Recommendations – impact for employers

trainee doctors

01 / 11 / 2013 4.06pm

The full report makes 19 recommendations, it is suggested a UK-wide Delivery Group is established to take these forward and identify who should lead on different strands. The following areas may be of interest to employers. Where “appropriate organisations” are mentioned, the report makes clear this includes employers.

  • Postgraduate training must be more responsive to changing demographics and patient needs, as well as identifying more ways to involve patients. Clear advice must be given to potential and current medical students about what to expect from a medical career.
  • Full registration should be at graduation from medical school, subject to measures being in place to assure employers doctors are fit to practise. Medical schools will need to ensure students are up to standard by graduation, but we would want to see employer input considered in terms of what fit to practise means for them. Research has suggested that around 50% of doctors starting their first jobs do not feel adequately prepared. Support and management of FY1 doctors is fragmented in the current system, with foundation training often taking place away from the medical school the doctor graduated from. There are also complexities around fitness to practice concerns. In the new system the responsibility of F1 doctors will clearly be positioned with postgraduate institutions. 
  • A “generic capabilities framework” for curricula should be introduced based on Good Medical Practice. Employer feedback will be needed to ensure the right capabilities are captured.
  • Assessments/processes will need to be in place to allow doctors to move through training at an appropriate pace. Currently time is sometimes used as a proxy for competence, where in reality some doctors will gain all the necessary competencies in an area more quickly than others. The report recognises that this could have a service impact, and we will be gathering employers views once any proposals are finalised.
  • Employers must introduce longer placements, which should help doctors integrate in to teams better and provide more cohesion. This should also allow employers to better plan rotas and development opportunities. We will be working with employers to understand the impact of this.
  • Only organisations which provide high quality training and supervision, and are approved and quality assured by the GMC, will be able to train doctors. We will represent employers in any discussions on potential new standards, and we will make sure any proposals take in to account potential service impacts.
  • Employers will be consulted in the review of curricula and on how doctors are assessed and progress through training. These will need to be reviewed to reflect broader specialty training, including more generic and transferable competencies. Employers will be asked to consider how training arrangements can be coordinated to meet local needs and national standards. Employers will also need to help develop “credentialed” programmes for specialty and subspecialty areas.
  • All doctors must be able to manage acutely ill patients with multiple conditions within their specialty area. This should improve service flexibilities for employers.    
  • Employers must consider how to support a flexible approach to clinical academic training, as well as reviewing barriers to training faced by doctors not already in a training programme.
  • Employers will need to ensure CPD is structured within a professional framework, and make sure doctors who carry out job planning and appraisal have appropriate time to do this.

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