The rise of trust doctors

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7421.943 (Published 23 October 2003) Cite this as: BMJ 2003;327:943
  1. Nicola Cooper,, specialist registrar in general internal medicine and care of the elderly (nacooper@doctors.org.uk),
  2. William Burr, dean for postgraduate medical education, Yorkshire
  1. 3 Teale Court, Mansion Gate, Chapel Allerton, Leeds LS7 4AY
  2. Department of Care of the Elderly, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds LS9 7TF

    Stop exploiting them and start rewarding their input

    Non standard grade doctors–more commonly called trust doctors–are a relatively new phenomenon in the United Kingdom. They have several different titles, but essentially they have arisen as a means by which hospital trusts can employ additional junior doctors, despite the Department of Health's ceiling on training grade numbers, which exists to prevent a bottleneck at specialist level. Trust doctors are employed by trusts (local hospitals) for service and are therefore not regulated by the royal colleges or the deaneries (departments of postgraduate medical education). There were few posts for trust doctors in the United Kingdom until the introduction of stricter regulations of hours for junior doctors. Trusts most commonly state that they employ trust doctors as a direct result of these changes. However, the big picture regarding trust doctors is only just emerging 1 2–they are employed mainly in the acute specialties, a significant number work at specialist registrar level, and their numbers are growing fast. Most want to be consultants in the United Kingdom and are in post as a temporary measure. Their work is often indistinguishable from that of the training grades yet few trust doctors have regular appraisals, and …

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