Monday, 3 February 2014

My letter to BMJ on Tooke's defense of the Shape of Training

I read Professor Sir John Tooke’s recent editorial with great interest (1) and it is strange that he sees the Shape of Training review as a ‘broad consensus’ of opinion. Professor Sir John’s ‘MMC inquiry’ concluded that:

“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.”

This quote is as true and relevant today as when it was originally published in 2008. Subsequent to the publication of the MMC Inquiry, information released as a result of Freedom of Information (FOI) requests proved that the motives behind MMC were ultimately cynical (2):
“The advantage of creating a new structure for doctors coming through the new training is that it avoids having to renegotiate the contract with existing consultants ... which would be bitterly resisted.”

The GMC has recently refused a specific FOI request to release documentation pertaining to discussions that Professor Greenaway had with ministers or civil servants about the Shape of Training review. This information may help to clarify the genuine motives behind the Shape of Training review and the GMC’s decision is currently under appeal with the Information Commissioner’s Office. The GMC’s refusal to release such important information appears inconsistent with the motives behind the Shape of Training review being entirely well intentioned.

The Shape of Training review seems another cynical politically motivated disaster in the making, one that prioritises the short term needs of politicians over the short and long term needs of both doctors and patients. Not only do the genuine motives of the review remain unclear, but the specific details regarding implementation appear almost entirely absent for all specialities other than for women’s health, child health and mental health. Forgive me for daring to question the ‘consensus’, but the Shape of Training appears to be no such thing and the medical profession is right be remain guarded until all the specific details have been laid bare on the table.

1. John T. Postgraduate medical education and training in the UK. BMJ (Clinical research ed.) 2013;347.

 2. Remedy UK. Remedy UK website 2009;17th May.