mrs. liftman

I have been back in the UK for a month and my e-mails to the LPN College have not been dignified with a reply so far, so I cannot tell you what appears to be 'lacking'. This, following my radio interview, is being addressed.

I have always agreed that I will may not have completely covered the same ground that an LPN has. I MAY need to take some extra courses to come to equivalency, but my argument has always been that I have been denied the chance to even find out what the differences are. The college knew what my course covered, and encouraged me to come and have my documents checked for that self same equivalence. They then "threw out the baby with the bathwater" by giving me a straight no. This has now been retracted by the Executive Registrar, live on radio, and she is taking the matter up with the Dean of the local college next week.

I have never, in any way, claimed to have a nursing qualification. What I do have is an Internationally recognised qualification in Operating Department Practice. A registered and regulated profession in its own right. The college were aware of this fact prior to my vist to them last month, and at that time it was not an issue.

You obviously have little knowledge of nursing models or you could not possibly, as an inteligent human being, claim that 'Nursing ' is exclusive to nurses. (See the Roper Model as an example)

My qualifications are, in relation to theatre work, considered by my trust as on a par with nurses within the Operating Theatre environment, as long as the nurses have completed extra courses.

In my Trust, nurses and ODP's are totally interchangable, provided the nurse has an anaesthetic qualification. I am not merely a technician.

Nurses in the UK have to take a further diploma based qualification to even attempt to act as an anaesthetic assistant. That course incidently is one year long both at college and practical.

With 'Agenda for Change' in the UK, ODP's could, as this is a skill based grading structure, end up earning more than nurses within the theatre complex. Wonder if this is why the nurses are rushing to apply for the anaesthetic courses to bring them up to speed and make them more flexible?

If I am wrong in my facts regarding the equality of qualifications, how come British surgeons and anaesthatists have to re-take the Canadian final exams in order to be 'allowed' to practice, and with restrictions placed on them.

Last time I looked, the proceedure for an appendix was the same whether in China, the UK or Canada. Same goes with anaesthetics.... There are only so many ways to anaesthatise a patient.

I work at a senior 'E' grade level and have the responsibilities that go with that grade. I take charge of my own theatre and the team within it, in fact today we had an all day list that was nurse free. That is not an uncommon event. Thats how 'lacking' my theatre skills are. Nurses in this day and age are totally superfluous within the Operating Theatre complex.

Perhaps you could enlighten this board as to your anaesthetic and surgical experience that gives you the right to state that my qualifications must be lacking?

Incidently, I have a copy of the Registered Nurse exam handbook, not the LPN handbook, and the majority of the questions can be answered with basic common sense and a process of elimination of a MCQ format. In my opinion that format is far too simple. It tests your elimination ability not your knowledge and understanding of medical conditions, treatments, pharmacology or patient groups.

Biiiiink

I blame Austin Powers - British dentists' training must be poor, look at their crooked teeth. And Myers a Canadian too Seriously though, a considerable number of the faculty at Canadian dental schools are British/South African/European, I don't think the influence stopped a long time ago at all.

Whilst North Americans tend to be more interested in cosmetic dentistry, there is no difference in clinical approach to treatment between the two continents. I think the interest in cosmetic work is a reason why the fees your accountant mentions are so high. With sums like that at stake no wonder the system is so protectionist. Irritating thing is until 2000 Mr Biiiiink would have been allowed to take a licensing exam straight off as a UK-qualified dentist. He'd not long finished his finals and was sick of exams and couldn't face another one at the time... If only we'd known.

I feel for patients in places like NWT who are really suffering under this new system - foreign-trained dentists were the only ones willing to go up there and now many have no access to treatment.

It's not the just the fees for the application, assessment and two year course that are a pain (and remember we have to fund these upfront from savings from a NHS dentist's salary which is nowhere near what you say a Canadian earns!), it's the fact that a trained Western dentist (who is moving to Canada because I, his Canadian partner, want to go home) may not even get the chance to get on one of these conversion courses let alone practice dentistry. There simply are not enough places available for people to convert their skills, even if it *is* over 2 years, and at considerable expense.

Mr B could go to Australia/NZ tomorrow and practice without problem. I'm having an almighty job convincing him Canada is the place for us.

Biiiiink

macmike41

[QUOTE=oceanMDX]Then again, when the Brits were setting up dental/medical schools in Canada, to remove a tooth they tied one end of a string to your tooth and the other end to a door.

So at least we started you off on the right track then a a a.



Any British influence over our educational system stopped a very long time ago. Canadian universities and professional schools are heavily influence by the US - not Europe. By the way, where is Europe? Would it be one of Jupiter's moons?

I guess that says a lot for the way you think a a.



I know all the fees are a pain. However, dentists can make a lot of money in Canada. My former accountant told me that he has a client who is a dentist that nets $1.4 million/year! That's after all his expenses have been paid - only income tax must be paid. Lots of dentists make $500,000/year net.

That 'dentist' would have to work 20 hrs a day every day of the week for every week of the year and charge $200/hr and that still wouldnt cover his expenses either - something not quite right there is it a.

Glaswegian

Is probably vastly understated for a dentist in Canada. I was at the dentist yesterday - the bill was $165 - the dentist spent about 20minutes out of an hour with me. The rest of the time I imagine he was doing the same with at least two other patients(I could hear some of it). Forty eight weeks per year at 40hours per week at $600/hr is around $1.1million gross. And thats not a dental specialist. Our children visit a pediatric dentist - the last bill was $350 for two children without any actual treatments - they only spend 5minutes (each) with the dentist and the rest of the time with the hygenist (cleaning, scaling, polishing, fluoride). She has three checkup chairs and three treatment chairs (max) on the go at any time - so between two dentists they are collecting approximately $500/hour just on checkups - treatment costs on top of that. And its never empty in there! And dont even ask about ortho fees!

So all in all I would say $200/hr is way off the mark for a dentist here.

Dentistry is not the same in Canada and the UK. The Canadian dentist is limited by the depth of the patients & insurance company pockets - the UK NHS dentist is limited by what fees/treatments are allowed especially considering many Brits find top up fees unacceptable.

Mrs G

oceanMDX

[QUOTE=macmike41] No, it says everything about the UK's importance to Canada - I'm just being very candid. The simple truth is that Europe is not very important to Canada - and vice versa. We send about 87% of our exports to the US. Canadian professional schools have experts come up from the US to evaluate their programs so that they can be accredited with the US educational standards.


The only thing that's not quite right is your figuring. $200 per hour, are you serious? Even if we assume that a dentist charged you only $200 for sitting in his chair for an hour, during that hour he would likely have worked on 1 or 2 other patients. The amount charged for that hour would be $400 - $600. Plus the dentist makes a fortune off the hygenist(s) working in his office; you have to figure that in too. Then there's big charges for x-rays etc.

Many dentists in Canada work 4 days per week - and they make big money.

oceanMDX

Exactly! Plus they make a fortune off their hygenists. Their incomes are so great because of the private insurance coverage and the dentists really know how to milk it. They often will do a minor thing, but check off a big thing on the insurance form - it's a real scam. However, the fact remains, in Canada dentists can make very serious money. Physicians - even most specialists make a pittance in comparison.

Purley

A long way back in this thread, Mrs. Liftman said:


"I was informed that I had been unsuccessful under section 8(4)(b). This section actually refers to the regulations governing elections of members of the board!"

Perhaps you should apply to be elected as a member of the board and then they might approve you in your real application!

I would have liked to hear the radio interview. Is it recorded anywhere so you can listen later. Some CBC radio shows are.

Iginla

As an intelligent human being with a nursing qualification where did I state that nursing was exclusive to nurses? I appreciate that you are frustrated but personal attacks get you nowhere and only make you look unprofessional. I simply stated that you have no nursing qualifications. It was a simple hard truth. Nursing certifications are for nurses with qualifications.

My nursing experience is 3 years vascular-surgery and 6 years ICU whatever that has to do with anything. If I was a nursery nurse I still would be able to deduce from this thread that you have no nursing qualifications which is a pre-requisite to sit the exam.

What I don't understand is why your internationally recognised qualification isn't being recognised internationally. Have you spoken to your association about this? Does Canada not recognise this?

Actually I'm guessing you might find some differences in operating practices over here. e.g. drug names and doses. Penicillin here is measured in iu not mg. Minor differences, nevertheless differences.

Thanks very much for your thoughts on the RN exam. Nobody is disagreeing with you there and I already mentioned this fact in another thread (see nursing Alberta). What you have glaringly overlooked however is that in order to be eligible to sit the exam you have to be a graduate nurse. In order to qualify as a graduate nurse you have to have a degree or diploma which (amongst other things) consists of separate examinations which tests "knowledge and understanding of medical conditions, treatments, pharmacology or patient groups" amongst other things. Interesting that now you are finding fault with the RN evaluation system over here as well.

I apologise if you interpreted my earlier post as a personal attack. I was simply pointing out some hard facts and believe that it was done in a non-rude way. I (believe it or not) do wish you luck in your endeavours.

I would be very interested to hear your radio chat or at least read a transcript of the conversation.

Biiiiink

It's the fact that university education is/was free that matters, not who exports what - you can't have folks who get a "free" education coming over and taking jobs from those who have paid through the nose for it. Hence the great protection of Canadian/US dentists.

I think everyone's forgetting how the business of dentistry works - 200dollars is *not* going into the dentist's pocket. Here an extract from Mr B's blog - yes, about the NHS, but the expenses are the same as in north america.

Why You Can't find NHS dentists any more...*

It may (or may not) have come to your attention that it is getting increasingly difficult to find an NHS dentist any more ( http://www.thesun.co.uk/article/0,,4...81432,,00.html ). This week has seen pictures of people queueing down the street like Eastern Europeans trying to buy bread to get registered with a new surgery in Scarborough. The last few months have seen the same scenes repeated in Scotland and West Wales. Only 40% of the population is registered with an NHS dentist, and it looks like things are only going to get worse.

So what's all this about? I mean, ask a member of the general public for their perception of dentists and they will probably say that we spend half the day on the golf course, and the other half driving the Mercedes around town. As someone working at the coalface on the NHS allow me to enlighten you....

NHS dentistry pays you for the work you do. An examination will net a dentist £6.70 roughly, an average filling about £14. A crown on the NHS will cost you about £100 all in. So far so good. What a great living dentist makes on the Nash!

Oh dear. Forgot to mention that an NHS dentist is an 'independent contractor', which means that practice owners have to buy, or pay rent on premises. Not cheap these days. You have to pay for your staff out of your fees as well. And of course, technicians generally like to be paid for making stuff like dentures and bridges for you. Associates (who work for a practice but don't own it), usually contribute to this by giving 50% of their fees directly to the practice principal.

Here's an example: I'm an associate. You pay me £100 for a crown. You generally think that I walk down the road pocketing the fee and cackling merrily at your gullibility. Not actually the case. £50 of the fee goes to my boss. It costs about £35-40 to make a crown, so that'll be another £20 of my fee gone. So *basically* I get £30 for about an hour of my time. This is assuming that the crown/denture/whatever fits first time. If it doesn't, then obviously I have to make it right on my own time.

Of course, NHS dentists will be well looked after by the system, won't they? Nope. Get sick? Can't work? Don't expect any sick pay. You're an independent contractor. So take out your own sickness plan. That's going to be about £900 a year if you don't fancy being thrown out of your home.

Want to work as a dentist in the UK? That'll be £388 per year please. The General Dental Council charges this so that patients can sue you in a salubrious location in Central London. A doctor (GP) gets charged about half this fee and earns probably twice as much.

And please, let's talk about being sued. The Great British Public is expecting private dentistry at NHS prices and as a consequence, you are slightly more likely to be the subject of litigation than a US dentist. Of course, if you were earning the sort of fees a US dentist was getting, you wouldn't mind so much. But of course, this is the NHS so you're not. That'll be £1100 per year in dental legal insurance, please.

And of course, you can't just do dentistry in this country. The Government is very keen you spend most of your day filling in paperwork. It's obviously extremely important for the practice of dentistry that an electrician checks that the plug for your kettle is properly connected. Likewise, it's not enough to sterilize your equipment - you have to fill out forms to say you have done so. In triplicate. And of course, if you use any chemicals ( for example, washing-up liquid), then it's mandatory to fill in a Risk Assessment Form. In triplicate. Are you immunized against HepB? Good. Now fill out a form in triplicate.

The basic problem with NHS dentistry is that the whole system is a compromise designed by shit-for-brain politicians who don't have the balls to admit that the whole thing is a disaster. Like most compromises, no-one is happy: the dentists because they can see that if they followed best clinical practice on the NHS fees scale they would be bankrupt within a week, and the patients because they are not aware of this fact. A molar root canal takes about two hours to do properly: that's an hourly fee for the dentist of about £25. BEFORE 50% to the practice principal/practice expense. Try and get a plumber out for that rate. They'd be laughing so hard they'd nearly forget to put the phone down on you.

So there you have it. That's why you can't get an NHS dentist. They've been screwed by successive governments for twenty years, are probably terrified of getting sued and frankly would be better off working in a call centre. Probably get more job satisfaction too. No wonder 50% of dental graduates quit or emigrate within a year of qualification.

On a final note, the dentist who set up in Scarborough recently was Dutch. Things must be *really* bad in Holland is all I can say. And of course, this is the government's great plan for NHS dentistry. Don't pay the poor bastards doing the job a fair wage - just get in some Euro-dentists who don't know how bad things are over here. They probably can't speak English, but hey, beggars can't be choosers. God knows, if they've recently escaped from repressive communist regimes they'll probably be right at home working for the NHS.

Oh well. That's my 6-day week as a happy NHS dentist in Glasgow done. I'd just like to thank Tony and New Labour for saving the NHS, like they promised way back in '97. Or possibly not.



Biiiiink

Glaswegian

Mr Bliink

Nobody had forgotten about the charges after the gross fee - especially me - I'm a chartered accountant and we used to run a business in the UK. If you read the posts you will see that we are claiming the dentist will be earning way more than $200/hour (gross). Nobody claimed the gross fee went in the dentists pocket - just be grateful the the Revenue still allow you to deduct your expenses!

And then compare your NHS charges to the Canadian equivalent. Try $2000 for a crown (I was quoted this week) and then tell me how you would feel if you got to charge GBP2000 for the same service - would you be better off financially - of course you would.

I never did see a dental practice in the UK where one dentist roamed around three or four dental chairs - not to say it didnt happen - but it does seem a more efficient use of time.

Mrs G

mrs. liftman

If you have worked in ICU/surgery, you will be aware what an ODP does. This job has evolved swiftly over the past three or four years to a point now where ODP's are studying for the same degree as Nurses.
A nursing qualification is NOT a pre requisite, if the board do not want it to be. This is covered under Chapter 7 Section 29 of the LPN Act.

Canada/USA are the only "Civilised" countries that do not recognise the qualification. It is accepted in: Australia, New Zealand, South Africa, The whole of Europe and more.

I am sure that there are many differences. It is often the little differences that are worse than the big ones. Fortunately, the SI units of measure are taught to ODP's as part of their pharmacology training, but this and any other difference, such as names, will be the same for everyone, nurses, doctors or ODP's coming from Europe.


If you would like this, just let me have your email address, and I will send it. Be aware though, it is 3.5Mb, so only if you have broadband!

My whole argument here may have been overlooked.

The Board of the LPN college HAVE the ability to allow anyone who is "suitably qualified" to be tested. There is no necessity for "suitable qualifications" to include Nursing of any sort. All that is wanted is for the college to apply their own rules in a fair fashion. Everyone (including politicians and Canadian media) can and have checked this.

The Executive Registrar has said in an email to me that she will take this up with the Dean of the training college next week, and then let us know what courses may be required before the exam can be written.

The media have taken up my case, as it is certain that the Maratime provinces are desperate for immigrants and skilled medical staff. For the LPN college to work in the way that they have, seems to be a case of cutting off your nose to spite your face.

We have made progress with this. I am sorry if I offended you or any nurse with my previous comments. All I was trying to do was put my point of view as forcefully as possible, and maybe I went a bit far.
This has been done via the media and politicians because the LPN College stopped answering my emails, and not as a yaa-boo reaction to being turned down.

Higgy

It would be a bummer if he forgot who was who and pulled your tooth out instead of filling it

oceanMDX

Mr.Bliiiink,

If any one on this forum understands the difference between the net income and the gross income in a healthcare practice it is me. For your information I operated an optometric office and adjacent optical dispensary for 15 years in Alberta.

Those quoted fees are lower than what I would pay here in Mexico. You're talking 3rd world fees in the UK. No wonder so many foreigners want to practice dentistry in Canada.

Biiiiink

According to the 2003 Alberta Wage and Salary Survey, dentists in our province earned an average salary of $138,900 per year - this isn’t the megabucks everybody thinks dentists are earning which seems to have passed into legend on both sides of the Atlantic. In fact, if we’re really comparing like with like (i.e. private dentistry in the UK with private dentistry in Canada) then this salary is almost exactly Mr B’s renumeration when he was in private UK practice in East Anglia. No great draw in going to Canada and spending a small fortune and 2yrs loss of earnings to “retrain� for foreigners then, is there?!

Ocean - if you think dentists are scamming and milking the system, report them!

Glaswegian - I don’t understand your comparison with the crown figures? I take your point about deductibles though, but for Mr B when it’s only laundry fees (200 GBP a year), insurance fees and GDC fees it’s hardly a lot...since the taxation is slightly lower in Canada anyway I wonder what the actual difference would be.

To come back to the point of all this, as Mrs Liftman says above, every other industrialised country recognises and values UK dental/medical qualifications (Aus, NZ, SA, Europe...etc) - and it’s nonsense to make someone take a 2yr “conversion� course before one is allowed to even sit the licensing exam.

Let’s not kid ourselves it’s all about difference in clinical practise.

Biiiiink

Gaz_F

I've been reading this thread with interest.
I will admit, I don't have any experience in the medical field, and I would also be outraged (I hope it isn't too strong a word) if I wasn't either:
1. Given the opportunity to take an 'equivalency' exam.
2. Given a detailed explanation as to why I was refused.

This reminds me of a friends emigration to New Zealand two years ago. We both served together, and he was one of the highest qualified chefs in the Corps. His application to NZ was turned down flat as his UK chef qualifications weren't good enough. What did get him in was that he had done a 3 week Nuclear, Chemical and Biological crisis management course, which covers both military and civilian incidents and accidents. Which made him the highest qualified (only) specialist in this field in NZ.

Which surprised us as we view this course as a pain to do and as useful as t*ts on fish. (But I'm on one in early 2005! You never know)

Best of luck with the application Mrs Liftman; I hope everything works out well.

G.