Senior house officer training

BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7097.1828b (Published 21 June 1997) Cite this as: BMJ 1997;314:1828

Training must be more structured

  1. G A Bunch, Associate deana,
  2. J Bahrami, Associate deana,
  3. R Macdonald, Regional postgraduate deana
  1. a Leeds University Department for NHS Postgraduate Medical and Dental Education, University of Leeds, Leeds LS2 9JT
  2. b Department of Liaison Psychiatry, Leeds General Infirmary, Leeds LS1 3EX
  3. c Park Surgery, Eastleigh, Hampshire SO53 2ZH
  4. d Aldermoor Health Centre, Southampton SO16 SST
  5. e University of Southampton, Southampton SO16 6YD
  6. f Orchard Centre for Women's Health, Gloucestershire Royal Hospital, Gloucester GL1 3NN

    Editor—The study by Elisabeth Paice and colleagues confirms that there is still considerable concern about trainees in the senior house officer grade.1 The Yorkshire Deanery shares these concerns and in an effort to improve matters has inspected all its senior house officer posts according to the requirements of the royal colleges for educational approval–for example, the Royal College of Surgeons.2

    During our survey of 1023 posts we interviewed around 600 senior house officers in every specialty and all districts. We collected information in a structured way about work, training, and education. We found that five essential criteria need to be addressed in assessing any training post: consultants' support; clinical experience; training and education; appraisal; and contractual compliance.

    We were disappointed to find that one third of the posts were unsatisfactory when judged against these criteria.3 We found consultants' support to be generally excellent (88% (899/1023) of senior house officers found it satisfactory), showing that consultants take their clinical responsibilities towards patients seriously. The most disturbing finding was that at least one third of senior house officers did not obtain sufficient clinical experience to prepare them for the next stage of their careers as specialist registrars, despite the fact that there was always sufficient clinical material available (62% (629/1023) considered the experience satisfactory). The duties of senior house officers have usually been designed to satisfy service needs and little thought has been given to devising a properly organised programme of activities. Particularly in specialties that do not have preregistration house officers, senior house officers spend much of their time on inappropriate duties while valuable learning opportunities are lost or even disregarded. We found that almost half of our senior house officers never attended outpatient clinics because they were too busy doing repetitive tasks on the wards (47% attended …

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