Trainees call for implementation of Shape of Training review to be paused

Fifteen organisations representing doctors in training have called for the implementation of last year’s major review of postgraduate medical education and training to be paused.

The organisations have published a joint statement in response to the UK-wide Shape of Training review, which was led by David Greenaway, vice chancellor of Nottingham University, and published in October 2013. The statement, addressed to UK health ministers, called for “a pause in any implementation of the Shape of Training recommendations” and “a full evaluation of the impact of Modernising Medical Careers before considering a further overhaul of training.”

Last year the trainee committees of four royal medical colleges warned that poor implementation of the review could have “a disastrous impact” on the future recruitment of doctors.1

The 15 trainee organisations said that the review’s recommendations would fail to tackle the problems faced by the NHS and could “risk all that currently works well in high quality medical education.” They criticised the review’s plan to create more generalists and to shorten the length of specialist training. “It is perfectly feasible for a well-trained doctor to be simultaneously a good generalist and specialist,” the organisations’ statement said. “The early years of training could be improved to provide doctors with a more general grounding in their speciality. This does not mean that length of training can be shortened without compromising the quality of speciality training.”

It also criticised recommendations for doctors to be awarded a certificate of specialty training on completion of their postgraduate training, rather than the current certificate of completion of training.

The statement said, “The case has not been made to shorten training programmes, nor to replace the certificate of completion of training (CCT) as a step within continuous lifelong learning, with a lower-level certificate of speciality training (CST). Patients want to be seen by a doctor who can deliver the best possible outcomes. Training doctors to a lower level of expertise will not achieve this.”

The group also raised concerns about the adverse effects that the review could have on medical academia and warned that the introduction of credentialing could not be used as a replacement for specialist training. It said that with improved resources, enhanced training, and a significant expansion of the workforce, UK general practice “can help to address the pressures posed by changing demographics and rising co-morbidity.”

The statement was signed by:

• Association of British Neurologists Trainees

• Association of Clinical Pathologists Trainees Group

• Association of Otolaryngologists in Training

• Association of Palliative Medicine Trainees Group

• Association of Surgeons in Training

• National Dermatology Trainee Committee

• British Junior Cardiologists Association

• BMA Junior Doctors Committee

• British Orthopaedic Trainees Association

• British Society of Gastroenterology Trainees’ Committee

• Oncology Registrar Forum

• Royal College of Obstetricians and Gynaecologists Trainee Committee

• Royal College of Ophthalmologists Ophthalmic Trainees Group

• Royal College of Radiologists Junior Radiologists Forum

• Young Diabetologists’ and Endocrinologists’ Forum