I think it is an excellent report not only because the
recommendations are sound but because the ideas underpinning it are right
and I really hope that it is accepted. To me it hits the spot every time
and says things that a number of people have been saying (but not loudly
enough) over a long time.
The desegregation of FY1 and FY2 and the incorporation of FY2 into a
three year basic training grade is very good. It will make it clear again
that the first postgraduate year should a culmination of the undergraduate
course. It will deal with the perception of FY2 doctors that they were
not making progress from FY1. The current foundation year curriculum
covers two years but many consider that the first year competencies are
mostly achieved in the undergraduate course so I think that both years
could be combined into one.
A three year programme after registration acknowledges that there are
large commonalities between different specialties and that many patients,
particularly the elderly, can have more than one diagnosis. Six monthly
attachments will be long enough for doctors to become useful and prevent
the current perception that doctors remain trainees for long periods with
no service function.
The report is much clearer than some documents on what assessments
should be trying to achieve and identifies the confusion between formative
and summative assessment. It also makes a clear distinction between
assessment designed to ensure when a basic competency has been reached and
the assessment needed to grade applicants on a scale when they are in
competition for a limited posts.
It identifies the limitations of a competency-based framework where a
course is divided into small discrete competencies each of which is tested
individually without any recognition that merely putting those
competencies is insufficient for the practice of medicine. It makes clear
that the practice of medicine is a much more complex task than is
generally conceded by politicians.
My only reservation is the emphasis on using written assessments.
They are cheaper and it is easier to reach good levels of reliability than
with clinical assessment. Nevertheless at this stage we should be aiming
to test ‘does’ not just ‘knows’. Written assessments may drive candidates
to the library rather than to the bedside.
I think this could be a great step forward. The two linked anxieties
are whether the Department of Health will accept it and whether the
profession will show a united front at least to the principles if not
always some of the specifics. The worry will be that a divided profession
might send mixed messages from which the Department picks off the ones it
wants.
Rapid Response:
Tooke report
I think it is an excellent report not only because the
recommendations are sound but because the ideas underpinning it are right
and I really hope that it is accepted. To me it hits the spot every time
and says things that a number of people have been saying (but not loudly
enough) over a long time.
The desegregation of FY1 and FY2 and the incorporation of FY2 into a
three year basic training grade is very good. It will make it clear again
that the first postgraduate year should a culmination of the undergraduate
course. It will deal with the perception of FY2 doctors that they were
not making progress from FY1. The current foundation year curriculum
covers two years but many consider that the first year competencies are
mostly achieved in the undergraduate course so I think that both years
could be combined into one.
A three year programme after registration acknowledges that there are
large commonalities between different specialties and that many patients,
particularly the elderly, can have more than one diagnosis. Six monthly
attachments will be long enough for doctors to become useful and prevent
the current perception that doctors remain trainees for long periods with
no service function.
The report is much clearer than some documents on what assessments
should be trying to achieve and identifies the confusion between formative
and summative assessment. It also makes a clear distinction between
assessment designed to ensure when a basic competency has been reached and
the assessment needed to grade applicants on a scale when they are in
competition for a limited posts.
It identifies the limitations of a competency-based framework where a
course is divided into small discrete competencies each of which is tested
individually without any recognition that merely putting those
competencies is insufficient for the practice of medicine. It makes clear
that the practice of medicine is a much more complex task than is
generally conceded by politicians.
My only reservation is the emphasis on using written assessments.
They are cheaper and it is easier to reach good levels of reliability than
with clinical assessment. Nevertheless at this stage we should be aiming
to test ‘does’ not just ‘knows’. Written assessments may drive candidates
to the library rather than to the bedside.
I think this could be a great step forward. The two linked anxieties
are whether the Department of Health will accept it and whether the
profession will show a united front at least to the principles if not
always some of the specifics. The worry will be that a divided profession
might send mixed messages from which the Department picks off the ones it
wants.
Competing interests:
None declared
Competing interests: No competing interests