The GMC has unveiled its proposals for improving training flexibility for junior doctors.
Its ‘Adapting for the future’ report proposes a seven-point plan to tackle the problem, including improving work-life balance, focusing on outcomes rather than time spent training and supporting doctors with specific needs.
In the BMA’s talks through ACAS relating to the 2016 junior doctor contract dispute, health secretary Jeremy Hunt agreed to ask the GMC to produce the plan, and doctors leaders, trainee doctors and other healthcare professionals told the regulatory body that the current approach to training is out of date and in urgent need of reform.
BMA junior doctors committee chair Jeeves Wijesuriya said the 2016 dispute raised issues that need to be addressed immediately, and said he was ‘encouraged’ that the GMC has committed to act on some of those concerns over the lack of flexibility in training.
‘Enabling doctors’ skills to be recognised and valued when transferring from one specialty to another, and addressing the arrangements for how doctors train, are central issues to the recruitment and retention of the medical workforce. Tackling them will help to improve the current staffing crisis and ensure that patient care is protected in the long term,’ Dr Wijesuriya said.
‘We look forward to working with the GMC to continue to add flexibility to the working lives of doctors, and to ensure this serves to improve their access to training despite serious service pressures that we, the GMC and others continue to highlight. Flexibility must not mean flexibility for employers to use junior doctors to cover up more rota gaps at the expense of their training.’
Barriers and a lack of support
The inflexible approach to postgraduate training is caused partly by the complexity of training rules. The GMC review highlighted that many of the 66 specialties and 32 subspecialties develop their training requirements in isolation from each other, creating barriers for trainees who seek to change specialty. It also found that the same structures limit the ability for postgraduate training to adapt to a changing population and service needs.
The plan identifies key issues to tackle, including the difficulty of transferring between specialties and too often having to go back to the start, work overseas or in non-training posts not being recognised, and a lack of career support for doctors who want to refocus.
GMC chief executive Charlie Massey said: ‘The way that medical training has developed in the last 30 years has contributed to the low morale that doctors in training continue to experience.
‘The actions that we set out in our report can make a meaningful difference to the professional lives of doctors and the choices they make about their careers. But ultimately it is patients who will benefit the most from these changes.
‘We are ideally placed to drive these changes forward but we cannot deliver more flexibility and choice for doctors on our own. We need all bodies involved in the delivery of UK medical education to work with us and be as determined as we are to deliver this ambitious vision.
‘If postgraduate training in the UK looks the same in five years’ time, then we will have failed trainees and we will have failed patients.’
Among the potential solutions, the plan outlines the GMC’s efforts to accelerate the long-term trend towards organising training by outcomes rather than the time spent in training, reduce the burden of its approval system so colleges and faculties can make quicker changes to curricula, promote existing support services for trainees wanting to change training programmes and ask the Government to make law less restrictive to allow the GMC to be more ‘agile in approving training’.
Discussions with health leaders will now begin in a bid to make the changes.
NHS Employers chief executive Danny Mortimer said: ‘Employers welcome this important work. It offers a real opportunity to better support doctors as they develop their careers in the NHS. We look forward to working with Health Education England, the Royal Colleges, the GMC and junior doctor representatives to apply the much-needed changes recommended in this report.’
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