Intended for healthcare professionals


Medical student training: five year backward view

BMJ 2017; 356 doi: (Published 24 January 2017) Cite this as: BMJ 2017;356:j294
  1. John Oldham, adjunct professor1,
  2. Sam Everington, chair2
  1. 1Institute of Global Health Innovation, Imperial College, London, UK
  2. 2NHS Tower Hamlets CCG, London, UK
  1. Correspondence to: J Oldham john.oldham{at}

Urgent modernisation is required across the board

The problems facing the NHS have been well documented.1 People with multiple conditions will dominate future demand, requiring multidisciplinary teams working in the community. Substantial numbers of community based medical generalists with expertise in multimorbidity will therefore be a critical part of every team. Ongoing financial constraints are a major problem and can be mitigated only by a rigorous approach to improving productivity through the use of technology and including patients to transform the delivery of care. In addition, costly errors have to be minimised through the systematic application of quality improvement methods into the working culture of NHS organisations.

High performing primary care organisations and trusts in England already use quality improvement systematically. This analysis aligns with the NHS’s strategic framework, the Five Year Forward View.2

But without fundamental changes in training, the future medical workforce is unlikely to have the attributes required by the populations it serves. Very few …

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