Healthcare systems and training programmes vary significantly across the world. By learning about other healthcare systems, we can identify blind spots in our own system and continue to improve training. Working in two different healthcare systems is definitely a challenge and presents a lot of advantages and disadvantages. Even among Western countries, healthcare systems seem to differ a lot regarding their priorities, principles, guidelines and funding.
Having worked as an ear, nose and throat registrar in both Greece and in the UK has left me with the impression that no healthcare system is perfect, and that the two countries have different strengths and struggles.
First, working in Greece as an ENT registrar involves a multifactorial role, being simultaneously the ward doctor, the outpatient doctor, the theatre doctor, and the all-I-can-do doctor. This means that all members of the ENT team share equal rights on all sectors of the specialty regardless of the stage of their training. This essentially qualifies them quickly with exposure to a great variety of subjects, including how to deal with emergencies and how to acquire basic surgical skills.
However, the stress that rushes in on the first on-call night is undeniable, since there is no difference in their duties compared to a finishing ENT registrar. On the other hand, the UK training system separates the trainees into core surgical trainees, junior registrars and senior registrars that all have different grades of roles and responsibilities as well as different benchmarks to achieve to proceed with their next step of training.
This is helpful to diffuse stress and to make clearer what is needed to progress as an ENT doctor. It also prevents highflyers from finishing too early for their skill level, ensuring that by the end of the training programme, the surgeon is safe and competent.
