London Medicine

Bringing together London’s medical, dental and healthcare higher education

The Shape of Training review

    There is much to be proud of within the UK’s medical education landscape.

    The General Medical Council’s 2011 national survey of trainees showed that nearly 90% of those nearing the end of their training were confident about taking up a new role as a specialist or GP.

    However, prior to the Shape of Training Review there had been six major reports that, as a whole, had concluded that the current system is too slow to adapt to patient and service needs and had limited flexibility for trainees.

    In recent years there have been several developments in UK medical education. However, with society’s needs changing, the review was commissioned in 2012 to transform medical training and education so that it may continue to produce doctors who are fit to practise and able to provide high quality care long into the future.

    The review focused on five themes across all of postgraduate medical training:

    • Patient needs
    • Balance of the medical workforce – specialists or generalists?
    • Flexibility of training
    • The breadth and scope of training
    • Tension between service and training

    It also gathered the expectations of and opportunities for doctors including their decisions about what they want to specialise in during training. The review began in late 2012 by gathering evidence from a number of individuals and organisations with interests in postgraduate training.

    The final report

    The final report was published in October 2013; setting out a framework for delivering change that caused minimum disruption to service.

    In total it made 19 recommendations describing an approach to training that would produce more broadly trained doctors. The key milestones in the new training structure were:

    • Full registration should happen at point of graduation from medical school
    • Doctors must have opportunities to follow patients through their entire care pathway
    • Specialties and areas of practice will instead be grouped together under patient care themes
    • During postgraduate training doctors should be given opportunities to gain wider experiences in related specialties, education or management
    • When doctors want to change specialties they will be able to transfer relevant competencies across without repeating the same learning
    • The exit point of postgraduate training will be the Certificate of Specialty Training
    • Most doctors will work in the general area of their broad specialty throughout their careers with options for further development of knowledge and skills

    The report also recommended the creation of a UK-wide Delivery Group that would be responsible for implementing the suggested changes to postgraduate medical and education training as well as evaluating the cost implications for the new structure. This group will consist of the Sponsoring Board organisations, the four UK departments of health, employers, other key professionals and patient groups.

    The Shape of Training review gave a possible timescale of having the new structure in place within 5 years and the desired outcomes being realised within 10 years.

    In February 2014 the four UK Departments of Health agreed to set up a steering group to consider how to take forward the report’s recommendations with the first meeting taking place in May. The initial steps will be to agree the principles for implementation, determine whether proposed policy changes are clear enough and if aspects of the review can commence immediately.

    Read the Shape of Training Review report in full here.