Letters Health and Social Care Act

Training and ignorance in the new NHS

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f2668 (Published 01 May 2013) Cite this as: BMJ 2013;346:f2668
  1. Abigail T Clark-Morgan, orthopaedic registrar1
  1. 1Salisbury District Hospital, Salisbury SP2 8BJ, UK
  1. abigailclarkmorgan{at}gmail.com

Having recently been on a course entitled “How does the NHS work . . . quick before it changes again” (yes, really), I am worried about the impact of the latest changes on doctors’ training and doctors’ and medical students’ ignorance of how the NHS works.1

Will commissioning bodies have an obligation for medical training or will this come down to providers? How will this work for private companies competing for tender? What about the impact of moving “routine” surgical cases out of NHS hospitals on surgical trainees’ exposure to different conditions? Where do our deaneries fit into this?

The latest version of the General Medical Council’s Best Medical Practice reminds us to check our privacy settings; shouldn’t there also be a section dealing with the need for doctors to understand the system within which they work? Is it not rather late to consider this only when consultant interviews are approaching?

The BMA champions junior doctors as agents for change. To maintain training high on the agenda, I think that we need to be more involved in the changes. We must consider generations of doctors yet to come, how their training will be influenced, and ultimately what kind of service they will be providing. We risk missing the opportunity to shape future healthcare.


Cite this as: BMJ 2013;346:f2668


  • Competing interests: None declared.


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