Shape of training review
Does anyone know any details of what is currently happen with the shape of training review ?
For those that dont know post-graduate training is planning to completely change based on a review of post-graduate education from 2008-2013.
Some of the changes include:
- Moving full registration from end of FY1 year to end of medical school year, (big concern for new doctors that UK doctors will be in competition with all europe for a foundation post given it is already oversubscribed)
- Move to generalised training, so you will train in 'general medicine', rather than cardiology. After this you would train as a specialist dependent on the hospital needs through credentials.
- 'Shortered' training to 6 years but in the end (at the end of the training you will be awarded a 'sub-consultant post' and will need extra training to specialise)
So anyway, the royal colleges and the BMA are up in arms but what will this mean for trainees.
Does anyone know
- What is happening next?
- When the changes will happen?
- How they will be introduced?
For those that dont know post-graduate training is planning to completely change based on a review of post-graduate education from 2008-2013.
Some of the changes include:
- Moving full registration from end of FY1 year to end of medical school year, (big concern for new doctors that UK doctors will be in competition with all europe for a foundation post given it is already oversubscribed)
- Move to generalised training, so you will train in 'general medicine', rather than cardiology. After this you would train as a specialist dependent on the hospital needs through credentials.
- 'Shortered' training to 6 years but in the end (at the end of the training you will be awarded a 'sub-consultant post' and will need extra training to specialise)
So anyway, the royal colleges and the BMA are up in arms but what will this mean for trainees.
Does anyone know
- What is happening next?
- When the changes will happen?
- How they will be introduced?
the link may provide more information. read guys, i didnt realise such major stuff was due to be happening.
http://bma.org.uk/working-for-change/policy-and-lobbying/training-and-workforce/shape-of-training-review
http://bma.org.uk/working-for-change/policy-and-lobbying/training-and-workforce/shape-of-training-review
I don't think that anyone really knows.
Original post by Revenged
Does anyone know
- What is happening next?
- When the changes will happen?
- How they will be introduced?
Does anyone know
- What is happening next?
- When the changes will happen?
- How they will be introduced?
As far as I was aware, it was still in consultation and figuring out the answers to these questions.
This kind of reminds me of the US system where you train in "internal medicine" and then do a speciality fellowship. However, this sort of negates any early attempts at career planning for anyone who wants to do medicine. I'm not sure how surgical/other specialities will change in relation to this but medicine training would become a total nightmare if this happens.
Worryingly the implication is you will pick sub specialty on 'local demand'.
Really hope it doesn't turn into another mtas fiasco. I remember remedy uk and junior doctors on the streets protesting when I was in medical school.
I suspect training will become longer with 'higher specialist training' replaced by credentialising and much less choice on specialty you will end up in. I would really rethink your training if you are thinking cmt or cst, might be better to flee to gp land !
Really hope it doesn't turn into another mtas fiasco. I remember remedy uk and junior doctors on the streets protesting when I was in medical school.
I suspect training will become longer with 'higher specialist training' replaced by credentialising and much less choice on specialty you will end up in. I would really rethink your training if you are thinking cmt or cst, might be better to flee to gp land !
Original post by Revenged
Worryingly the implication is you will pick sub specialty on 'local demand'.
Really hope it doesn't turn into another mtas fiasco. I remember remedy uk and junior doctors on the streets protesting when I was in medical school.
I suspect training will become longer with 'higher specialist training' replaced by credentialising and much less choice on specialty you will end up in. I would really rethink your training if you are thinking cmt or cst, might be better to flee to gp land !
Really hope it doesn't turn into another mtas fiasco. I remember remedy uk and junior doctors on the streets protesting when I was in medical school.
I suspect training will become longer with 'higher specialist training' replaced by credentialising and much less choice on specialty you will end up in. I would really rethink your training if you are thinking cmt or cst, might be better to flee to gp land !
Or take a more forceful interpretation of the definition of flee and take up residence elsewhere.
I suppose making people flee to GPland is part of the aim. There's an impending massive shortage, in addition to a move to ship more care 'into the community'. The current setup already implicitly encourages the fleeing: GPs make money much earlier, and I'm sure there are would-be surgeons out there that don't fancy nationalised ST3 selection lest they end up in Bangor or Carlisle (no hate to either 
).
Will be interesting to see how they intend to dumb down surgery in particular. What they're suggesting is sort of the norm in orthopaedics already: there's the hip guy, the knee guy, the shoulder guy, the foot and ankle guy, the paeds guy, all post-fellowship (or 'credentialed'
). The main difference between that and SoT is the cost. The McKinsey consultant wet dream would clearly be to churn out fracture and acute abdomen machines on lower salaries, but is that even possible?
).Will be interesting to see how they intend to dumb down surgery in particular. What they're suggesting is sort of the norm in orthopaedics already: there's the hip guy, the knee guy, the shoulder guy, the foot and ankle guy, the paeds guy, all post-fellowship (or 'credentialed'
). The main difference between that and SoT is the cost. The McKinsey consultant wet dream would clearly be to churn out fracture and acute abdomen machines on lower salaries, but is that even possible?Original post by Blatant Troll
I suppose making people flee to GPland is part of the aim. There's an impending massive shortage, in addition to a move to ship more care 'into the community'. The current setup already implicitly encourages the fleeing: GPs make money much earlier, and I'm sure there are would-be surgeons out there that don't fancy nationalised ST3 selection lest they end up in Bangor or Carlisle (no hate to either ).
Will be interesting to see how they intend to dumb down surgery in particular. What they're suggesting is sort of the norm in orthopaedics already: there's the hip guy, the knee guy, the shoulder guy, the foot and ankle guy, the paeds guy, all post-fellowship (or 'credentialed'). The main difference between that and SoT is the cost. The McKinsey consultant wet dream would clearly be to churn out fracture and acute abdomen machines on lower salaries, but is that even possible?
).Will be interesting to see how they intend to dumb down surgery in particular. What they're suggesting is sort of the norm in orthopaedics already: there's the hip guy, the knee guy, the shoulder guy, the foot and ankle guy, the paeds guy, all post-fellowship (or 'credentialed'
). The main difference between that and SoT is the cost. The McKinsey consultant wet dream would clearly be to churn out fracture and acute abdomen machines on lower salaries, but is that even possible?Wet dream? I like the analogy... but it is difficult to picture someone having a wet dream over that seeing as it the subconscious brain that controls it.... So someone must REALLY like it enough for them to subconsciously orgasm over it.... Interesting...
what is McKinsey consultant exactly ?
are you really wanting to do surgery. surgical training in the uk is an absolute shambles! training people no one wants or needs. even in the current system core surgical trainees cant progress. most cant core surgical trainings have never done an appendicectomy independently and the seniors dont care as there are so many post-cct without a consultantship. if they go onto becoming st3 (which many do not) then once you get CCT you have to do further fellowships. so yes surgery already has credentialising and still there are problems. Add in a changing structure - there will probably not be the ST3 hurdle in this new system - I would jump ship before you drown !
medical training would be better off. i think if you dont might get something general and are flexible with your options - acute medicine, geriatrics, etc - it is shouldnt affect you. i think some people who have straight ideas (palliative care / dermatology) may be in a shock as they will have to be 'THE MEDICALS REGISTRAR
' - i suspect this will happen. there is no need for a 'dermatology on call' at all so if doctors are going to be for the demands of the hospital then this will change. i think this junior consultant role is probably the future their will be too many consultants and too few juniors (in the past people used to be SHO for years and years, and SHO without training posts did not all go to australia to locum in A&E as they all do now). so perhaps this is why they want to remove a rigid training structure. one benefit maybe you can change your career as now we have to pick too early (perhaps the only good point i can think of now 
. i think the junior consultants and 'credentialise' may be something we might have to live with unforunately and i dont think the royal colleges will fight as most are already consultants and trainees dont have much power in the places high up that matter (BMA / royal colleges) etc.
as for GP crisis i think it is a result of three things - 1) older GP are leaving in droves or retiring early re QOF / silly targets, 2) many new graduates working as locum 3) most women go straight into part time work when they get their qualification (this is a big, sometimes the only reason, people pick it). i think this is why there is a 'crisis', they always fill all GPVTS training posts no problem, but yes GP is all over the BMJ at the moment with problems there so I am not sure it is necessary a good 'flee' option as yet. Maybe many of us will flee to GP later on, however, but i think giving specialisation a go is still good but maybe some people have to rethink their options.
are you really wanting to do surgery. surgical training in the uk is an absolute shambles! training people no one wants or needs. even in the current system core surgical trainees cant progress. most cant core surgical trainings have never done an appendicectomy independently and the seniors dont care as there are so many post-cct without a consultantship. if they go onto becoming st3 (which many do not) then once you get CCT you have to do further fellowships. so yes surgery already has credentialising and still there are problems. Add in a changing structure - there will probably not be the ST3 hurdle in this new system - I would jump ship before you drown !
medical training would be better off. i think if you dont might get something general and are flexible with your options - acute medicine, geriatrics, etc - it is shouldnt affect you. i think some people who have straight ideas (palliative care / dermatology) may be in a shock as they will have to be 'THE MEDICALS REGISTRAR
' - i suspect this will happen. there is no need for a 'dermatology on call' at all so if doctors are going to be for the demands of the hospital then this will change. i think this junior consultant role is probably the future their will be too many consultants and too few juniors (in the past people used to be SHO for years and years, and SHO without training posts did not all go to australia to locum in A&E as they all do now). so perhaps this is why they want to remove a rigid training structure. one benefit maybe you can change your career as now we have to pick too early (perhaps the only good point i can think of now . i think the junior consultants and 'credentialise' may be something we might have to live with unforunately and i dont think the royal colleges will fight as most are already consultants and trainees dont have much power in the places high up that matter (BMA / royal colleges) etc.as for GP crisis i think it is a result of three things - 1) older GP are leaving in droves or retiring early re QOF / silly targets, 2) many new graduates working as locum 3) most women go straight into part time work when they get their qualification (this is a big, sometimes the only reason, people pick it). i think this is why there is a 'crisis', they always fill all GPVTS training posts no problem, but yes GP is all over the BMJ at the moment with problems there so I am not sure it is necessary a good 'flee' option as yet. Maybe many of us will flee to GP later on, however, but i think giving specialisation a go is still good but maybe some people have to rethink their options.
Original post by Revenged
what is McKinsey consultant exactly ?
are you really wanting to do surgery. surgical training in the uk is an absolute shambles! training people no one wants or needs. even in the current system core surgical trainees cant progress. most cant core surgical trainings have never done an appendicectomy independently and the seniors dont care as there are so many post-cct without a consultantship. if they go onto becoming st3 (which many do not) then once you get CCT you have to do further fellowships. so yes surgery already has credentialising and still there are problems. Add in a changing structure - there will probably not be the ST3 hurdle in this new system - I would jump ship before you drown !
medical training would be better off. i think if you dont might get something general and are flexible with your options - acute medicine, geriatrics, etc - it is shouldnt affect you. i think some people who have straight ideas (palliative care / dermatology) may be in a shock as they will have to be 'THE MEDICALS REGISTRAR' - i suspect this will happen. there is no need for a 'dermatology on call' at all so if doctors are going to be for the demands of the hospital then this will change. i think this junior consultant role is probably the future their will be too many consultants and too few juniors (in the past people used to be SHO for years and years, and SHO without training posts did not all go to australia to locum in A&E as they all do now). so perhaps this is why they want to remove a rigid training structure. one benefit maybe you can change your career as now we have to pick too early (perhaps the only good point i can think of now . i think the junior consultants and 'credentialise' may be something we might have to live with unforunately and i dont think the royal colleges will fight as most are already consultants and trainees dont have much power in the places high up that matter (BMA / royal colleges) etc.
as for GP crisis i think it is a result of three things - 1) older GP are leaving in droves or retiring early re QOF / silly targets, 2) many new graduates working as locum 3) most women go straight into part time work when they get their qualification (this is a big, sometimes the only reason, people pick it). i think this is why there is a 'crisis', they always fill all GPVTS training posts no problem, but yes GP is all over the BMJ at the moment with problems there so I am not sure it is necessary a good 'flee' option as yet. Maybe many of us will flee to GP later on, however, but i think giving specialisation a go is still good but maybe some people have to rethink their options.
are you really wanting to do surgery. surgical training in the uk is an absolute shambles! training people no one wants or needs. even in the current system core surgical trainees cant progress. most cant core surgical trainings have never done an appendicectomy independently and the seniors dont care as there are so many post-cct without a consultantship. if they go onto becoming st3 (which many do not) then once you get CCT you have to do further fellowships. so yes surgery already has credentialising and still there are problems. Add in a changing structure - there will probably not be the ST3 hurdle in this new system - I would jump ship before you drown !
medical training would be better off. i think if you dont might get something general and are flexible with your options - acute medicine, geriatrics, etc - it is shouldnt affect you. i think some people who have straight ideas (palliative care / dermatology) may be in a shock as they will have to be 'THE MEDICALS REGISTRAR
' - i suspect this will happen. there is no need for a 'dermatology on call' at all so if doctors are going to be for the demands of the hospital then this will change. i think this junior consultant role is probably the future their will be too many consultants and too few juniors (in the past people used to be SHO for years and years, and SHO without training posts did not all go to australia to locum in A&E as they all do now). so perhaps this is why they want to remove a rigid training structure. one benefit maybe you can change your career as now we have to pick too early (perhaps the only good point i can think of now . i think the junior consultants and 'credentialise' may be something we might have to live with unforunately and i dont think the royal colleges will fight as most are already consultants and trainees dont have much power in the places high up that matter (BMA / royal colleges) etc.as for GP crisis i think it is a result of three things - 1) older GP are leaving in droves or retiring early re QOF / silly targets, 2) many new graduates working as locum 3) most women go straight into part time work when they get their qualification (this is a big, sometimes the only reason, people pick it). i think this is why there is a 'crisis', they always fill all GPVTS training posts no problem, but yes GP is all over the BMJ at the moment with problems there so I am not sure it is necessary a good 'flee' option as yet. Maybe many of us will flee to GP later on, however, but i think giving specialisation a go is still good but maybe some people have to rethink their options.
McKinsey & Company, as in the international management consultants in bed with DoH.
I don't disagree with anything you've said, and find it all rather depressing.
The one thing we have in our favour is the yin & yang inherent in all of this tinkering. Derm/GUM medical on call (and yet more women out of secondary care)? 7 day working (both in primary and secondary care)? Salaried McGPs working for a corporate behemoth inevitably headquartered in the Cayman Islands?
...you'll excuse the hyperbole on the last one
but just how far can they squeeze doctors before things really go tits up? I'm not so sure they'll get the workforce they're planning for, at least not so smoothly.Anyone have any further information/opinions about this? (Essentially bumping the thread.)
My friend was at the A.o.M.E. conference yesterday where there was a talk or two on this and according to their testimony, the aim is to have c. 75% of 'end-stage' doctors at the 'trained doctor' (a.k.a. sub-consultant) stage and c. 25% at the 'credentialed' (a.k.a. current consultant) stage. Stratification of doctors similar to the current staff grade-consultant situation but with far more at the lower rung than currently.
This seems to me that anyone who came into medical school anticipating the sort of salary (and thus, indirectly, lifestyle) current consultants get is in for an unpleasant shock.
My friend was at the A.o.M.E. conference yesterday where there was a talk or two on this and according to their testimony, the aim is to have c. 75% of 'end-stage' doctors at the 'trained doctor' (a.k.a. sub-consultant) stage and c. 25% at the 'credentialed' (a.k.a. current consultant) stage. Stratification of doctors similar to the current staff grade-consultant situation but with far more at the lower rung than currently.
This seems to me that anyone who came into medical school anticipating the sort of salary (and thus, indirectly, lifestyle) current consultants get is in for an unpleasant shock.
(edited 9 years ago)
Original post by Revenged
I think it will depend on your choice of career. It is all an unknown ATM.
That's the thing: I'm not sure it's true. I just don't know how well known it is by the workforce.
Original post by Blatant Troll
Salaried McGPs working for a corporate behemoth inevitably headquartered in the Cayman Islands?
Most of them already run prescription factories anyway.
In general I'm supportive of the greenaway recommendations, but it is somewhat concerning for those of us already on the treadmill to specialism
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