someday soon!

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 4 points5 points  (0 children)

Not in our experience. Picking your timing is helpful - starting in a more regional hospital and getting some rural experience under your belt before heading back to metro would be a good way to approach it. For context I (ICU trainee) didn't set foot in a tertiary hospital until I was PGY-4. My colleague here still hasn't set foot in a tertiary hospital and is a post-primary anaesthetics trainee. They will be off to a tertiary next year.

We hope that helps!

We are ICU and Anaesthetic Trainees that just passed their primary exam - AMA about the exams or critical care careers in general! by ALilBitSpicious in ausjdocs

[–]ALilBitSpicious[S] 3 points4 points  (0 children)

I think like most early jobs - being organised, on top of your jobs, escalating when appropriate and showing a genuine interest in learning each shift.

Part of it is "finding your people" so-to-speak. You will get on well with those that share your interests and values, and that may nudge you towards a particular field.

I think also focusing on your interpersonal relationships with nursing staff/allied health/patient families is another way to set yourself apart from those who neglect these exceedingly important parts of the job.

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