My best man’s wedding!

My best man's wedding. It's been a long time coming! Having known each other for almost as long as Rachel and me, Leonard and Libby finally tied the knot two weeks ago. It was a glorious day. Rachel and I travelled down to Somerset the day before and checked into the inn down the road. It was very nice at the Hood Arms, the staff were friendly and they had a lovely old dog who roamed around the bar. We got up early the next day, and having some hours to kill had a trip down to Kilve beach.

Apparently it's a Site of Specific Scientific Interest, something to do with lots of fossils. We had a lovely walk along the coastal path, and met lots of the local wildlife - butterflies, rabbits, foxes (not trying to eat the rabbits amazingly). We managed to catch site of the house where the wedding was to take place, which looked amazing. The manor house (St. Audries Park) was as impressive close to as it was from afar. Great towers loomed, the walls draped with ivy, and the inside decorated with more oak than in the wood outside! The ceremony was lovely, they married in the Orangery and we had Champagne in the sunshine afterwards.

There was a croquet lawn, which brought the male competetive instincts (including my own). Dinner was delicious, a string quartet played throughout. Trying to film the speeches was a little tricky as we were right at the back, but we still heard Len's Best Man's slip up!

Anyway, the weekend was finished off nicely by visiting our Goddaughter Nicole, and the rest of the family. They really are growing fast! Won't be long until we've got a small person of our own to care for, he/she is due in just over six weeks!

Career problems

When I first started anaesthetics, I was pleased with the idea that I could be an SHO (senior house officer) for a couple of years, then be eligible for the idolised position of the SpR (Specialist registrar), a position that comes with reverance and respect from HOs and SHOs alike. A comfortably secure five year training programme as an SpR, rotating round various hospitals in the region gaining experience would be ideal in my current situation - a new father needs some job security and to know what is coming for the next few years. However, this goal is now looking unobtainable.

This government has brought in so many reforms, and altered the workforce so dramatically, by increasing graduate numbers, by shunning non-EU doctors, and changing the training infrastructure that things no longer are even close to certain. The introduction of MMC (modernising medical careers) and RTT (run through-training) has been rushedThe introduction of MMC (modernising medical careers) and RTT (run through-training) has been rushed. It was designed to push junior doctors through their training faster to increase the number of consultants to the government's target level ASAP. Unfortunately, this desire to acheive targets has meant that junior doctors are unclear on the process they are about to embark on. Myself, I have been told I will be eligible for an ST3 post (the specialist training will be from years ST1 to ST7 or ST5 depending on who you listen to) but how I am to apply for this is uncertain.

My college tutor seems just as in the dark about what I am to do, and cannot help. The bit that really gets me, is that in order to make space for ST3 anaesthetists, the last permanent appointments to the hallowed SpR rotations will be December 2006. I would have been eligible for my SpR job from March 2007, so close!!! No-one at my institution, nor anyone I have spoken to knows what will happen at the end of the first ST3 year, and especially what will happen to all those who successfully complete their 'ST' years. Will they all get consultant jobs? Will they be channelled into cub-consultant grades? What about those who struggle to get passed the competitive entry to 'ST'? The younger ones can have up to two years trying to get into this training scheme, but after that what happens to them? Do they have to retrain as something else? GP? Medicine? Surgery? Will they have to emigrate to the USA/Australia? I feel that there needs to be full transparency in this process, and that the juniors need more information to be comfortable with all these changes to their training.

I'd really like for there to be an information leaflet to be waiting for me on my doorstep from the Royal College when I get home.

The exam’s over!

So! It turns out that life can be pretty demanding on one's time, and I don't have hours on end to play 'top blogger'! I think I last wrote about cramming madly for the Primary FRCA exam, back in April. Good grief, what a roller coaster ride. The exam revision was gruelling on all involved, myself, Rachel, my close family, my friends (OK, so I'm not sure if they didn't secretly enjoy being left alone ;-) ), but all together I hardly saw anyone other than at work, or during weekend viva practice sessions with my buddy Lloyd - yes, not the rabbit.

The longer it has been since the OSCE and viva day the easier I remember it being. No doubt if I'd failed, I'd remember the true horror. My first part to the exam (in London) started at 8.20am, so I had to travel down the day before. I decided it best to travel by train, as anyone knows, parking in central London is a big no-no! Trying to travel light however, I travelled in my super shiny new shoes. Therein lay my first mistake. I arrived in good time at St. Pancras station, and began the hike to my hotel. The first 250yds were OK, but soon after that I realised the sound coming from my feet must be leather on bone, because it certainly didn't feel like I had any heels left! I persevered, and arrived at the Holiday Inn Bloomsbury and was surprised by its smart interior. I hobbled over to the reception and told the lady my name. 'Hmmmm.... Ummmm... Are you sure you have a reservation?' OK, problem number 2. I had somehow managed to book a different Holiday Inn, on the internet, despite having clicked the 'Location/Map' link and making sure I had the right one. 'Oh, no sir, you have booked the Holiday Inn Bloomsbury Kings Cross. My heart sank, I'd just walked from there! She gave me a map and marked the spot where my new destination lay. After checking my pedal pulses and estimating blood loss as acceptable, I decided it prudent to get the Tube back to King's Cross station and walk from there. After more painstaking tiptoeing, and the sun beating down on me like a stranded desert man, I turned the corner before the X on the map. Where's the Holiday Inn? Ummmm... Oh dear, the clever woman has mismarked the map. From my vantage point I can see a Travelodge, and go in for help. 'Yes sir, your hotel is a good 3/4 mile down the road from here'. So I set off again, about to expire from dehydration and anaemia. Finally, the hotel looms down on me, and I check in without the energy to kick off.

Exam day went much more smoothly. My morning breakfast at the hotel was left half eaten, my nerves quivering. I arrived at the Royal College of Anaesthetists and went in. As is customary at medical exams, everyone is dressed well in suits (quite out of character for gasmen) reading textbooks, trying in vain to grasp that last insight into the innards of a laser, or how chest compliance is made up. I met a friendly chap by the name of Steve, who became my bosom buddy for the duration. Lloyd had already been through his OSCE/Vivas on the Monday, passing well, and being Friday he'd had chance to tell me the gruesome reality. He'd had Dr. Colin Pinnock for his Physiology viva - I'd chuckled, he was the main editor for our revision textbook "Fundamentals of Anaesthesia". It served me right, I walked into my Clinical/Physics viva, and the man there said "Good morning, I'm Dr. Pinnock. This other chap is Dr. Nicholas Hirsch." My heart sank, but at least the second viva was going to be from an unknown! It wasn't until after lunch when I spotted another well known textbook that Dr. Hirsch is the second named editor of 'A-Z'. Phew, I thanked whoever is in charge that I never knew!

The OSCE didn't start well either. My first station was an anatomy station, 'Tell me about the anatomy of this plastic sacrum'. Oh dear, I'd given it a cursory glance, but only knew about the bone, not any of the clinical detail surrounding it! It got better however, and as my confidence grew, the stations began to feel more normal, more comfortable. There was enough time to fit in a couple of pints before the results were out. I spotted my candidate number quickly on the pass list, and went over to the 'Winners' circle'. I call it that because those had passed were invited to have a glass of wine and a pat on the back with the examiners. It felt awkward to leave the sobbing failed, and be singled out for congratulations with the others. Luckily Steve, myself and the others from the pub had all passed. Thankfully, the alcohol numbed the still aching pains from my feet and I stumbled home via the station. I'm now in the process of tutoring the next batch of hopefuls from my hospital before the millions of minute details fall out of my head. Good luck everyone!