Review to consider shorter training for consultants in England

The postgraduate training and deployment of doctors in England is to undergo a major review designed to reduce the length of training and to provide more generalist consultants, the Department of Health and the medical royal colleges agreed last week.

The Department of Health and the Academy of Royal Colleges, which includes all the royal colleges, have set out recommendations for improving the care of patients and providing better training and career opportunities for doctors. This will be done, they say, by increasing the number of trained doctors and modernising training programmes for specialist registrars.

Senior registrar training will place greater emphasis on assessment and demonstration of practical competence and on equipping doctors to work in patient centred, multiprofessional teams. The training will include more leadership and management training, as well as developing communication and team working skills.

Some training courses for particular types of consultant could be shortened from the current five years to four. The aim is to create more generalist consultants and to hasten the expansion of the medical workforce. The agreement also plans to speed up consultant appointment procedures.

The changes will be overseen by a new postgraduate medical education and training board, which will lead in the supervision and implementation of education and training matters. The process by which the various royal colleges visit NHS trusts to assess the quality of medical education and training will be streamlined.

Professor Peter Hutton, president of the Academy of Royal Colleges, said, “This programme will not only benefit patients but also improve the working lives and career opportunities for doctors.”

The BMA welcomed the proposals but were concerned that high quality training should be provided. Many doctors currently training to be consultants consider that they do not spend enough time training but have only in-service education opportunities, a BMA spokesman said. “The question is how we achieve that whilst maintaining the gold standard of UK consultant training,” he added.

Dr Paul Thorpe, chairman of the BMA Junior Doctors Committee, said, “We are entirely supportive of shorter, more effective training, but not shortening it for shortenings' sake.”

*Concerns about undergraduate medical training were expressed after last week's publication of a white paper on higher education that suggested that universities could set their own fees and that graduates could defer payment of their university tuition fees until they were earning salaries of at least £15 000 ($24 600; ‡22 600) a year.

Dr Colin Smith, chairman of the BMA's Medical Academic Staff Committee, said, “Universities with medical schools derive around one third of their income from medical faculties. If universities are allowed to set their own fees, medicine is likely to be hardest hit. Medical students already qualify with an average total debt of almost £13 000, and this will rocket under the government's plans.”

Undergraduate medical degree courses in the United Kingdom generally last five years, with students having to pay for the first four years, compared with three years for many other courses. Medical students also have longer terms—50 weeks a year in their last three years—so are less able than other students to earn money during holidays.

• The average debt for new doctors graduating from University of Minnesota Medical School is about to exceed $100 000 (£61 200; ‡92 200) for the first time.

The agreement between the Department of Health and the medical royal colleges can be accessed at: http://www.aomrc.org.uk/