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BMA fears training overhaul will create extra grade

The BMA has expressed concerns about a review suggesting a major overhaul of medical training without a commitment to consult on the changes.

trainingThe association fears the independent Shape of Training review published this week could open the door to a sub-consultant grade by moving highly specialised skills outside the scope of postgraduate medical training.

The BMA is also concerned by the review’s suggestion that full GMC registration should be moved to the end of medical school.

The review suggests altering the structure of postgraduate curriculums to introduce broad-based specialty training under ‘themes’ such as women’s health or children’s health.

Doctors would be required to develop and maintain generic capabilities.


Rapid pace

BMA junior doctors committee co-chair Kitty Mohan said the BMA welcomed the contribution to the debate on postgraduate medical training but was concerned about the rapid pace of implementation, especially for areas where there was not a strong evidence base.

Dr Mohan added that the BMA supported the concept of broader-based training including generic capabilities and greater flexibility for trainees.

She agreed that medical training should be responsive to changing demographics and patient needs but she said there were less disruptive ways of achieving that.

She said: ‘We are very concerned by the recommendation to move the achievement of highly specialised skills outside the scope of postgraduate training, and fear it will lead to a de facto sub-consultant grade.’


Postgraduate change

The review, sponsored by the four UK health departments and the GMC and chaired by Nottingham University vice-chancellor David Greenaway, suggests changing the end point of postgraduate training from a certificate of completion of training to a CST (certificate of specialty training).

Dr Mohan said: ‘The CST must remain the end of postgraduate training and demonstrate that doctors are competent to work in their chosen field.’

The report also proposes moving the point of full GMC registration to the end of medical school, placing the onus on medical schools to demonstrate that graduates are ‘capable of working safely in a clinical role’.

The JDC and BMA medical students committee expressed surprise at this recommendation, which they believed was outside the scope of the review.

BMA medical students committee co-chair Andrew Wilson said: ‘We are surprised to find recommendations about undergraduate training appearing in the report, the scope of which we understood to be primarily postgraduate training. 

‘Although we could not agree more, as it recommends in the report, it is crucial for doctors to be properly prepared and safe to practise at full registration, this seems at odds with the idea of removing a whole year of education and experiential training by bringing forward the point of full registration.’

Mr Wilson added: ‘We are also concerned about the effect this change could have on workforce planning, with additional scope for applicants from many more EU member states to an already oversubscribed foundation programme.’ 

The BMA will respond formally to the proposals.


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