Three months after the interim report from Sir John Tooke’s independent inquiry into Modernising Medical Careers (MMC) in the United Kingdom123 comes the final report.456

The interim report was well received—87% of respondents to consultation either agreed or strongly agreed with the original 45 recommendations. Some of these have been slightly tweaked in the final report and two new ones have been added—the creation of a new oversight body for postgraduate medical education and training, and exploration of ways to legally offset or compensate for the effects of the European Working Time Directive.

For practising doctors the final report’s recommendations for the structure of postgraduate training will matter most (see figure⇓). Sir John recommends abandoning run through training for something that seems familiar, beginning with a one year post that resembles the pre-registration house officer of old, followed by three years of core specialist training as a registered doctor—a post that resembles the old senior house officer grade.

The report argues for the uncoupling of current foundation years 1 and 2 (FY1 and 2), which would allow universities to guarantee a first …