Training doctors in the new English NHS: The real challenge to the medical profession

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7558.99-b (Published 06 July 2006) Cite this as: BMJ 2006;333:99
  1. James Penston, consultant physician (james.penston{at}nlg.nhs.uk)
  1. Scunthorpe General Hospital, Scunthorpe, North Lincolnshire DN15 7BH

    EDITOR—Hutchinson has done us all a favour.1 Her article—full of unfounded assumptions and opinion disguised as fact—merely draws attention to the poverty of the arguments of those promoting NHS reforms. Moreover, her case is poorly served by an excess of tiresome jargon. Apparently, if medical training is to assist the “cultural change,” we need to “role model patient engagement” and use the “patient voice”; we must check documentation for “subtle messages” and ensure we have “embedded patient autonomy and team working.”

    The message, though, is clear: if medical students do not think “correctly”—if they do not toe the party line—then they must be taught to do so. Medical education is to be manipulated to achieve a political objective. The author seems to care little for the medical profession, seeing it primarily as an obstacle to progress. She has no qualms about devolving duties formerly the domain of doctors to other healthcare workers and disingenuously implies that such changes are not driven by the need to reduce expenditure. As for medical schools, she finds it “incongruous” that the brightest of school leavers, spending five or more years in the most expensive of higher education courses, are still not “job ready” for several years. Precisely to whom does this seem “incongruous”? If to the layman, then the apparent incongruity may be resolved by giving a detailed account of the knowledge and skills to be acquired before qualification. If to a member of the medical profession, then all that can be said is that a fine education has been wasted on him or her.

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    The challenge to the medical profession is to argue vociferously against all who peddle reforms that belittle and degrade the practice of medicine.


    • Competing interests None declared.


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