The English Doctor

The book describes what goes on behind the scenes in undergraduate and postgraduate medical education, scientific research and general medical practice in the United Kingdom. It covers the years 1945 to 2012 and is an account of a unique medical journey.The author was brought up by parents who were general practitioners in Yorkshire. His upbringing was thoroughly middle class and his observations of his parents work and lifestyle resulted in his wanting to be a doctor.Medical student life at University College London was hard work. Several of his teachers were eminent and world famous. Two of them were Professors J Z Young (anatomy) and Andrew Huxley (Physiology and Nobel Prize winner). Life-long friendships were made with fellow students who worked together dissecting a human body. Experiments were performed on one another. The social life in the 1960s of a group of medical student friends is described.Studying octopuses and squid in Naples, Italy. Was part of an extra degree course which was undertaken before starting hospital clinical studies? These were at The London Hospital, Whitechapel, in the east end of London. There was so much to learn before being allowed to practice as a doctor.Clinical studies were undertaken at The London Hospital, Whitechapel. This is one of the oldest hospitals in the UK. There is a huge learning curve which resulted in a doctor just about able to deal with patients.A year of pre-registration work started on the medical wards at Mile End Hospital followed by a period in the Receiving Room (Accident and Emergency Department) at The London Hospital.The pre-registration house jobs sometimes involved working 100 hours a week. Nights in the accident emergency department were manned by one pre-registration house officer and a nurse.There is a description of what is involved undertaking research to PhD level in physiology. A new clinical thermometer was designed, tested and eventually manufactured and sold by the instrument developer Muirhead Ltd. So soon after being a student, the wheels had turned and the author was teaching students himself.There is an account of starting work as a General Practitioner in Cheltenham having not seen a single patient for the previous three years. After that he worked for a short time in a London practice and then in Castleford, West Yorkshire from 1978 to 2005. He and his wife build the practice up from a zero base to a thriving training practice housed in a large modern clinic. Doing this was financially risky as well as stressful.The development of postgraduate general practice education in Yorkshire in the last two decades of the twentieth century is described. There are descriptions of becoming a trainer of prospective GPs and then organising and managing trainers. The role of a GP tutor in the education of GPs was undertaken as a specific job.Work on the assessment of the competence of trainee GPs was overseen in the Yorkshire Deanery, based in Leeds, West Yorkshire. Work on the monitoring of the GP contract with the NHS and the GP appraisal scheme was undertaken by NHS Wakefield district, a Primary Care Trust. The author worked for both these bodies and what was involved in GP appraisal and inspection of practices target achievements is examined in detail.Work with ill and underperforming general practitioners is described as well as mentoring GPs with problems and worries.Very few patient problems and cases are included in this book which rather tells of the work that went on in the background. It is that work that produces high quality doctors and also year on year improvement in patient care.The last chapter involved informal interviews in 2012 with people studying and working in the same fields experienced over the years by the author and outlined above. Readers are asked to judge whether the present day situation is an improvement on