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The real cost of PMETB education

PMETB fee rise ­ blatantly unfair or the price of independence through financial self-sufficiency?

From Dr Nathan Goldrick, Westboughton, Bolton

What a great start for the PMETB! When it took over, it had people answering the phones saying: 'Call us back in a month when we know what we're doing.' Now it proposes a blatantly unfair fee hike.

To hide the true cost of this increase it has asked the RCGP to do most of the hard work and has persuaded the college to collect £350 from us directly. Added to the £750 it will ask for, the true cost of receiving a certificate of completion of training will be £1,100. A year ago it was only £250. Oh, and the sum is NOT tax deductible.

Suspiciously the PMETB has tried to rush through the fee increase by allowing an unusually short consultation period which finished on 13 January. This was before most GPs and trainees even knew about the increase.

In less than a week, 30 trainees from my area put their names to a formal letter of objection to the fee increase. Given more time, the list would have had at least 100 names.

The PMETB has been created to improve postgraduate medical education, as if we didn't have enough people trying to do that.

The Department of Health has told the PMETB it must do this without financial support. This is ludicrous. Surely the department is exactly the body that should be supporting and funding postgraduate education.

The PMETB in its wisdom has decided that the beneficiaries of this process are the trainees, who should therefore pay.

Excuse me, but last time I checked, the people who benefit from better doctors are the people who use the NHS, not the ones who spend their lives working hard to keep it going.

The PMETB needs to realise it is creating a generation of trainees who resent it from the outset. To reach its long-term goal of improving medical education it will need us on board and this is simply the wrong way of doing things. It needs to reconsider ­ quickly.

From Paul Streets, Chief Executive, PMETB, London SE1

Your editorial (Scrap fee rise for registrars, 19 January 2006) is misleading. Government funding for PMETB does not end in April 2006 but gradually declines over the next four years. The consultation was not 'an apparent effort to deter people from becoming a GP' nor did it suggest that registrars are the only ones that benefit from certification and therefore should pay.

The suggestion that 'if...PMETB really wants to be a champion of should tell the pay' could mean great central direction of postgraduate medical education at a time when the medical profession is calling for less Government interference.

The responses received during the fees consultation largely support our rationale for the need for independence but some reject the idea we need to charge fees to achieve this, let alone raise them.

PMETB has proposed the fee rise because we believe effective independence can only come from financial self-sufficiency. Also, the Government subsidy PMETB receives will be phased out by 2010.

If we cannot raise the necessary revenue we believe we require, we cannot fulfil our statutory role to 'develop and promote' postgraduate medical education.

PMETB believes it is important that the beneficiary of certification (ie trainees) should bear some of the costs as their potential earning power increases significantly once certified as a GP or specialist.

However, we recognise that others, including the NHS and society at large, benefit from a doctor's certification and we are looking at generating other revenue streams as the Government subsidy we receive declines.

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