Doctors' Working Lives News
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Monday, January 14, 2008
Tooke final report on Modernising Medical Careers
The final Tooke report following the inquiry into Modernising Medical Careers has concluded that the original principles of the recruitment process were "well-conceived" but "lost in translation", resulting in "an inflexible structure that does not encourage excellence". The recommendations include:
* A new body, NHS Medical Education England, to manage postgraduate medical training
* A ring-fenced budget to prevent money intended for education and training from being used to plug hospital deficits
* A more flexible approach to the 48 hour working time limit (for instance by separating education and service time) if possible, and an examination of how changes to training can compensate for the EWTD's impact
On the EWTD issue, the report concludes that:
"....the current interpretation in UK legislation impedes the acquisition of experience, of confidence and the ability to shoulder responsibility. This promotes further the 'trainee mentality' over and above a recognition of the trainee's service contribution. In the interest of patient safety, no one would wish to see a return to hours of duty that impact on adequate rest and relaxation, but few other professions in the UK, nor medical career structures in Europe embrace the Directive in the same way that it has been embraced in the UK...
The Panel recommends that urgent attention should address whether there are ways in which a more flexible approach to EWTD could be legitimately embraced (e.g. separation of service and educational contracts). Due regard should also be given to whether additional compensatory mechanisms (which have been the subject of valuable but as yet unpublished scoping studies) could offset any reduction in clinical experience. DH should explore the potential for contractual solutions."
The full report can be found here. The BMJ has an audio interview with Sir John Tooke about the report. You can also access a full transcript here.
The report is so far being warmly welcomed by everyone, apparently. Click for responses from:
BMA
Remedy UK
Department of Health spokesperson
Royal College of Physicians
Royal College of Surgeons
Royal College of General Practitioners
Royal College of Radiologists
Royal College of Anaesthetists
Medical Schools Council
Academy of Medical Sciences
See also reports from the BBC, Telegraph, Times, Guardian, etc.
0 Comments:
* A new body, NHS Medical Education England, to manage postgraduate medical training
* A ring-fenced budget to prevent money intended for education and training from being used to plug hospital deficits
* A more flexible approach to the 48 hour working time limit (for instance by separating education and service time) if possible, and an examination of how changes to training can compensate for the EWTD's impact
On the EWTD issue, the report concludes that:
"....the current interpretation in UK legislation impedes the acquisition of experience, of confidence and the ability to shoulder responsibility. This promotes further the 'trainee mentality' over and above a recognition of the trainee's service contribution. In the interest of patient safety, no one would wish to see a return to hours of duty that impact on adequate rest and relaxation, but few other professions in the UK, nor medical career structures in Europe embrace the Directive in the same way that it has been embraced in the UK...
The Panel recommends that urgent attention should address whether there are ways in which a more flexible approach to EWTD could be legitimately embraced (e.g. separation of service and educational contracts). Due regard should also be given to whether additional compensatory mechanisms (which have been the subject of valuable but as yet unpublished scoping studies) could offset any reduction in clinical experience. DH should explore the potential for contractual solutions."
The full report can be found here. The BMJ has an audio interview with Sir John Tooke about the report. You can also access a full transcript here.
The report is so far being warmly welcomed by everyone, apparently. Click for responses from:
BMA
Remedy UK
Department of Health spokesperson
Royal College of Physicians
Royal College of Surgeons
Royal College of General Practitioners
Royal College of Radiologists
Royal College of Anaesthetists
Medical Schools Council
Academy of Medical Sciences
See also reports from the BBC, Telegraph, Times, Guardian, etc.
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