Tooke review out

The eagerly await Tooke review has proverbially hit the shelves, it can be read in full here. There is plenty upon which to cogitate and at first glance it appears that John Tooke has done a pretty damn good job. There are some very damning words which should make the government and some of the other chief architects behind MMC and MTAS think very hard about the wrong they have done.

Importantly it is emphasised that training should aspire to excellence, a thinly veiled jab at the destructive force of competency based training if ever there was one. I will go into the details more at a later date, but I would like to reproduce this short extract in full:

"Service needs cannot be met now or in the future unless there is a clear understanding of what part each healthcare professional plays. This is particularly true for doctors and needs to be articulated for each career phase, including doctors in training and certificated specialists.

Without such definitions it is impracticable to pursue outcome focused medical education or attempt to plan the workforce. The Inquiry has revealed evidence of non-resolution of these fundamental definitions, and a lack of acknowledgement of the professional attributes the doctor brings to the healthcare team.

The doctor’s role as diagnostician and the handler of clinical uncertainty and ambiguity requires a profound educational base in science and evidence based practice as well as research awareness. The doctor’s frequent role as head of the healthcare team and commander of considerable clinical resource requires that greater attention is paid to management and leadership skills regardless of specialism. An acknowledgement of the leadership role of medicine is increasingly evident nationally with the appointment of an NHS Medical Director and a medically qualified Health Minister.

Role acknowledgement and aspiration to enhanced roles be they in subspecialty practice, management and leadership, education or research are likely to facilitate greater clinical engagement. Encouraging enhanced roles will ensure maximum return for the benefit society will derive from the investment in medical education.

Greater acknowledgement of the service contribution of trainees will help
reverse the emerging trend wherein some young doctors in training seem to
see themselves as trainees first and doctors second."

The emphasis here is key, doctors are not just another member of the leaderless impotent multidisciplinary team, they are the most highly skilled and highly trained leaders of the team; and it is about time that the government started treated medical training with the respect that it deserves, not with utter contempt like a political football that can be cynically abused at will.