Improving the training of SHOs

The General Medical Council has turned its attention to the training of senior house officers. Its new guidance, The Early Years, follows Tomorrow's Doctors on undergraduate education and The New Doctor on the preregistration year, but it lacks the bite of its influential precursors and in its present form is unlikely to provoke similar change.

The document recommends high quality education and training, flexible enough to meet the personal needs and professional aspirations of senior house officers. It emphasises the importance of careers advice, clinical and educational supervision, and provision for welfare. It refers to the particular needs of overseas doctors.

None of this is new. 1 2 Colleges and postgraduate deans have promoted induction programmes, training agreements, structured teaching, consultant appraisal, log books, structured training rotations, flexible training schemes, and (with the BMA) improvements in hours of work. Improvements have occurred in all these aspects, and there is evidence that consultants are taking their role as educators increasingly seriously.3 Nevertheless, although most senior house officers enjoy their work, others are overwhelmed by the responsibility and find the grade both depressing and demotivating. 4 5

Part of the problem derives from lack of clarity about the purpose of the grade. Sandwiched …