The Shape of Training was a review of postgraduate medical education and training in the United Kingdom, which reported in 2013. The review was undertaken to consider workforce issues, such as the balance between specialisation and generalism in medicine. The review was supported by a range of organisations concerned with medical education and had an independent chair, Professor Sir David Greenaway.
Background
In 2005, Modernising Medical Careers had launched, introducing a new style of specialist training across the UK. The independent inquiry into these changes led by John Tooke in 2007 had commented on some of the issues. In 2011, Medical Education England scoped themes that could be considered as part of further restructuring of medical training. The relative lack of generalist training had been highlighted by another advisory group, the NHS Future Forum, who pointed towards the review that would follow.
The report suggests an argument for changing the structure of training is that there are more patients with a complex mixture of conditions. This means doctors need to have a greater breadth of knowledge, rather than specialising early in their careers, it says.
Proposals
The final report of the review listed 19 recommendations. There were a number of suggestions for the UK governments, including that :
on leaving medical school, doctors should be allowed to be fully registered to practise, rather than completing a year working under supervision as they do now.
on completion of their postgraduate training doctors should be awarded a certificate of specialty training, rather than the certificate of completion of training
the length of training for a qualified doctor to become a consultant could be reduced to between six and eight years
specialties be grouped together under “patient care themes” with common clinical objectives
Responses
, the chair of the GMC, acknowledged that moving the point of full registration would need further discussion. He also said that there would need to be "some stability in a system that has already been subject to a great deal of change and pressure in recent years." There were questions raised about transparency and political independence of the review, after details emerged of meetings between the GMC and civil servants from the Department of Health which were not mentioned in the final report.
