29.10.13
Changes recommended to doctors’ training
The ‘Shape of Training’ final report has been published, recommending a more flexible training structure for doctors and for doctors to be able to change roles and specialties throughout their career.
The full report by Professor David Greenaway can be found here. He said: "Patients’ needs are changing fast and we need to ensure that medical training keeps pace. Today’s report sets out a framework for delivering this. It will ensure that the training doctors receive continues to be of the highest standard and meets the increasingly complex demands of future medical care. I trust the Government, and all those that work in and with the health service will adopt and use the report to steer the changes in postgraduate medical education and training to meet patient needs and ensure that doctors in the UK continue to receive the highest quality training."
The GMC said it “particularly welcomed” the recommendations around flexibility. Its chair, Professor Sir Peter Rubin, said: “We are pleased Professor Greenaway’s focus is on the changing demographics in the UK, and especially on the ageing population and growing number of people with complex medical conditions.
“Some of the recommendations will require further discussion, including the suggestion that full registration should be awarded at the point of graduation from medical school. But overall we are confident that these recommendations will help to improve the way doctors are trained and provide clear benefits for patients and the public within the health service now and in the future. The key is to ensure that we are able to make steady progress towards these reforms while maintaining some stability in a system that has already been subject to a great deal of change and pressure in recent years.”
NHS Emploers' Dean Royles said: “Employers generally favour the proposed move to a more broad based training system. Medical careers and consequently pay and terms and conditions will need to change to reflect this, as will the way doctors' careers progress - and this is timely given the negotiations taking place with doctors on terms and conditions.
“It is right that broad specialty areas be defined on patient themes rather than professional specialties. We absolutely agree that there must be more and better patient and employer involvement in curricula, assessment and progression arrangements. Linking training progression to competence achieved, and not driven by time alone, makes sense and poses challenges in its own right. However we must also consider how we can best link such progression with pay.
“Our current doctor contract negotiations – the first in ten years – are absolutely focused on facilitating change in the way doctors work, always with a focus on the benefits to patient care. Professor Greenaway’s report will be an important factor in how these negotiations move forward."
The below bullet points form the ‘key messages’ from the report:
- Patients and the public need more doctors who are capable of providing general care in broad specialties across a range of different settings. This is being driven by a growing number of people with multiple comorbidities, an ageing population, health inequalities and patient expectations.
- We will continue to need doctors trained in more specialised areas based on local patient and workforce needs.
- Postgraduate training must adapt to train doctors in the general areas of broad specialties in order to prepare them to deliver safe and effective patient care over the next 30 years.
- Medicine has to be a sustainable career with opportunities to change roles and specialties throughout doctors’ careers.
- Local workforce and patient needs should drive opportunities to train in new specialties or to credential in specific areas.
- Doctors within academic training pathways need a training structure flexible enough to allow them to move in and out of clinical training while meeting the competencies and standards of that training.
- Full Registration should move to the point of graduation from medical school, provided there are measures in place to demonstrate graduates are fit to practise at the end of medical school. Patients’ interests must be considered first and foremost as part of this change.
- Implementation of the recommendations must be carefully planned on a UK wide basis and phased in. This transition period will allow the stability of the overall system to be maintained while reforms are being made.
- A UK wide Delivery Group should be formed immediately to oversee the implementation of the recommendations.
(To see the above graphic in full, click here.)
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