Responses to the Tooke inquiry show support for his proposals

BMJ 2008; 336 doi: (Published 10 January 2008) Cite this as: BMJ 2008;336:66
  1. Zosia Kmietowicz
  1. 1London

    The proposals in the final report from the inquiry into postgraduate medical training led by John Tooke (see News doi: 10.1136/bmj.39455.498600.4E) drew widespread support across the medical professions.

    “Under MMC, trainees are required to make specialty choices far too early in their career without having gained enough experience or the opportunity to experience ‘taster placements’ in other related specialties they may subsequently prefer. The college strongly favours training which allows a greater freedom of movement between specialties.”

    “The virtually unanimous positive response by the medical profession to the report is unparalleled, and so we very much hope that the report is accepted by the government and implemented without delay.”

    “It is vital that the medical profession, government, and other key constituents take ownership of the Tooke recommendations and ensure these changes are implemented.

    “The academy supports the establishment of NHS Medical Education England, an arm’s length coordinating body able to act as an ‘honest broker.’ This presents a fresh opportunity for all the key players to re-engage with the challenges so clearly identified in the Tooke report and agree a coherent, coordinated approach to medical training.”

    “However, we are concerned that if the government does not listen—and there are signs from Liam Donaldson that that may happen—then the profession is lost and we are in a very dangerous position. If the government has paid for an inquiry then it must be prepared to act on its recommendations.”

    “Government incompetence ruined the training chances of many doctors last year and threatens to do so again for those applying for placements now.

    “The recommendations seem to make sense but will not help junior doctors this year, many of whom will be left without work after an expensive training programme.”

    “This inquiry has resulted in a damning indictment of the failings of government training reforms. We must never go back to a system that so contemptuously ignored the concerns of the medical profession. There must be better workforce planning, and far greater value [must be] placed on the crucial role of doctors within the NHS.

    “But while this report gives us hope for the future, the huge problems facing doctors currently going through the system must not be ignored. There is massive competition for training posts, and many excellent doctors will not be able to progress in their careers because of poor workforce planning. In response to Sir John’s challenge, the BMA is ready and willing to play a leading role in developing a mechanism for providing coherent advice on matters affecting the entire profession.”

    “There are some areas of detail within the recommendations that need further, careful consideration. We have argued for and very much hope that psychiatry placements will be compulsory for GP trainees when their training period goes up to five years as recommended.

    “We must also ensure that junior doctor training does not suffer when the European Working Time Directive fully comes into force in 2009. In some areas the directive has had a major impact on training, and we must ensure that the experience can be gained in these constraints to produce psychiatrists for tomorrow who will be fit for purpose.

    “The recommendations will not be implemented until 2009 [if the government accepts them], and it is therefore vital that we support those caught in the transition period. We need a quick response from the government so that we can start pilot work on implementing these changes.”

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