Medical education 2010

It all seemed so simple then. The NHS was still young, doctors were held in high regard, and medical education was safely secure in the great teaching hospitals and their associated medical schools. The system, largely unchanged from the end of the 19th century, seemed to work well, patients were satisfied (or at least did not complain), and few questioned the universally accepted approach to undergraduate medical education. The preregistration house officer (PRHO) year had been introduced in the 1950s. Significant changes to medical education, however, had to await the General Medical Council reports of the 1980s and 1990s. The success of Tomorrow's Doctors, produced in 1993, had more to do with the effective way in which it was implemented than with its contents.1 Most of the recommendations had been published a decade earlier to little effect.

The new curriculums envisaged in Tomorrow's Doctors are now only fully established with graduates entering the PRHO year and training grades. And yet a new version of Tomorrow's Doctors has been widely circulated for consultation (on the GMC website www.gmc.uk.org): the number of medical undergraduates in England increased by around 40% over the past few years; four new medical schools were established; graduate entry was …