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Securing the future of excellent patient care

29 Oct 2013

The influential Royal College of Physicians and Surgeons of Glasgow has given its backing to a proposed shake up in the way doctors are trained.

The influential Royal College of Physicians and Surgeons of Glasgow has given its backing to a proposed shake up in the way doctors are trained.

The Shape of Training report – published today – proposes:

  • Giving doctors more general training in hospitals and in the community before specialising
  • Introducing an apprentice model for junior doctors – so they can be mentored while building experience
  • Increasing flexibility of the training programmes so that doctors can more easily move from one training stem to another.

The report by Professor David Greenaway meets head on the challenge of improving the training of doctors in general medicine, which is needed to meet changing demands on doctors as a result of our ageing population.

Currently hospital doctors begin to specialise in their chosen field, for example as a cardiologist or neurosurgeon, just three to four years after graduating from medical school. However, changing demographics and patient needs, including the strain on emergency departments, are indicative of a need for a longer period of more generalised training for all doctors and surgeons. As a result of the changes, doctors will have a much broader basic knowledge and will specialise much later in their careers. We strongly support this recommendation as we believe it will lead to better care for patients and relieve pressure on our hospitals.

Among the proposed changes is a plan to move towards an apprentice model for junior doctors which will involve longer hospital rotations, allowing them to gain more experience in different areas of the hospital while also allowing their trainers to mentor and support them more effectively. While training for junior doctors was previously mainly confined to hospitals, it will now be extended to community settings so that a better balance can be achieved. Overall, training for young doctors is more flexible and likely to be more attractive to them, encouraging them to train in the UK.

The report also addresses a need to ensure patients are informed about the various roles within the medical profession and are involved in the process of educating and training doctors, which we believe will be of benefit.

Dr Frank Dunn, President of the Royal College of Physicians and Surgeons of Glasgow commented:

“While there is much to commend in the report, we remain concerned about achieving the right balance between service and training. Surveys of young doctors have made it clear that the demands of the busy work schedules of their supervisors make it difficult to find sufficient time for training.”

He added: “It is essential that both junior and senior doctors (consultants) are allowed adequate time for training and supervision to ensure the highest standards of patient care can be met. An increase in consultant numbers must be considered in order to make this possible.”

We support the view that patient needs should dictate the need for specialists but urge careful planning in regard to issues of being trained in specified areas or procedures (credentialing).

Currently young doctors cannot register with the General Medical Council and gain their licence to practice until they have completed one year of hospital work experience/postgraduate training after graduating from medical school. We are concerned about the proposal to bring forward registration to the beginning of the first year of postgraduate training. This is a radical step which attempts to address a current issue of too many medical graduates for the postgraduate training posts available. A better solution may be to increase the number of training posts available.

We are absolutely committed to working with others to ensure the implementation of this report begins immediately and is well planned.

Progress on the implementation of this report will be one of the highlights of our international triennial conference, Advancing Excellence in Healthcare in June 2014, when Professor Greenaway will speak on the Shape of Training.

Available for comment:

Dr Frank Dunn, President of the Royal College of Physicians and Surgeons of Glasgow. Please call Linda Irvine on 0141 227 3223 or email to arrange an interview.

Further information

The Royal College of Physicians and Surgeons of Glasgow is a leading UK centre for postgraduate training, examination and professional support of doctors, surgeons, dentists and other health professionals. The College was consulted on the Shape of Training report prior to publication.

Information about Advancing Excellence in Healthcare 2014 can be found at

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