Helen Salisbury: Experts at the front door

While doctors in training were on strike last week, consultants and GPs did their best to cover their work and keep patients safe. Some hospitals were quieter, and although this was mostly due to elective activity being scaled back, it was also because senior decision makers were at the front door.Medical students and junior doctors spend many years learning to do more and more, whereas higher postgraduate training could be described as learning to do less but with confidence. Experience enables doctors to base more of their decisions on symptoms and examination findings: they order fewer tests and can reassure more patients without lengthy investigations or admission to hospital.1 A major part of medical training is encouraging learners to think critically about their differential diagnoses—what they really suspect might be going on and what unlikely but dangerous possibilities need to be excluded.Learners are encouraged to whittle down their investigations to…
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