The results of a snapshot survey published in Postgraduate Medical Journal report that newly qualified medical graduates seem to be poorly prepared to work as trainee doctors.

Data is based on critical evaluation made by 228 senior doctors. They reviewed an extensive range of core skills and competencies among trainee doctors at two major teaching hospitals in the East Midlands of England.

Currently, trainee doctors complete a two year generic Foundation Programme. It is the bond between medical school and specialist or general practice training.

Using a five point scale, the senior doctors were asked to score how well prepared their Foundation Year 1 (F1) postgraduate trainees were to work as doctors, six months after they had graduated from medical school.

The evaluation assessed the junior doctors on most of the expectations for newly qualified doctors set out by the professional regulator which is the General Medical Council (GMC), in Tomorrow’s Doctors, as well as eighteen general criteria.

Tomorrow’s Doctors covers recommended curricular content for medical schools. It emphasizes clinical and practical skills, critical thinking and effective communication.

Out of the total of 443 evaluations that were sent out, 107 consultants and 121 specialist registrars completed the questionnaires.

There was a high degree of agreement between the two groups. The responses showed that the senior doctors judged the novice juniors as improperly prepared to start work as a doctor.

The score was below three on 48 of the 70 items assessed against the GMC criteria. It was graded above the midway point for only six of the 20 clinical and practical skills.

Some of the areas where juniors performed below par were: carrying out basic respiratory function tests, prescribing, and more advanced communication skills.

However, they scored well on basic communication skills and on how to ask for help. This led the authors to question whether medical schools have not “gone too far in emphasising risk management and, perhaps inadvertently, helplessness.”

The authors call attention to the fact that their survey provides only a snapshot of graduates from one medical school and in one area of England. As a result, it may not be indicative of trends across the UK. However, they also remark that their findings corroborate other broadly similar research.

“The findings give cause for concern,” they comment. “[Senior doctors] perceived that the undergraduate medical degree had not adequately prepared F1s for practice, especially in clinical and practical skills.”

They recommend, among other things, further opportunities for ward based experiential learning and for senior doctors to be more precise about what is expected of F1 trainees.

“How well prepared are medical students for their first year as doctors? The views of consultants and specialist registrars in two teaching hospitals”
C Matheson, D Matheson
Postgrad Med J 2009; 85: 582-9
Postgraduate Medical Journal

Written by Stephanie Brunner (B.A.)