Is The Programme Of Reform Of Training Of Junior Doctors Still Fit For Purpose? UK

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Main Category: Medical Students / Training
Also Included In: Public Health
Article Date: 31 Aug 2007 - 0:00 PDT

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Anthony Madden and son George Madden discuss Modersnising Medical Careers (MMC) in the latest issue of the British Medical Journal (BMJ). They ask whether the programme aimed at reforming the training of junior doctors is still fit for purpose.

MMC was meant to tackle problems with the senior house office grade, writes Anthony Madden, who works as consultant anaesthetist at Southmead Hospital, Bristol, and George Madden, University of Birmingham, a final year medical student (Foundation Year 1 doctor in the West Midlands). The MMC has since expanded and includes all levels of postgraduate medical training. The writers say it bears little resemblance to its original approved aims.

The Maddens warn that the MMC risks delivering a generation of doctors who are highly specialised, but do not have the breadth of experience and flexibility to help them deal with unusual clinical problems, or adapt as new medical breakthroughs appear. How can this be good for the NHS, the Government and patients, they wonder. They ask whether the MMC might not have lost its way.

The plans, as they stand, are disappointing for doctors. Doctors need a robust, modern training system which satisfies the '5 principles' for reform, they write.

Specialised training was envisaged to be broadly based; this will not be the case. It will be difficult to move between programmes. The aim of having individually tailored programmes seems to have fallen by the wayside. The provision of flexible training is uncertain, while career advice is lacking, they write.

The writers believe the MMC has failed to meet most of its original principles.

MMC will result in fewer Senior House Officers, another headache for workforce planners. Senior House Officers are seen as the most flexible medical staff for staff. The morale of doctors who are forced into specialties they did not particularly aim for could be undermined.

The Maddens write "It's better news for the government, which will see its 'increasing need for hospital services to be delivered by fully trained doctors' met by the shorter training, and thus longer time spent as a consultant."

As consultants produced by MMC will have less experience than their peers of yesteryear, as well as a more limited range of expertise, they will struggle to meet the increasingly complex needs of patients, warn the writers.

"It is difficult not to conclude that MMC has lost its way and will not fulfill its original aim," they write.

"Has Modernising Medical Careers lost its way?"
BMJ Volume 335 pp 426-8
http://www.bmj.com


Written by: Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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