Specialty Training in the Future

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Specialty Training in the Future

• Elisabeth Paice
• Dean Director London Deanery
• Chair of COPMeD

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What is the Role of the Doctor of the Future?

• It would help Postgraduate Deans to know what
  product we are trying to produce..

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The NHS Reforms

• More choice and a much stronger voice for
  patients doctors who explain and listen
• More diverse providers, with more freedom to
  innovate and improve services doctors who are
  champions of change
• Money following the patients, rewarding the best
  and most efficient, giving others the incentive
  to improve doctors who can work in teams
• System management and decision-making to support
  quality, safety, fairness, equity and value for
  money doctors who share these values
•  

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Our Health, Our Care, Our Say

• Services closer to home
• Closer working between health and social care
• Plurality of provision
• Payment by results
• More emphasis on public health and self-care
• Reconfiguration
• - Doctors who are reliably competent, business
  aware, patient centred, and used to working in
  lots of settings

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NHS PLan

• More and better paid doctors and nurses

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Increases in medical staffing England 1990-2005
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Workforce modernisation

• Flexible productive working practices
• From occupational roles to defined competencies
• Reform of education, training, pay, contracts,
  pay, workforce planning and regulation
• Staff enabled to deliver the necessary change in
  practice and culture

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How do we train for better safer and more
responsive care?

• Safe working patterns 24/7 towards 2009
• New ways of working - in teams
• Using educational technology to the hilt
• Professionalising specialty training
• Developing specialists who are competent, humane
  and professional in all they do

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The Aims of MMC

• To produce enough trained doctors to provide
  frontline treatment
• To streamline training and make it more efficient
  
• To modernise the output of training by
  modernising the structure, content, delivery and
  the assessment of training
• Modernising recruitment and selection.??

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So what about ..?

• Competency-based selection?
• Foundation Programmes?
• Runthrough training?
• New Curricula?
• Core and higher specialty training?
• The Gold Guide?
• ARCP?

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Specialty Schools

• Bringing colleges, deanery, service and trainers
  together
• Joint (college/deanery) appointments of school
  directors
• Schools financed by and accountable to deaneries
• Manage and quality control local training
• Peer review arrangements with other schools

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PMETB Placements, Process and Product

• Placement is induction, supervision, training,
  appraisal, assessment meeting PMETB standards?
  Are trainers trained?
• Process Does recruitment, assessment, RITA,
  ARCP, rotational planning meet standards? Is the
  curriculum covered?
• Product Has the trainee achieved the
  competences required? Does the trainee perform to
  the required standard in practice? Can CCT or
  CESR be awarded?

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Trainer Development and Support

• Training for supervisors, assessors, appraisers,
  tutors, mentors,coaches, career advisors,
  educational leaders
• Time to do the job
• Tools to support the various activities
  e-portfolios, courses, assessment instruments etc
• Quality control and quality assurance

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The Challenge .

• To train specialists in a shorter working week
• while shortening the duration of training
• maintaining educational standards
• and improving the quality of patient care
• while at the same time reducing the hours of
  consultants
• A tall order

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The principles were right - the problems were
with the implementation
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The principles of postgraduate training

• Aspiring to excellence
• Flexibility
• Humane training for humane doctors