Aspiring to Excellence: Final report January 8, 2008
Posted by western4uk in Grey Literature, Medical Education, Medical Staff.Tags: Grey Literature, Modernising Medical Careers, Postgraduate Medical Education
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The final version of Aspiring to Excellence: Final report of the Independent Inquiry into Modernising Medical Careers (the Tooke Report).
It identifies the following issues:
- The policy objective of postgraduate medical training is unclear. There is currently no consensus on the educational principles guiding postgraduate medical training. Moreover, there are no strong mechanisms for creating such consensus.
- There is currently no consensus on the role of doctors at various career stages.
- Weak DH policy development, implementation, and governance together with poor inter- and Intra-Departmental links adversely affected the planned reform of postgraduate training.
- Medical workforce planning is hampered by lack of clarity regarding doctors’ roles and does not align with other aspects of health policy. There is a policy vacuum regarding the potential massive increase in trainee numbers. Planning capacity is limited and training commissioning Budgets are vulnerable in England now that they are held at SHA level.
- The medical profession’s effective involvement in training policy-making has been weak.
- The management of postgraduate training is currently hampered by unclear principles, a weak contractual base, a lack of cohesion, a fragmented structure, and in England, deficient relationships with academia and service.
- The regulation of the continuum of medical education involves two bodies: GMC and PMETB, creating diseconomies in terms of both finance and expertise.
- The structure of postgraduate training proposed by MMC is unlikely to encourage or reward striving for excellence, offer appropriate flexibility to trainees, facilitate future workforce design, or meet the needs of particular groups (e.g. those with academic aspirations, or those pursuing non-consultant career grade experience). It risks creating another ‘lost tribe’ at FTSTA level.
The following corrective actions should be undertaken
- There must be clear shared principles for postgraduate medical training that emphasise
flexibility and an aspiration to excellence. - Consensus on the role of doctors needs to be reached by the end of 2008 and the service
contribution of trainees better acknowledged. - DH policy development, implementation and governance should be strengthened. DH should appoint a lead for medical education, and strengthen collaboration, particularly the
health:education sector partnership. - Workforce policy objectives must be integrated with training and service objectives.
- Medical workforce advisory machinery should be revised and enhanced. SHA workforce planning and commissioning should be subject to external scrutiny. Policies with respect to the current bulge in trainees and international medical graduates should be urgently resolved.
- The profession should develop a mechanism for providing coherent advice on matters affecting the entire profession.
- The accountability structure for postgraduate training and funding flows should be reviewed.
- Revised management structures should conform to agreed principles but reflect local circumstances. In England Graduate Schools should be trialled where supported locally.
- PMETB should be merged within GMC to facilitate economies of scale, a common approach, linkage of accreditation with registration and the sharing of quality enhancement expertise.
- The structure of postgraduate training should be modified to provide a broad based platform for subsequent higher specialist training, increased flexibility, the valuing of experience and the promotion of excellence.
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