The training pathway for newly qualified doctors has recently (2005) been reviewed and the traditional grades of medical career before the level of consultant have been changed. Modernising Medical Careers (MMC) is a new programme for postgraduate medical training: www.mmc.nhs.uk
After completing their pre-clinical and clinical university course applicants still have a way to go to being a fully-fledged doctor. It takes 5 further years to become a qualified GP and 7-9 years until they are a consultant in a hospital.
On completing medical school, junior doctors enter a vocational training phase. Newly qualified doctors apply for a place on a 2-year Foundation Programme. This is a bridge between university and specialist training. It consists of a series of placements in a variety of healthcare specialities to give applicants a broad insight into the different areas of medicine and enable them to decide the specific area on which they wish to focus.
During the F1 and F2 years, doctors are “Foundation House Officers” (FHO1 and FHO2). This replaces the traditional grades of Pre-registration House officer (PRHO) and Senior House Officer (SHO). During the F1 year, student only hold provisional registration with the General Medical Council - full registration is granted on completion of the first year. During F1, students rotate through 3/4 jobs in different hospital specialities. The GMC specifies that these must include General Medicine and General Surgery (General Practice is not allowed). The focus of the F2 year is the assessment and treatment of the acutely ill patient and also encompasses generic skills such as teamwork, time management, communication and IT skills.
Following the Foundation Programme is a training period known as Speciality Registrar (StR). This involves structured specialist or general practitioner training programmes and leads to the award of a CCT – Certificate of Completion of Training. To become a GP applicants must spend 3 years as a Speciality Registrar; for a hospital speciality, applicants carry out 6 years of training before qualifying as a Consultant. Previously doctors were required to take the relevant Medical Royal College membership examinations whilst still an SHO, but under the new system, the exams are taken later on during year 1/2 of the Speciality Registrar Training Scheme.
Criticisms
Concerns have been expressed by the BMA that the changes to the training programme have not been thought through and may worsen the training situation for junior doctors. Criticisms have been made about the new MMC system. There have been technical problems with the application procedure for Speciality Registrar positions and also a huge reduction in the number of posts available. On 17th March 2007 doctors marched in mass protest orchestrated by Remedy UK (pressure group representing junior doctors) against the system.
Links:
• Applicants can apply for Specialist Training through the MTAS – Medical Training Application Service: www.mtas.nhs.uk/
• The following website gives a more detailed description of the medical career progression: www.mmc.nhs.uk
• General Medical Council – www.gmc-uk.org
• Remedy UK: www.remedyuk.net/
Royal Colleges:
College of Emergency Medicine (Accident and Emergency/trauma)
Royal College of Anaesthetics (Anaesthesia/pain management)
Royal College of General Practitioners (GP)
Royal College of Obstetricians and Gynaecologists (sexual and reproductive health)
Royal College of Ophthalmologists (Eye disease)
Royal College of Pathologists (Diagnosis of disease)
Royal College of Paediatrics and Child Health (Child health)
Royal College of Psychiatrists (Mental health)
Royal College of Radiologists (Medical imaging)
Various colleges of physicians and surgeons depending on location |
