Doctors urge caution over proposals to shorten training time

http://www.theguardian.com/society/2015/jan/30/doctors-caution-proposals-shorten-training-time

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Leading doctors have warned that proposals to shorten medical training in the UK could compromise patient safety.

They claim there is a lack of evidence for changes that could reduce the training time to become a consultant from eight to 10 years, to six to eight years.

The British Medical Association said there were concerns that as a result of the changes doctors would not reach the necessary level of expertise.

The independent Shape of Training review, chaired by Professor David Greenaway of the University of Nottingham, looked at specialist doctor training.

It made a number of recommendations, including the shortening of training and changes to doctor registration.

A BMA spokesman said: “Changes affecting the future medical workforce cannot and should not be rushed.

“The government needs to listen to the concerns raised by the BMA and other stakeholders now that the report is out.

“The quality of future patient care is on the line – these changes need to be right, not rushed. That’s what many experts in medical education believe and we agree.”

Concerns have also been raised about the transparency of the review.

Dr Ben Dean fought for publication of minutes relating to a series of meetings between Professor Greenaway and the Department of Health which were not documented in the final report.

He told BBC Radio 4’s Today programme there were “potential influences” on the review that were not transparently documented in the paperwork.

“It was not as transparent as it could have been,” he said.

“We [doctors] very much embrace change we feel is in the best interests of the profession and patients.

“Without doing anything to improve training quality, cutting training time is potentially harmful, particularly if you devalue what it means to be a consultant.

“There is also the potential of de-skilling creep. The consultants do train the trainees so if the consultants are less skilled, then there may be a knock-on de-skilling effect.”

The Royal College of Physicians is also concerned that cutting doctors’ training could compromise both patient care and safety.

A spokesman said: “As many physicians train for both a medical specialty and in the more general medical skills they need to diagnose, manage and treat patients with a wide variety of medical conditions, shortening the time they take to complete both kinds of training would compromise both quality of patient care and patient safety.”

But the Department of Health confirmed any changes would only be implemented if they were in patients’ best interests. It also said no decision had been taken to shorten training or change registration.

It denied there had been anything but routine engagement with the review.

A spokeswoman said: “There was nothing other than routine engagement with Sir David Greenaway’s independent report from anyone at the Department of Health.

“What’s more, no decision has been taken to shorten consultant training or change doctors’ registration – any changes would only take place if they were in the best interests of patients and following appropriate consultation.”