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Medical graduates ‘not fit to take up foundation programme posts’, say employers



Employers believe that medical graduates ‘lack professionalism’ and are ‘not fit’ to take up their foundation programme training posts, an influential review body has found.

The latest findings from the Shape of Training Review of postgraduate medical education and training warn that NHS employers are concerned that medical graduates lack the ‘essential skills’ necessary for their jobs and they had to teach graduates basic skills as part of their postgraduate training.

The review – which has been sponsored by the General Medical Council and the Academy of Medical Royal Colleges among others – also found that medical trainers were worried that medical graduates were losing learning opportunities as treatments were being removed from the NHS.

The panel interviewed hospital and GP trainers to gather evidence for its final report due out in the autumn.

Its evidence document said:  ‘We heard from almost all employers that they were concerned that many doctors when leaving medical school are not fit to take up their foundation programme posts. They suggested medical graduates often lack professionalism and do not have essential skills necessary for their job. Many employers suggested they had to teach graduates basic skills as part of their postgraduate training.’

However, Dr Krishna Kasaraneni chair of the BMA’s GP trainees subcommittee, told Pulse that this was not his experience.

He said: ‘Since my graduation eight years ago, the number of assessments newly qualified doctors have to do has increased significantly. It is no secret that workload in primary and secondary care has now reached record levels. Junior doctors now have to treat patients with more complex health needs due to an ageing population as well. I would suggest they are more competent than they have ever been before. A junior doctor’s work has been more intense and more focused than ever before.

‘I am very surprised at these suggestions from some employers that most junior doctors lack professionalism. If they do have some evidence to back it up, I would suggest they share it with medical schools to improve undergraduate training. This is nothing but anecdote and I wouldn’t want statements like this to form the basis of shaping the training of the future medical workforce.’

Elsewhere the review evidence showed that medical trainers were worried that many learning opportunities were being lost to the private sector as some treatments were being removed entirely from the NHS. They also raised concerns that doctors have a lack of exposure to outpatient clinics, which could give them another way of developing their decision-making skills.

Dr Kamal Sidhu, a GP trainer in Country Durham said: ‘NHS care becomes more fragmented by the day, there are and clearly will be lost opportunities for trainees. 

‘We already have been restricted in choice of out of hours providers who agree to take on GP trainees for the experience they need. Even when training requirements are a part of the contract, the ethos of providing a learning environment are very different from when expectation is purely of an additional pair of hands.   A lot of goodwill to make it work has been lost.’

He said that the next generation of GP trainees faced a challenge in learning to work in and with a ‘very fragmented environment’.

Dr Chand Nagpaul a GPC negotiator,  agreed and said that the BMA had always warned that the consequences of the Government’s insistence on the introduction of private providers would undermine and fragment NHS hospitals, which provide the bulk of junior doctor training.

‘This was always a concern about the reforms and one of the reasons the BMA believe it is important to recognise that the NHS does not just provide a service to patients.’

A spokeswoman for the review said the final report will be used to help assess the future of medical training and education and set future standards.

Pulse today revealed that deaneries are failing to produce enough medical graduates to meet Health Education England’s target of 3,250 GP trainees by 2015.