SAM response to the Shape of Training report

Official response by Dr Alistair Douglas & Dr Mark Holland to Shape of Training report dating January 2014 is available here (PDF).

The Society for Acute Medicine welcomes the Shape of Training report and supports the underlying principles of:

  • The move towards generalism recognizing that acute medicine has many specialists who focus on the generality of acute medical disease;
  • Greater flexibility, recognising for example the differing needs of separate specialties but at the same time focusing on the need for greater breadth of training to alleviate the significant pressure off the medical registrar role;
  • The emphasis on protecting the UK wide system of medical training;
  • The “apprentice” model for doctors and their trainers and the increased focus on mentoring that should be available for  all doctors as they progress in the early part of their senior career;
  • Extended rotations as have already been promoted within acute medicine training;
  • The delivery of training in both the community and hospital settings that will promote better understanding of the whole patient pathway;
  • Training being limited to places that provide high quality training and supervision.

These remain high-level objectives and the detail that will have to be determined to deliver these principles will be critical. In particular the impact of broader based thematic training programmes in acute medicine will have to be determined as will the need to ensure that sufficient skills and experience continues to be accrued by the end of core specialist training.

The assessment of progression will be crucial to ensure patient-centred care is truly effective and safe. We feel strongly that an aim to focus on CST to produce doctors with more generalist skills should not be interpreted as a way of creating a sub consultant grade.

The proposed pace of change is extremely challenging but even with that these changes do not address the problems of the patient with acute medical problems who develops such problems today. An emphasis on improving the contribution of senior and trainee physicians from across the specialties to the acute medical take could improve both training and service delivery.

Dr Mike Jones

SAM Education and Training Committee Chair

1 November 2013

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