Modernising Medical Career mmc.nhs.uk

1. Modernising Medical Careerwww.mmc.nhs.uk Dr Chris Wong Mr. Chris Low

3. Changes over the past decade • 1996 Calman reforms • Introduction of structured training in UK • 1996-2004 • Establishing Calman Training, ‘grid’ trainees • 2005 onward • ‘Modernising Medical Careers’ • Establishing education programmes at all levels • Promotion of continuous professional development

4. Changing Training • Combination of (1) Calman changes and (2) New Deal reduced time for training a consultant by ~ 50% • Further reductions from EWTD (Aug 2004) reduce this further (~20%) • Expectations that streamlining training through SHO-SpR grades will substancially reduce training time may be optimistic • Move from time-based to competency-based training

5. Competency-based training • A real and demonstrated ability to successfully carry out an identified activity • Thus competence focuses on the outputs from activities, not inputs. It is not what is known or has been learnt, but what is implemented when the job is performed.

6. MMC • All graduates now enter a Foundation programme focused on developing key competencies (started Aug 2005) • F1=PRHO, F2=SHO • Move from experienced-based to outcome- based training • Stage specific learning objectives • In training work-based assessments • Demonstrated competence in (7 areas of Good medical practice) will drive career progression • GMC apporval • PMETB – quality assurance • Deaneries – implementation and management

7. CCT Senior medical appointment Specialist/GP register Article 14 Career post ST3+ FTSTA 2 ST2 ST1 FTSTA 1 F2 F1 Medical Training Application Service – Online, Score provided by medical school and application answers Medical school MMC career map

8. The Big Bang • ST1, ST2, ST3 will start simultaneously in 2007 • Junior SHOs will be permitted to enter a ST2 • Year 1 SpRs will move to ST3 • As few as 9500 entry points for all three years of specialist training • Deferred places announced • After 2008, entry to specialty training will mainly be ST1.

9. CCT Senior medical appointment Specialist/GP register Article 14 Career post ST3+ FTSTA 2 ST2 ST1 FTSTA 1 F2 F1 Medical school MMC career map

11. CCT Senior medical appointment Specialist/GP register Article 14/11 Career post ST3+ ST2 FTSTA 2 ST1 FTSTA 1 MMC career map

12. CCT Senior medical appointment Specialist/GP register Article 14 Career post ST3+ FTSTA 2 ST2 FTSTA 1 ST1 F2 F1 Medical school MMC career map

13. CCT Senior medical appointment Specialist/GP register Article 14/11 Career post ST3+ ST2 FTSTA 2 ST1 F2 FTSTA 1 F1 Medical school MMC career map

14. CCT Senior medical appointment Specialist/GP register Article 14/11 Career post ST3+ ST2 FTSTA 2 ST1 FTSTA 1 MMC career map

15. Advantages of MMC • More structured training • More emphasis will be placed on training in the workplace as opposed to theory style instruction • Follow set curriculum • Produce consultants on average about 2 years earlier

16. Disadvantages • Make decision regarding chosen specialty after 2 postgraduate years • Unable to gain experience in some specialties and shortage in some specialties • Shaortage in number of training positions – increased competition! • Acceleration to consultant level (restriction in training time with EWTD) result in less experienced newly qualified consultants