CHANGES TO POSTGRADUATE TRAINING

By The College
Contact the author by e-mail at christopher.johnstone@ntlworld.com

In April 2004, Modernising Medical Careers: the Next Steps, was published by the Department of Health. This takes forward arrangements for the reform of medical training and provides greater detail on the future shape of foundation programmes and specialist and general practice training. As well as defining the standards for foundation training, it discusses how doctors should be assessed against these standards and explains the relationship between the Foundation Programme and the regulatory framework for basic medical education, specialist and general practice training.

A key proposal of the Modernising Medical Careers agenda (MMC) is the introduction of a two-year foundation programme which aims to develop generic competencies useful in any branch of medicine. The foundation programme offers the chance to improve the educational experience of the early years after graduation, to ensure greater supervision and support for young doctors, to expand the breadth of clinical and research experience and to enable greater flexibility in training and working. Pilot schemes are currently running in England and commissioning of the two year foundation programme for medical graduates is scheduled to begin from August 2005.

In Scotland, Modernising Medical Careers Scottish Delivery Group, which is led by Professor Stuart MacPherson, oversees the implementation of MMC. RCGP Scotland Chair, Dr Mairi Scott, is one of two Scottish Academy of Faculties and Royal Colleges representatives on this group.

Until now, the work of the group has focused on the creation of ‘Foundation Programmes’ in Scotland as the current cohort of final year medical students will need to be informed in May 2004 about the proposals for August 2005. There have been concerns around the nature of the changes to PRHO arrangements, particularly given the timescales involved, and the Scottish Delivery Group are developing a quick guide to help inform students and trainee doctors about MMC and the Foundation Programmes (FPs).

Foundation Programmes in a Nutshell
A Foundation Programme (FP) will be delivered through four Scottish deaneries to standards that have been set by the General Medical Council (GMC) and Postgraduate Medical Education and Training Board (PMETB). It is envisaged that the programmes will comprise around 30 doctors (15 in each year), each pursuing their own individual programme, of usually 6 placements of 4 month durations. The guidance document outlines that the FP will include ‘a broad range of experience in mainly acute care settings and a clear aim to provide experience in mental health as well as in general practice’.

The College is concerned at the apparent lack of focus on general practice in the planning of FPs and will continue to work with the Scottish Delivery Group and others, e.g. the Academic Forum, to ensure that the opportunities for increasing access to general practice as part of the foundation programme are maximised.

All medical students wishing to undertake FP in Scotland must apply through the Scottish Foundation Allocation Scheme (SFAS), while current PRHO and SHO posts will be progressively configured to create the FPs.

Further information

A copy of Modernising Medical Careers: the Next Steps is available at www.dh.gov.uk/publications (type Modernising Medical Careers: the Next Steps into the search bar).

Details of the Scottish Foundation Allocation Scheme will be available shortly on the NHS Education for Scotland web site at: www.nes.scot.nhs.uk.

For further information on Modernising Medical Careers, visit: www.mmm.nhs.uk/index.asp. Details of MMC in Scotland will be available shortly on the SHOW site: www.show.scot.nhs.uk.

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.