Background: Medical trainees go through various transitions during the medical education continuum.
Aims: The aim of this study was to understand how transitions in licensure and increased responsibility may affect trainees' competence development.
Method: We carried out a questionnaire study in Leeds (UK). Trainees and supervisors were asked to determine the trainee's competence at different stages of training to carry out a diversity of medical activities on a five-point Likert scale. The questionnaires were completed by final-year medical students, trainees of foundation year 1 (FY1) and 2 (FY2), and their supervisors.
Results: For all activities listed: (1) the trainees' presumed competence increased over time and (2) the mean scores given by trainees were significantly higher than the mean scores given by supervisors across all years the questionnaire covered. As estimated by both trainees and supervisors, the impact of a responsibility transition, i.e., from medical school to FY1, is larger than that of a licensure transition, i.e., from FY1 (pre-MD) to FY2 (post-MD).
Conclusions: The transition to formal responsibility with a license to practice medicine seems to have less impact on confidence of trainees and their supervisors to execute critical activities than the transition to informal but significantly higher responsibility.