10 days to PACES....

I have ten days until my PACES (Practical Assessment of Clinical Examination Skills) exam. I am scared. It will be very embarassing. Not because I'm a crap doctor, and not because I haven't worked hard. I am a good doctor. I get on well with my patients. I have good clinical skills and I have done a lot of work. I have invested more money in this exam than I have in any one thing before (exam fee, courses, hotels for courses, travel to courses, books). It's just that so much of this exam depends on lady luck. She has been good to me in the past, but she tends to abandon people on PACES day for some reason.

I should be studying now but I feel too wired. All I want to do is chain-smoke and play 'Spider Solitaire' - I keep getting into a cycle of 'I'll stop playing and do some revision when I win a game', but then inevitably I lose game after game and suddenly it's 1am and I have to be at work at 8am and oh dear it's too late to study now and I'm tired anyway never mind....

One thing that pisses me off is that this exam will be scrapped within the next few years, presumably to be replaced by some kind of super 'mini-CEX' and 'DOPS' extravaganza thanks to the fuckers in charge of 'Mangling Medical Careers'. I finished my application form last week to MTAS (AKA pick a random doctor's name out from a hat, give them a job anywhere between 5 and 5000 miles of the one they applied for and hope they can speak English) (I couldn't think of anything clever starting with M, T, A and S). The application form was basically like a submission to a creative writing competition, except 1st prize is a job (just a job, anywhere - if it happens to be several hundred miles from your house, who cares, it's a job! Be thankful to Mrs Hewitt, boys and girls).

For the uninitiated (you lucky bastards), MTAS is the new application 'service' for doctors. From the newly qualified to the nearly-Consultant, from now on ALL doctors in the UK can only apply for jobs once a year - that is every single doctor and every single doctor's job in the UK. You can apply for up to four different specialties - which it encourages, to 'maximise the chance of success'. Never mind the fact that you want to be a cardiologist and you end up working as a dermatologist - hey, you got a job and therefore MTAS is a success. Or, if you really want to be a cardiologist, you can apply to up to four areas (or 'units of application'). Never mind if you live in Devon, you should 'maximise your chances' and apply to areas as diverse as London, Kent, Surrey and Sussex (ALL one single unit of application), Eastern (AKA Norfolk), West Midlands (AKA Birmingham) and Wessex (AKA Southampton and Portsmouth). Bad luck if you're Scottish - the WHOLE of Scotland, from the northernmost Scottish Isles down to Edinburgh, is ONE unit of application. So theoretically you could apply when living on the Scottish/English border and end up in Wick. And remember you must MAXIMISE those chances, so you should also apply to the whole of the north of England (one unit), Yorkshire (one unit) and, oh I don't know, how about Mersey as well? If you really just want to be a cardiologist.

God I am so pissed off with this steaming pile of horseshit. I love my job. I love being a doctor. I think I'm quite good at it now. I just don't know if I can put up with being treated like a child by the Government, condemned by the press and bullied by managers.

Fuck it. I'm going to play some Spider.