education and quacilifations

[JohnW2]

Well, actually the original question was:

all I want is a "recognised qualification" to install or work on LV domestic & light industrial. including being able to do PIR and EIC.

It was RF's reply which seemed to get the topic narrowed down to EICRs....

That's very true, but the last umpteen messages in the discussion have been about the EICR issue.

.... which is a shame, because I think his general sentiment applies to the full scope of the original question.

I partially agree - but the generality of what I've been saying remains. Whatever the minimum amount of training and experience one feels a person needs before they can reasonably work as an electrician, I think that they need to have a lot more experience than that before they are trusted as an 'inspector'.. That works in all fields - my father was trusted as an aircraft fitter and draftsman for years before he became an inspector.

A 5-day, or a 1-evening-a-week-for-10-weeks, course does not provide adequate training to do design & construction in domestic environments, let alone anything else. Nor does the full C&G route, because you still need experience to do the job properly.

I would hope that there wouldn't be any disagreement about that - but I fear some might try!

There are two ways to gain that. One is working for and with other electricians who supervise and mentor you, come to your rescue when you get stuck, and so on. The other is to practise on your paying customers and to use internet fora when you get stuck. ... I know which I think is the more responsible course, and which is the one householders should look for when choosing an electrician.

Indeed ... and, given the OP's delectation for 'doctor analogies', I wwould repeat what I said that night that all sub-Consultant-grade hospital doctor posts are categorised as 'training posts', with a Consulrant 'boss'on hand to do that supervision/mentoring/rescuing (and, indeed, bearing a lot of the ultimate responsibility).

Kind Regards, John

 

[stillp]

all sub-Consultant-grade hospital doctor posts are categorised as 'training posts', with a Consulrant 'boss'on hand to do that supervision/mentoring/rescuing (and, indeed, bearing a lot of the ultimate responsibility).

Unfortunately, "on hand" can mean 50 miles away but available on the phone.
I know someone who as a junior doctor was the only surgeon present in a fairly large hospital when 4 patients were brought in from an RTA with life-critical injuries. 2 died, one was left with life-changing impairments.

Sorry for the 'off-topic' comment.

 

[JohnW2]

all sub-Consultant-grade hospital doctor posts are categorised as 'training posts', with a Consulrant 'boss'on hand to do that supervision/mentoring/rescuing (and, indeed, bearing a lot of the ultimate responsibility).

Unfortunately, "on hand" can mean 50 miles away but available on the phone. I know someone who as a junior doctor was the only surgeon present in a fairly large hospital when 4 patients were brought in from an RTA with life-critical injuries. 2 died, one was left with life-changing impairments.

That's very true, although that situation has changed a lot (for the better) over the last few decades. Particularly in the context you mention, UK trauma care has changed dramatically in the last 30-40 years. Back then, there were no 'senior junior doctors' in A&E departments - all you would have found would have been one or three very junior doctors (usually only one at night), and the 'A&E Consultant' (usually one of the hospital's orthopadic surgeons) was often someone who had virtually no involvement or presence in the department. Now, we have proper US-style 'trauma teams', and a 'career structure' (i.e. there are now mid-range, as well as very junir, doctors) with senior (and 'trained') staff physically present 24/7.

More generally, the truly dramatic reduction in the number of hours worked by 'junior' hospital doctors (partially by EU edict) over that period means that Consultants are now very much more physically involved, particularly 'out of hours'.

Kind Regards, John

 

[stillp]

The incident I described was around 12 years ago.

 

[JohnW2]

(I'm not sure one gets much more off-tpic than this!)...

The incident I described was around 12 years ago.

I didn't claim that the problem had been solved, merely that it has improved a lot during my adult life.

There's probably never going to be a complete (and practical) solution for the sort of (rare) situation you describe. If the situation was that four patients, all requiring immediate surgery presented at night, then that would have required the immediate availability of 8-12 doctors (including 4 anaesthetists) and probably a similar number of (theatre and anaesthetic) nurses. Since such an event is extremely rare in most hospitals, if one wanted such staff on-site 24/7 'just in case', that would be ~20 people who would be being paid for 'twiddling their thumbs' for most of the time.

This is, of course, an argument used for 'centralising' trauma services - but the sting in the tail of that is the highly undesirable consequence of increasing the transport time for many/most patients.

Kind Regards, John

 

[stillp]

Yes, I know the situation has 'improved', partly by the merging/closure of various A & E departments. The real problem in the event I described was that the junior doctor, in spite of his relatively limited experience, had to make the decisions about which patients received the benefit of the limited resources available. Of course he couldn't save all 4, but he was left for a long time worrying whether he'd made the right choice of which ones to save. having the consultant 'on'hand' rather than 'on call' might or might not have made a difference to the outcome, but would have made a huge difference to the junior's stress levels.

 

[JohnW2]

Yes, I know the situation has 'improved', partly by the merging/closure of various A & E departments. The real problem in the event I described was that the junior doctor, in spite of his relatively limited experience, had to make the decisions about which patients received the benefit of the limited resources available. Of course he couldn't save all 4, but he was left for a long time worrying whether he'd made the right choice of which ones to save. having the consultant 'on'hand' rather than 'on call' might or might not have made a difference to the outcome, but would have made a huge difference to the junior's stress levels.

Yes, I agree. As I said, things have improved a lot, but obviously not as much as one would like. In terms of A&E, it's not so much the merging/closing etc., but that there is now a career structure in Emergency Medicine, with doctors at all levels, including Consultants all existing and having very-much hands-on roles (often 24/7). The 'old system' was ridiculous. Apart from a notional 'Consultant in Charge' (who usually had no operational role in the department at all), the only doctors in A&E were at the lowest possible level - then called Senior House Officers, often starting just one year after qualification (and 0 years after achieving 'full registration'!), often doing the job whilst studying for higher qualifications (A&E was the one and only junior hospital doctor post which has 'shifts' and ~40h week, when everyone else was working 80h+). In terms of 'serious' cases (as opposed to 'scratched fingers'!), the role of such a person was essentially just one of providing immediate basic supportive care and 'triage', referring patients on to appropriate (and more senior) specialists, such as surgeons.

Kind Regards, John

 

[ban-all-sheds]

You mean it's not like it is on Monroe?

 

[JohnW2]

You mean it's not like it is on Monroe?

Can't say I've ever seen it, so wouldn't know! We certainly haven't got to the 'ER' stage yet (although I gather that it's fairly realistic in terms of what US ERs are like!). Ignore 'Casualty' (and 'Holby City') There are plenty of documentaries around these days about present-day UK A&E depts - although they are obviously highly edited (since 95% of the time in most such departments is 'boring bread and butter', which would make dreadful TV!), I presume they represent a reasonable reflection of how things are now in large A&E Depts in the UK.

Kind Regards, John

 

[stillp]

(A&E was the one and only junior hospital doctor post which has 'shifts' and ~40h week, when everyone else was working 80h+).

That might have been the theory. In practice the junior doctor concerned had already worked over 80 hours in A & E before the incident I described.

 

[ban-all-sheds]

Can't say I've ever seen it, so wouldn't know!

You should try and catch it on the ITV website - it's quite entertaining, even if hokum. James Nesbitt plays a caustic, swashbuckling, dysfunctional consultant neurosurgeon, there's a repressed emotionless super-rational female cardiac consultant, struggling trainees, newly appointed pompous arrogant registrars...

 

[JohnW2]

(A&E was the one and only junior hospital doctor post which has 'shifts' and ~40h week, when everyone else was working 80h+).

That might have been the theory. In practice the junior doctor concerned had already worked over 80 hours in A & E before the incident I described.

To be clear, I was talking about A&E doctors ('Casualty Officers' in old-speak), who have for several decades been pretty unique in having fixed-hours shifts. OK, so there are times when a department gets very busy (or some staff are 'missing') when they have to work beyond their shifts, but that is relatively minor. I got the impression that the doctor you were describing was a junior surgeon, not an 'A&E doctor'. Whilst the EU is still trying to impose much shorter working hours for all doctors, it is not yet remotely practical for most hospital doctors who often still work very long hours, whatever their contracts may say!

I'm sufficiently long in the tooth to remember when the contracted 'standard working hours' for hospital junior doctors (beyond which hours one could theoretically apply for 'overtime' pay - although no-one did because the old-school Consultants, who had to approve overtime claims {and wrote references}, didn't approve!) was reduced from 120 hours per week to 80 hours per week! Just to remind you, there are 168 hours in a week!

Kind Regards, John

 

[JohnW2]

Can't say I've ever seen it, so wouldn't know!

You should try and catch it on the ITV website - it's quite entertaining, even if hokum. James Nesbitt plays a caustic, swashbuckling, dysfunctional consultant neurosurgeon, there's a repressed emotionless super-rational female cardiac consultant, struggling trainees, newly appointed pompous arrogant registrars...

Yes, I've heard about it, but for some reason have never got around to seeing this particular one. I'll have a look when I have a moment or three!

Kind Regards, John