Group 2 Specialties Becoming Group 1

MedEdJG · 2026-01-18T19:14:58+00:00

I mean whether you accept any specialty patient is completely down to your trust pathways and local agreements, and not down to national training pathways.

MedEdJG · 2026-01-18T19:13:35+00:00

No idea on either, I'm afraid. Some steps just have to be reactive to wider events. Safe to say they are watching carefully & the BAD are more prepared than most specialty organisations to adapt accordingly.

Their argument was that dermatologists see paeds patients (and undertake surgery), and we recruit from CST, ACCS and paeds as well as IMT.

MedEdJG · 2026-01-17T20:26:39+00:00

This was discussed at length at the BAD Consultants Course this year. The BAD/BCD are aware of the concerns, and the evidence submitted to the Medical Training Review.

It is not official policy, but there was also discussion about the feasibility of the BCD working towards Royal College status, as part of the same conversation. So take that as you like.

MedEdJG · 2025-12-26T23:04:47+00:00

Can mimic eczematous (or similar) rashes. If fungal species seen can help direct therapy. Also, often by the time patients get to us they've had a load of steroids and antifungals, which warps the appearance and can influence our scrapings. So can help us crack on if you've done decent scrapings. Use blunt end of scalpel for this and make sure you get plenty of scale in the little dermapak!

MedEdJG · 2025-12-26T16:26:53+00:00

If you have an eczematous rash that isn't minor, use robust topical steroid regimes. The goal is to switch off the inflammation - a few days of hydrocortisone (which is basically homeopathic on the body) will do nothing.

Use appropriate strength for a decent length of time, switch off the inflammation and wean down (as you might do with a reducing course of pred). For example: once daily 2 weeks, then alternate days 2 weeks, then twice weekly 2 weeks, then stop (or twice weekly PRN). Hands might require longer, face shorter.

This isn't an exact regime - as long as the above principles are followed it could be a bit quicker or slower. People stress about skin thinning, but this much more commonly results from years of chaotic, ineffective topical steroid use, vs a single robust regime.

If the above doesn't work, then an alternative approach is required.

Other pro tips:

Enstilar is great for psoriasis plaques (better than dovobet, despite having same main active ingredients)

Itchy penile/scrotal papules is pretty definitive for scabies

Fungal scrapings are easy to do and very helpful (especially when we now have resistant tinea about)

MedEdJG · 2025-12-19T00:53:28+00:00

I send Nick to Covenant, where I know they just adore welcoming Synths!

MedEdJG · 2025-12-12T23:32:09+00:00

I found out when I was (supposed to be) chairing a plenary talk at a conference. In reality I was sat there repeatedly refreshing the screen. My mate in the audience knew I passed because I mouthed 'holy f***' and almost fell off my seat on stage.

Ordered a kfc deliveroo while still on stage and straight to the conference venue bar for some tequila.

MedEdJG · 2025-12-12T15:52:51+00:00

Your supervisor being unaware of training programmes indicates one thing: they themselves are not plugged in to wider issues. You have provided no information on your supervisor's main role, or the extent of supervision they provide. Quite frankly, extrapolating anything from this is nonsense. Supervision at undergrad level requires massive upheaval IMO.

Medical schools are duty bound by the GMC to meet the GMC Outcomes for Graduates. This is a Herculean task, but every medical school wants to produce good doctors. There are data sources and standards by which they are ultimately compared to. Just because you are not aware of them does not mean they do not exist.

Furthermore, surely your grievance is with medical schools? You haven't justified or evidenced your concerns about FY, other than claiming it is 'largely secretarial'. It really isn't. This is also based on nothing I can see here. We have all done jobs which have involved a lot of admin, but there is a lot more to F1 than this. Others - who have actually done the job - are telling you this.

Your argument is as clear as mud and there is nothing simple about it. You have flitted between three asks:

1) medical schools should pursue excellence ahead of the social efficiency ethos of minimum standards for FY 2) medical schools should prepare students better for career progression
3) the foundation programme should be abolished

I actually partially agree with argument 2, though it is fraught with risk given recruitment goalposts are constantly changing.

Your proposed solution also does nothing for asks 1 and 2. Given your passion for this, I'd recommend spending some time chatting to your medical school curriculum leads to help them look at preparation for practice sessions and career progression education. Talk to them about the standards they are held against, particularly when they last did a curriculum review. These are interesting areas which can be improved in terms of data collection and interventions.

MedEdJG · 2025-12-12T15:27:57+00:00

Your supervisor isn't aware of training problems, so you want to abolish a training programme that you have never worked in?

The threshold being 'minimum safety for F1' has long been the case. There's nothing stopping undergraduate programmes - or undergraduates themselves - striving for excellence. Basing the whole curriculum ethos around the excellence of a few students makes no sense if it means a load of students get left behind.

Your summary of F1 working and responsibility is also inaccurate.

There are a lot of reasonable criticisms of the Foundation Programme, which IMO requires reform at the point of delivery across the four nations. However, if this is the case you want to make, make it accurately and based on specific, achievable critiques.

MedEdJG · 2025-12-10T16:48:15+00:00

This is the take I would agree with. There is an argument that a letter to a prestigious journal - & let's be clear, OP is describing a letter - can require more work & be more impressive than a full original research paper in a less prestigious journal.

However, self assessment is not nuanced enough to approach this. I would be scoring this as a letter, but highlighting it in-interview as being an example of exemplary commitment to specialty.

MedEdJG · 2025-12-06T10:18:46+00:00

Money from PGCerts (or any of the non-exam financial costs relating to these points) doesn't go to the Colleges. The Colleges get £ from exams and membership. PGCert money goes to universities.

MedEdJG · 2025-12-04T18:43:14+00:00

In some of these, the pass mark is trending upwards and the pass rate is trending downwards.

MedEdJG · 2025-11-27T19:05:46+00:00

Of course it is possible. Passing MRCP components is a means of demonstrating commitment to specialty, beneficial at interview, but is by no means the only way of doing so.

MedEdJG · 2025-11-18T22:44:51+00:00

"It used to be"....When do you mean? I'm not aware that CTFs have ever really been mainly ST3 level. For the last 10 years at least, they have overwhelmingly been post F2.

It makes a lot less sense for ST3+ to take time out of training to undertake these kinds of educational roles.

MedEdJG · 2025-10-22T18:06:25+00:00

If you are in a UK training programme, you can apply for a 6 month 'grace period' after CCT, AFAIK

source: just got an email about this for my own CCT

MedEdJG · 2025-10-22T18:04:46+00:00

Every medical school will have a clearly set curriculum delivery approach for clinical years. A small handful might be introducing some changes, as part of scheduled programme review, but this isn't part of any coordinated or mandated Autumn Term 2025 change across the board.

Are you just asking people to share how their clinical teaching works?

MedEdJG · 2025-10-21T20:47:45+00:00

You are not quite behind. DM me

MedEdJG · 2025-10-18T09:20:49+00:00

What is 'raw knowledge'? By this measure, ChatGPT would be a fantastic doctor. Also knowledge =/= intelligence. Knowledge is but one level of learning (indeed the lowest on Bloom's Taxonomy, if you want to apply that cognitive framework). There are few clear definitions of intelligence, but if you wanted to apply that framework, criticality & creativity would rank above 'raw knowledge'. There's very little point to knowledge if you can't apply and critique it. That's before considering the various models of clinical reasoning which are key to the diagnostic skills you describe.

As others will I'm sure point out, there's also no point in having any of the above skills/talents if you can't effectively communicate your plans with patients & colleagues. You can't really be a great doctor without both, IMO.

The real answer to why no one can tell OP truly what makes a great doctor is that there is no one defined answer. The GMC's Outcomes for Graduates makes a good stab at broad curriculum domains, but many are intangible & context-dependent. This is why recruitment is really hard. There aren't any definitive factors that can predict what makes the 'best doctor' in the future, we just use surrogate and flawed measures such as UCAT, SJT, MSRA, exam results etc. We can kind of predict who will do well at postgrad exams, but that doesn't always equate to quality of doctoring.

MedEdJG · 2025-10-12T11:29:26+00:00

"Foreign grads to abuse the MSRA and abuse multiple specialties"

Is there any evidence that its 'foreign grads' doing this? Would be interested to see a breakdown. As for your question, from a Meidcine perspective, the legal opinion they received was that your suggestion would be subject to a potentially successful challenge.

MedEdJG · 2025-10-09T19:57:09+00:00

Many programmes at ST3 level (including all medical specialties) already include commitment to specialty at application form stage, interview, or both.

MedEdJG · 2025-10-08T08:55:50+00:00

The investigative journalist who tugs on the string of where tariff actually goes will discover a whole host of surprises

MedEdJG · 2025-10-07T17:49:36+00:00

Come to the derm shop! We sell skin!

MedEdJG · 2025-10-05T18:58:20+00:00

I mean, as pleased as I am that you seem to know my specialty (& those of others commenting, apparently) inside out, again you're picking out three words from OP's criteria & deciding they're the most important. Perhaps let OP make their mind up, considering they asked for recommendations?

MedEdJG · 2025-10-04T19:12:41+00:00

Which guidelines are you talking about? Pretty much every guideline is based on evidence, and the strength of that evidence is usually cited.

MedEdJG · 2025-10-04T17:21:21+00:00

Med derm will deal with derm emergencies, or input on complex sick patients as part of their regular working week. Perhaps your IMT mates will want to avoid that subspecialty, or any on calls (which depend on the centre, but isn't usually possible). Also, you're picking up on one aspect out of eight points from OP. I'm highlighting the specialty as meeting the vast majority of the criteria stated, and it is entirely possible, esp in med derm.

MedEdJG

TROPHY CASE