Greenaway Shape of Training Review

Appropriate organisations must make sure post-graduate medical education and training enhances its response to changing demographic and patient needs.

Postgraduate training must be structured within broad specialty areas based on patient care themes and defined by common clinical objectives.

Appropriate organisations, working with employers, must review the content of postgraduate curricula, how doctors are assessed and how they progress through training to make sure the postgraduate training structure is fit to deliver broader specialty training that includes generic capabilities, transferable competencies and more patient and employer involvement.

All doctors must be able to manage acutely ill patients with multiple co-morbidities within their broad specialty areas, and most doctors will continue to maintain these skills in their future careers.

Appropriate organisations, including employers, must consider how training arrangements will be coordinated to meet local needs while maintaining UK-wide standards.

Appropriate organisations, including postgraduate research and funding bodies, must support a flexible approach to clinical academic training.

Appropriate organisations, including employers, must structure continuing professional development (CPD) within a professional framework to meet patient and service needs, including mechanisms for all doctors to have access, opportunity and time to carry out the CPD agreed through job planning and appraisal.

Appropriate organisations should develop credentialed programmes for some specialty and all subspecialty training, which will be approved, regulated and quality assured by the GMC.

Appropriate organisations should review barriers faced by doctors outside of training who want to enter a formal training programme or access credentialed programmes.

Appropriate organisations should put in place broad based specialty training as described.

There should be immediate discussion about setting up a UK-wide Delivery Group to take forward the recommendations in this report and to identify which organizations should lead on specific actions.

Appropriate organisations should identify more ways of involving patients in educating and training doctors.

Appropriate organisations must provide clear advice to potential and current medical students about what they should expect from a medical career.

Medical schools, along with other appropriate organisations, must make sure medical graduates at the point of registration can work safely in a clinical role suitable to their competence level, and have experience of and insight into patient needs.

Full registration should move to the point of graduation from medical school, subject to the necessary legislation being approved by Parliament and educational, legal and regulatory measures are in place to assure patients and employers that doctors are fit to practice.

Appropriate organisations must introduce a generic capabilities framework for curricula for postgraduate training based on Good medical practice that covers, for example, communication, leadership, quality improvement and safety.

Appropriate organisations must introduce processes, including assessments, which allow doctors to progress at an appropriate pace through training within the overall timeframe of the training programme.

Appropriate organisations, including employers must introduce longer placements for doctors in training to work in teams and with supervisors including putting in place apprenticeship based arrangements.

Training should be limited to places that provide high quality training and supervision, and that are approved and quality assured by the GMC.