The regulation of medical training: a problem ignored

Dean, Benjamin; Evans, Matt Jameson

doi:10.1136/bmj.e3101

Cited by 1 publication

(3 citation statements)

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“…Prior to MMC the PRHO year was regulated robustly by the Royal Colleges in order to ensure that all house officers obtained core experience in the common medical and surgical emergencies. Our data would suggest that the shift of regulatory responsibility to the GMC, 10 in combination with an over emphasis on chronic disease management 3 have led to this core emergency experience being neglected. 11,12 This is even more worrying given the concerns being raised about the acute care component of undergraduate medical training in the UK.…”

Section: Discussionmentioning

confidence: 92%

“…13 It is arguable that routine regulatory workplace visits need to be re-introduced to ensure that trainees are getting the necessary emergency exposure. 10 Certain vested interests groups appear to be indirectly lobbying for more input into the undergraduate and postgraduate medical curricula; 14 this has the potential to further dilute the emphasis on the core of acute medicine and surgery.…”

Section: Discussionmentioning

confidence: 99%

“…10 We would argue that the regulatory system needs to be reformed so that it is inherently more democratic and more responsive to those involved in training on the frontline. There needs to be a renewed focus on emergency work for FY doctors and this can only be done with better regulation; the issue of the ‘failing FY doctor’ can arguably be addressed by increasing training continuity in tandem with a more effective system of regulation.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Foundation doctors’ experience of their training: a questionnaire study

Dean

Duggleby

2013

JRSM Short Reports

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ObjectivesWe set out to evaluate the impact of Foundation Year (FY) training on the doctors who had been through this training system.DesignDoctors in training were surveyed using a structured web-based questionnaire.SettingPostgraduate training in the UK has been the subject of much upheaval in recent years.ParticipantsA total of 1065 doctors in training were surveyed in late 2011 and early 2012, of which 638 were current FY doctors.Main outcome measuresThe survey was both quantitative and qualitative, focusing on selection, working hours, training quality, training assessments and the regulation of training.ResultsA majority of current FY trainees worked extra weekly hours with the breakdown being: 5–10 hrs (54%), 10–15 hrs (17%), >15 hrs (9%) and no extra weekly hours (20%). All current FY trainees wanted to work for more than 40 h a week with the following breakdown of desired hours: per week 40–48 (22%), 48–60 (50%) and 60–70 h (19%). The average hours per week spent clerking emergency admissions by current FY trainees were as follows: zero hours (11%), 0–5 h (37%), 5–10 h (30%), 10–15 h (11%) and greater (11%).A large majority (90%) felt that it was possible for incompetent trainees to obtain satisfactory results from assessments and that the FY training program was poor at identifying failing trainees. There were high levels of dissatisfaction with the selection process.ConclusionsFY training appears to be failing in several key areas with the lack of emergency exposure a particular area of concern. It is essential that any future reforms of training address these problem areas.

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Section: Discussionmentioning

confidence: 92%