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Letters Mandatory training for doctors

Doctors have too much mandatory training: who will take the lead on reducing its curriculum?

BMJ 2024; 384 doi: (Published 20 February 2024) Cite this as: BMJ 2024;384:q444

Rapid Response:

Mandatory Training requires better focus and curating

Dear Editor

Mandatory training, whilst having a laudable aim, is in danger of conflating hospital level risk management and medicolegal considerations with appraisal and education. It is also inconsistently rolled out and implemented

1. In many secondary care settings - such mandatory training is often not job planned and is expected to be completed in the doctor's own time

2. During the pandemic, when mandatory training was paused for in house staff, locums and agency staff were still expected to complete mandatory training - I suspect this was decided unilaterally by administrative and junior HR staff without recourse to governance teams

3. Additional mandatory training is sometimes imposed, sometimes based on patient, political and external pressures and it would appear, without agreement from doctors representatives. A recent example "The Oliver McGowan Learning Disability and Autism" has recently been added following the unfortunate death of a patient with autism following poor clinical care [1]. The NHS England e learning for healthcare website states "The training is named after Oliver McGowan. Oliver was a young man whose death shone a light on the need for health and social care staff to have better skills, knowledge and understanding of the needs for autistic people and people with a learning disability. "The Oliver McGowan Mandatory Training on Learning Disability and Autism is the government’s preferred and recommended training for health and social care staff. Oliver’s training is delivered in 2 Tiers. Staff need to complete either Tier 1 or Tier 2. Both tiers consist of 2 parts.
The first part of both Tier 1 and Tier 2 is this elearning. Everyone will need the elearning regardless of where they work and the Tier of training they require...."
It is not clear on the process that took place prior to adding this further training to the curriculum, which I recently completed in my own time. Although the teaching was of interest, it is not clear how the "mandatory raining" will alter my personal practice.

I would therefore like to propose a more focussed core mandatory curriculum e.g basic resuscitation together with speciality and grade specific additional modules. The principles of mandatory training are to be applauded but in order to maintain confidence of the profession in the process, the curriculum needs to be better curated.

Yours sincerely

1. NHS England e learning for healthcare. The Oliver McGowan Mandatory Training on Learning Disability. ( accessed 21st Feb 2024)

Competing interests: No competing interests

21 February 2024
Anjan K Banerjee
Consultant Gastroenterologist
Bronglais Hospital