Minutes of the meeting of the Warwick Medical School
Intra-School Committee
15th January 2008, 19.00.
Medical Teaching Centre, University of Warwick, CV4 7AL.
In Attendance:
Simon Roughneen – ISC Chair
Dora Hemson – ISC Secretary
James Watson – ISC Representative Yr 1
Tara Craggs ISC Representative Yr 2
Claire Wallace – ISC Representative Yr 3
Seb Morton – ISC Representative Yr 4
Naomi Brown – MSC Representative
Andrew Dawes – SSLC Representative Year 2
Chloe Orton - SSLC Representative Year 3
David Metcalfe - Faculty Representative
Tom Hannan Medsoc - President
Michelle Saunders – MedSin Representative
Peter Ptashko – Education officer & Deputy President (Students Union)
Emma Rivers Fletcher – Staff Representative
Dr Neil Johnson – Director of Short Courses
1. Introduction and Welcome
The Chair thanked members for attending, especially our guest speaker Dr. Neil
Johnson, and the new staff representative Emma Rivers Fletcher.
2. Apologies for absence
Apologies were received from:
James Chambers (SSLC Rep Year 1)
Anna Taylor (SSLC Rep Year 3)
Dan Border (Royal Society of Medicine)
Gwydion Rhys (Phase II Management Rep Year 4)
Neelima Vijapurapu (SSLC Rep Year 4)
Lucy Bownass (SSLC Rep Year 4)
Michelle Jones (Marrow)
Tom O’Connor (Warwick Surgical Society)
Craig Knott (JDC)
3. Previous minutes
The minutes of the ISC meeting held on Tuesday 4th December 2007 were approved.
4. Matters Arising
ACTION NOV 2007 5.2 –JAHD opinion survey Naomi has heard back from
Colette Marshall who says she is open to ideas for making JAHD more appealing to
students. She has suggested that setting up a focus group may be an idea, alongside a
survey to provide detailed student feedback.
Concerning SAHD Seb is awaiting feedback from Alan Pryce Forbes, so when he
does he will contact Naomi, with their suggestions.
ACTION DEC 2007 5.1 Communications regarding Clinical Skills and
newsletter. Simon intends to meet with Kelly Parkes to discuss the mailing list of the
newsletter, as it seems that some people are not on the list. Seb brought up the idea of
including it on the web page newsfeed, he will speak to Stephen Bridges about doing
this.
Simon emailed Sarah Jenks a FEF to clarify what clinical teaching was given to the
Phase I students. He has not heard back fom her, and will try again.
5. Agenda items
5.1 Physician Assistants – Dr Neil Johnson
Dr Neil Johnson presented an oral report of the current status of the Physicians
Assistant Course, between Warwick & Coventry University.
The current idea behind introducing a Physician’s Assistant Course, was triggered
after concerns of NHS provision when the European Working Directive 2009 comes
into effect. The 2009 directive further reduces the maximum working hours from 56
hours per week to 48 hours per week. Historically training grade doctors would cover
antisocial hours, however clearly with the European Directives this is restricted. It is
thought now ‘Hospital at Night’ teams will cover the hospital during these hours. In
addition, it is hoped Physician Assistants will help ease the gap in service provision
created when the European Working Time Directives comes into place in 2009.
The Physician Assistants will work closely to a medical model (opposed to a nurse
based model) as used by the US Physician Assistant. This medical model follows that
they are trained in basic skills such as assessing, forming diagnosis, and a range of
clinical management, all under the supervision, and answerable to the most senior
doctor accountable.
It is thought a newly graduated Physician Assistant will enter at a level equivalent to
F2 and ST1, ST2 training levels. The idea is that they will work in a variety of
locations; General Practice, A&E, Medical Admissions, and Outpatients. Indeed
similar are already in place such as the Anaesthetic Care Practitioners and Nurse
Practitioners.
It is a 2 year course aimed at graduates with 2.1/2.2 degrees in Biological Disciplines.
Currently there has been a small pilot in London, Wolverhampton has started a course
this January for 20 students, and West Midlands Deanery has expressed a keen
interest. University of Birmingham have started a course for 20 people to graduate
2010. University of Warwick and Coventry, have expressed an interest and are still in
early talks.
Why at University of Warwick?
1.
The programme is based on a medical model, so the training is best done
in close proximity to doctors/medical students.
2.
Warwick has much experience in graduate entry.
3.
There is a strong feeling that it will be supportive to the local NHS when
the 2009 Working Directive comes into play.
4.
In 2007 a review was carried out, that suggested there is a small capacity
within clinical placements, to accommodate 14-16 extra students without
disrupting the 2:2 partnership of clinician to students. However, in the
light of the 2007 cohort size this will need to be reviewed.
The progress so far?
There has been interest in the proposal and the University of Warwick & Coventry are
in the middle of discussions with the NHS, they have appointed a course director but
it is ‘not set in stone’.
ISC Questions
1.
It was asked, that with the training shortened to 2 years not 4 years,
what would be expected from the new Physician Assistant? Dr Johnson
stressed that their training would not be to the depth or level of that on
the MBChB, however there is scope that some lectures may be common.
The Physician Assistant will be focussed on a particular role, which they
will train in, then do for the rest of their career. For medical students we
are trained in breadth and depth so we may use this as a springboard to
pursue whichever career pathway we choose.
2.
It was asked that with the ST Job crunch; why not give the extra work to
ST jobs not Physician Assistants? Dr Johnson replied that this was
mainly due to financial constraints. He also explained that with the
usual 4 month placements for F2, ST1, ST2 jobs, after settling in for the
first 3-4 weeks, and then the final month doing assessments, there is only
2 months of consistent work. By using Physician Assistants they will
constantly be appointed, providing a more continuous service provision.
This would also have the benefit of allowing the Consultants to devote
more time to the training of their Junior Doctors.
However, there is a problem that hands on experience is lost. In the US
there is approximately 1 Physician Assistant for every 5 practising
doctors. The other suggestion of staggering placement start dates has
proven to be more disruptive.
3.
It was asked whether after 2 years training the Physician Assistant
should enter at a F2 level? Dr. Johnson emphasised they would have a
strictly delineated role, eg. treating Post Operative Fever, TTOs, Fluid
prescription. They will have prescribing rights, and for this will be
personally accountable as junior doctors are, but ultimately under the
supervision of the most senior doctor on their team.
4.
5.
6.
7.
Would it not just delay the time a patient gets to see an actual doctor?
In US it speeds the entry onto a unit and speeds their management.
Similar scenarios are already in place in certain units such as CCU
where thrombolysis can be started without a doctor seeing the patient.
It was asked if the entry levels are the same for the MBChB at Warwick
why would students choose the Physician Assistant Course? Some
people do not want the responsibility of a doctor. They want the
experience of patient care in a differing role to that of nursing, but not of
an advanced carer. In the US it is seen as a clear career choice.
It was asked why the DoH has not involved the BMA in the decisions
about the Physician’s Assistants? Junior Doctors do not feel they have
been involved in the process, and they are worried about the impact this
may have on their ST training. Dr. Johnson thought the DoH felt they
hadn’t needed to consult the BMA, as they had consulted the RCP and
RCGP. In addition, in late 2005 he remembers there was an open
consultation about the topic for 3-4 months. However, this was at the
time that the MTAS and MMC were launched, so he thinks attentions
may have been diverted.
The issue of pay was brought up, as the Birmingham website, stated a
starting salary of £22,500, for the Physician Assistant, which is in excess
of a starting F1 salary. Dr Johnson replied that as yet there was no fixed
salary, so that figure must have been based on estimation. The DoH has
not yet agreed on a payscale, however there are rumours that some
Physician’s Assistants already in jobs have salaries in excess of this,
which Dr. Johnson explained is due to market forces.
The presentation was concluded, with Dr Johnson thanking the ISC for allowing him
the opportunity to speak. He reiterated that he would like medical students to be very
much involved in future proposals and he is more than willing to return if we have
further questions or concerns.
5.2 MSC Conference Motions- Naomi Brown
The ISC members were given a printout of the proposed MSC conference motions,
these were then read for suitability and some editions made. University of Warwick
are submitting 6 motions, which can be found on the MSC web page at
http://www2.warwick.ac.uk/fac/med/study/ugr/mbchb/societies/isc/msc/conference_motions.doc.
The 3 motions that the ISC allocated as priority were:
1.
The impact of Physician Assistants
2.
Independent Status
3.
The removal of funding for second degree students
James Watson and Simon Roughneen will attend the MSC Conference which is being
held at Churchill College, Cambridge 4th-5thApril.
5.3 Car Parking/Car parking permits at UHCW – Simon Roughneen
Simon reported back to the ISC committee the further developments:
1.
Thanks to WMS 30 permits have been agreed and funded through the SIFT
funding for 1 year only. These will be allocated to students working
lates/on-calls/labour week. However, the PGMC at UHCW cannot provide
administration support to issue the permits. Simon is planning to meet with
Mike Glover (school secretary) and Lara McCarthy to try and decide on a
changeover venue, possibly the medical school once every 8 weeks.
2.
The park and ride scheme has been set up, UHCW have negotiated 30
parking spaces at the Cross Point Tescos. It will operate from 7.30 am to
10.15 pm and with a UHCW ID badge the tariff will be half price at 80p.
Gemma Rowan from UHCW has requested that we provide a list of names
of students that are interested in the service. From the online survey, Simon
noted many that expressed interest were Phase I students.
3.
Other options
 UHCW have now allowed in principle to allow bus’ onsite, at bus stops
near the West Wing entrance. Simon had been in talks with Gemma
Rowan that revealed VAT can be claimed back on ‘work buses’. Using
this, UHCW may be able to help with the funding of a bus, that ferries the
Phase I students to UHCW from Campus, for those modules based there.
 Negotiations are being made to allow free travel on service 801
 There have been no advances on the concept of Express bus yet, Simon
was wanting to contact the Green Wing, to see if they would like to pursue
this option.
Naomi said she had heard there was some problems with the 801 service from
campus, that takes both students and patients to UHCW. It had been turning up late,
and on some occasions, had not been able to go all the way to UHCW, dropping
passengers off half way, as it neede to turn back for the next service. Simon was
aware that UHCW have had talks with Travel Coventry to try and improve the
service.
ACTION JAN 2008 5.3- Tara will speak to Green Wing about express bus service
-Simon will report any advances on the parking permit situation
-The park and ride option will be re-presented to students
6. Other business
Monday 21st January 6pm Room 4 there is a meeting to be held in Room 4 of MTC
with Professor Ed. Peile about the timing of ESA 3. Andrew Dawes has extended the
invitation to Seb due to his Welfare position, and members of the ISC with a vested
interest in welfare are welcome to attend. Simon has expressed interest to attend.
They are wishing to bring up the timing of the exam, and the unnecessary stress that
this imposed on the students.
7. Dates of future meetings
The next ISC Meeting will be held on Tuesday 12th February in the Medical Teaching
Centre.
The meeting adjourned at 21:02