Abstract
What is the future of medical training? After the disruptions of a pandemic, one of the major pressure points is the medical workforce. The considerable challenge of clearing waiting lists and restoring services is easy enough to talk about but hard to address. First is the scale of the challenge itself, of delayed operations and missed follow-ups. Second is the daunting prospect of asking overworked staff to give more. Third is the struggle to retain people who no longer see medicine as a desirable career. All this on a background of doing things differently, and promised NHS reforms.
Throughout these developments, young people have seen their lives transformed and their voices silenced. This month, doctors in training tell us what lessons should be learnt and how specialties can adapt. 1 Already, careers are being disrupted with trainees powerless pawns in the game of post-COVID-19 workforce management.
When doctors are short in supply or undertrained, the burden falls on colleagues within a healthcare team. Nursing has experienced its own pressures in the last 18 months, but the role of nurses continues to evolve and can evolve further. 2020 was meant to be the Year of the Nurse, before Sars-CoV-2 intervened. Philip Darbyshire and David Thompson explain why 2021 can be that year instead. 2
Twenty Twenty One also sees the return of full capacity live events after a year of near silence. Theatres are reopening, concerts are rebooking and football crowds returned for the final round of league fixtures. But with variants emerging and risks of transmission at indoor gatherings, Matthew Harris and colleagues offer advice on how venues should reopen safely. 3
Vaccination is one plank of any strategy to reopen society. Vaccine hesitancy can quickly descend into an undesirable blame game towards marginalised communities and ethnic minorities, both of whom struggle to make their voices heard. Mohammad Razai et al. propose the ‘5 Cs’ of vaccine hesitancy, to help think through a complex public health problem that is ripe for stigma and political blunders. 4 Another plank is port health, or border controls, to limit introduction of new variants, although the silence of policy makers in response to calls for stricter border controls suggests that lessons from the past are not being learnt, such as from the Liverpool influenza epidemic of 1950. 5
Meanwhile, clinical matters unrelated to COVID-19 continue to struggle in COVID’s attention economy, but this month’s research paper brings some good news: active community management of people with type-2 diabetes does reduce emergency hospital admissions. 6 Good news is rare in medical journals but the voices of trainees must not be.