Intended for healthcare professionals

Observations Medical Training

“Modernising Medical Careers” to “Shape of Training”—how soon we forget

BMJ 2014; 348 doi: (Published 30 April 2014) Cite this as: BMJ 2014;348:g2865
  1. Geraint Fuller, consultant neurologist, Gloucestershire Royal Hospital,
  2. Iain A Simpson, consultant cardiologist, Wessex Regional Cardiac Unit, University Hospital Southampton NHS Foundation Trust
  1. Correspondence to: G Fuller Geraint.Fuller{at}

The greatest cost of all in the latest proposal for the training of doctors may be the effect on the care of patients

Modernising Medical Careers (MMC) changed all aspects of medical training in the United Kingdom from its introduction in 2005. It shortened the duration of training, introduced “run-through training” (removing the need to reapply for higher specialty training places, but which some specialties subsequently reversed), and reduced flexibility.1 2 3 MMC got doctors protesting on the streets and led to questions being asked in parliament and to John Tooke’s independent report into its failings.4 The longest run-through programmes are just completing their first cycle.

It would be useful to analyse the current state of training—and thus identify the sources of several problems. These include the shortfall in core medical trainees needed to fill specialist training in acute medicine and geriatrics; difficulties in appointing locums, with consequent disruption of training and service delivery; and falling numbers of specialist trainees dually accredited in general medicine, because limited training time is only just enough to train adequately as a specialist.5

Instead we have the Shape of Training review of all …

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