Whilst welcoming some aspects of the report’s conclusions, in particular recommendations for longer placements for doctors in training, a return to apprenticeship-based models of training and greater flexibility to facilitate movement between specialties, we have a number of significant concerns with the report which we have outlined in an interim response. This has been circulated to key stakeholders within Scottish and UK medical training and will form the basis of our future engagement with the Shape of Training Implementation Group as we seek to positively influence the implementation of these recommendations on medical trainees’ behalf.
We believe that –
- proposed changes to doctors’ training should be based upon sound evidence that they will improve patient safety and the provision of high quality care.
- changing patient demographics, advances in technology and rising patient expectations necessitate an expansion in the number of specialists in parallel with an expansion in the number of generalists; most specialties already operate beyond capacity.
- for physicianly specialities, training in General Internal Medicine (GIM) should be undertaken in parallel with specialty training, leading to a Certificate of Speciality Training. GIM must not be seen as a "stepping off" point and cannot be completed in a shorter time frame than already exists in postgraduate medical training.
- the consultant model ensures the highest standards of safe and effective patient care, is what patients choose and ensures that medicine remains an attractive career. In introducing post-CST credentialing for trainees wishing to sub-specialise, we need to be careful that the report does not lead to the development of a sub-consultant grade. Completion of training, and the ability to practice independently, should equate to consultant status and not vary by specialty.
- any changes to the current system of medical training must be phased to avoid destabilisation of the medical workforce and compromise of patient care; stability and security are vital for existing trainees to avoid attrition and exacerbation of the recruitment crisis.
- any changes to the SAS Grade and the Undergraduate curriculum need careful consideration to ensure patient safety and high quality care.
- protected time for training for trainees and trainers is essential to ensure the provision of high quality patient care. Excellent training is fundamental to excellent patient care.
Read the Shape of Training report
