Many rivers still to cross

The report of the working party on the unified training grade1 is the first piece of a jigsaw that will provide the picture for higher specialist training recommended in the Calman report.2 But even after elision of the registrar and senior registrar grades, in Britain, unlike in other members of the European Union, specialist training will comprise two grades: senior house officer and specialist registrar.

Entry to, assessment of progress through, and exit from the new specialist registrar grade will be managed by postgraduate deans in close collaboration with the medical royal colleges. Before the new grade is implemented satisfactory appointment systems and instruments for assessment will have to be developed and the curriculums for all specialties and other guidance will need to be published. All specialties are expected to begin transitional arrangements within one year of the commissioning date, but much more information, particularly the numbers for the grade in each specialty, is urgently needed. Some specialties are likely to make rapid progress to a steady state …