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Government proposes to shorten training for doctors post-Brexit

The BMA has warned that proposals to shorten training for doctors post-Brexit ‘would be a mistake’ and put ‘patient safety at risk’.

The warning comes after health minister Stephen Barclay told the Telegraph that doctors could be fast-tracked through training after Brexit in an effort to tackle staff shortages. 

The latest Pulse survey revealed that GP vacancy rates have rocketed to the highest level ever recorded, with one in six positions unfilled, according to a major Pulse survey last month

But in a letter to the minister the BMA said that moving forward the ‘point of registration’ would ‘seriously dilute the quality of our current training programmes’.

EU regulations currently require medical students to have at least five years of medical training before they are registered but after Brexit, the UK will be able to set its own length of training for doctors.

Mr Barclay said: ‘There are opportunities that come with Brexit – not to lower regulatory standards we want to maintain standards – to look at how we make things more bespoke to UK needs.’

He added: ‘There is scope to increase the number of doctors and the number of clinicians. It is not just doctors because what we need in the NHS is a wider skills mix.

‘At the moment you don’t qualify as a doctor when you leave medical school – you have to do a further year and that brings with it some additional costs.’

Mr Barclay suggested that the money saved ‘could be reinvested into training more medical students’.

But the BMA wrote to Mr Barclay to warn against his proposals, which suggested fully registering a doctor after their undergraduate study, instead of after FY1.

The letter said: ‘Under provisional registration, the first year of the foundation programme provides vital opportunities for medical graduates to participate in and to provide diagnoses and treatment under close supervision. 

‘This cannot be matched by current clinical placements in medical school. It allows graduates to learn through experience and to increase their confidence in their abilities.

‘It also creates significant opportunities for trainers to identify and support trainees who may be struggling with their clinical responsibilities.’

BMA representative body chair Dr Anthea Mowat, called the proposal an ‘ill thought out scheme’.

She said: ‘Training doctors takes time and experience. Patients want to be seen by a doctor who can provide them with the best possible care. 

‘Reducing their training time so that junior doctors have less expertise and less support than the current system provides will not achieve this.’

House of commons health committee chair Sarah Wollaston MP also criticised the idea that EU regulations were holding UK policymakers back on shortening doctors’ training.

Ms Wollaston tweeted: ‘This is rubbish, faster post-grad courses already exist for those who have relevant degrees. It’s not a #Brexit dividend to have worse training for doctors fgs. What planet are these straw clutchers on?’

The latest official statistics revealed that the number of FTE GPs in the workforce has decreased more than 1,000 since September 2015 – when health secretary Jeremy Hunt announced he would increase the number of FTE GPs in England by 5,000.

How long should GPs spend in training?

The length of time GPs should spend in training has long been debated, with an extended four-year training an RCGP priority for years

It was even backed by health secretary Jeremy Hunt until 2014 when realisation of the scale of the workforce crisis saw ministers kick plans into the long grass.

In 2017, a group of experts on the Shape of Training steering groupargued instead in favour of a more flexible ‘three plus one’ model, which would include a one-year fellowship scheme.

The RCGP said last year it would continue lobbying for extended training and HEE backed further discussion over extending GP training to four years in its 10-year workforce plan published in December 2017.

But this all comes against the backdrop of a severe workforce shortage in general practice, with health secretary Jeremy Hunt confessing earlier this month that he is ‘struggling to deliver’ his pledge for 5,000 additional GPs by 2020.