02 FYi


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Welcome News


WORKING CLASS STILL


MINORITY IN MEDICINE ONLY four per cent of doctors are from working class origins, according to a new report from the Social Mobility Commission. Despite efforts to change the social make-up of the professions, the


Welcome to your FYi


DOCTORS have a privileged position in society and patients trust us not to abuse that position. Key to that is maintaining appropriate professional boundaries - but the right course of action isn’t always clear. My article on page 12 looks at prescribing requests from friends, personal relationships with patients and Facebook friend requests. Do you know what it takes to


be a “good doctor”? Our article on page 4 offers a useful overview of the GMC’s professional guidance for trainees. Making the transition from F1 to F2 brings lots of new responsibilities. Read the latest advice from the UKFPO on page 5. The way doctors consent


patients for treatment changed subtly but significantly last year. Find out what this means in practice on page 7. All doctors have to do it – but what exactly


does reflective practice entail? MDDUS medical adviser Dr Greg Dollman provides some insight on page 6. Women currently make up


just over 10 per cent of consultant surgeons in England – but one initiative is hoping to change all that. On page 10 Miss Nicola Stobbs talks more about the Women in Surgery programme and the challenges of working in a “man’s world”. With cancer diagnoses


continuing to rise, the demand for specialists in the field of histopathology is sure to increase. Our article on page 8 takes a closer look at the career opportunities in this fascinating specialty.


And finally, our case study on


page 14 highlights the case of an infected wound following knee surgery.


• Dr Naeem Nazem Editor


report found people from poorer backgrounds were largely locked out. While medicine fared the worst, the legal profession wasn’t far behind with only six per cent of barristers from working class origins and 11 per cent of journalists. The State of the Nation 2016 – Social Mobility in Great Britain report


noted that, despite initiatives to improve attainment in schools, “the link between social demography and educational destiny has not been broken: over the last five years 1.2 million 16-year-olds – disproportionately from low-income homes – have left school without five good GCSEs.” Only five per cent of children eligible for free school meals gained five A grades at GCSE. The income gap, the report said, is larger than either the ethnicity gap or the gender gap in schools. A child living in one of England’s most disadvantaged areas is 27 times more likely to go to an inadequate school than a child living in one of the least disadvantaged. Medicine remained “one of the most inaccessible professions,” said


the report, with “80 per cent of medical school applicants coming from around only 20 per cent of schools, the majority of which were independent or grammar schools.” The report also pointed out that there wasn’t a single applicant for medical school from half of all the sixth forms in England between 2009 and 2011.


NEW GUIDANCE EDITOR:


Dr Naeem Nazem MBChB BSc (Hons) MRCP LLB (Hons)


ASSOCIATE EDITORS: Joanne Curran Jim Killgore


DESIGN: Connect Communications www.connectmedia.cc


PRINT: Printwell www.printwell-ltd.co.uk


CORRESPONDENCE: FYi Editor MDDUS Mackintosh House 120 Blythswood Street Glasgow G2 4EA


t: e: 0333 043 4444 jcurran@mddus.com w: www.mddus.com


ON SURGICAL CONSENT NHS trusts face a dramatic increase in litigation payouts if they do not make changes in patient consent processes prior to surgery, warns the Royal College of Surgeons of England. The College believes clarification is needed in the understanding of


patient consent in light of the 2015 landmark judgment given in the Supreme Court case of Montgomery v Lanarkshire Health Board. It’s published new guidance to help doctors and surgeons understand the shift in the law and its implications, as well as give them tools to assist in improving their practice. The NHS Litigation Authority (NHSLA) paid out over £1.4 billion in claims on behalf of NHS trusts in England during 2015/2016 and the RCS is concerned that this bill could go up significantly if hospitals do not take the Montgomery ruling seriously. The Montgomery ruling set a legal precedent clarifying how the


FYi is published by The Medical and Dental Defence Union of Scotland, Registered in Scotland No 5093 at Mackintosh House, 120 Blythswood Street, Glasgow G2 4EA. The MDDUS is not an insurance company. All the benefits of membership of MDDUS are discretionary as set out in the Articles of Association. The opinions, beliefs and viewpoints expressed by the various authors in FYi are those of the authors alone and do not necessarily reflect the opinions or policies of the Medical and Dental Defence Union of Scotland.


courts should view the consenting process. The court held that patients must now be made aware of any and all risks that they – not the doctor – might consider significant. Doctors can no longer be the sole arbiter in determining what risks are material to the patient.


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