3. What was MMC Trying to Fix?
• Curricula out of date for modern service
needs
• New consultants not fit for purpose -
obstacles rather than enablers of change
• SHOs over-specialised, under-skilled
• SHO, Trust doctor and ‘honorary SHO’
posts burgeoning
• Bottleneck at entry to SpR training
• New UK graduates crowded out by IMGs
4. The Aims of MMC
• To produce enough trained doctors
to provide safe frontline care - ie
reduce dependency on trainees
• To streamline training and make it
more efficient
• To produce doctors fit to play their
part in a modern, safe, first-class
patient-centred health service
5. To reach those aims we need to
modernise…
• the structure of training
• the content of training
• the delivery of training
• the assessment of trainees
• the support for trainers
• the management of training
• the QA of training programmes
6. Our Health, Our Care, Our Say
• Services closer to home
• Closer working between health and social
care
• Plurality of provision
• Payment by results
• More emphasis on public health and self-
care
• Reconfiguration
7. PMETB QA
• PMETB sets generic standards for post-
Foundation training
• PMETB approves college-developed
specialty curricula
• PMETB quality assures programmes by
monitoring local Deanery QC processes
• Deaneries responsible for Quality
Management
8. QA –Process, Placements and
Product
• Process – recruitment, assessment, RITA,
rotational planning. Is the curriculum covered?
• Placement – Does each placement offer
adequate induction, supervision, appraisal,
assessment and access to educational
resources – eg trained trainers and educational
resources
• Product – Has the trainee achieved the
competences required? Does the trainee
perform to the required standard in practice?
9. PMETB/COPMeD National
Survey of Doctors in Training
• All trainees in Senior House officer or
Specialist Registrar posts in UK, 2006
• Purpose of the survey to determine whether
hospitals etc met the national training
standards (PMETB’s Generic Standards for
Training)
• Questions developed from interviews with
trainees, validated by University of
Winchester
10. Data Collection
• Deaneries used one or more of the routes of
administration (all with the same items):
• Portable standalone electronic survey units
• PMETB – web invitation by email
• PMETB – web invitation by letter
• PMETB – scannable paper form
• Response rate was 65% (N = 24,880)
11. Points from Survey
• 62% of trainees were using a learning
portfolio
• 69% were using a log book
• 70% were involved in clinical audit
• 33% were participating in research
• 10% had made a serious or potentially
serious error in last month
12. How easy is it to get access to
the library services you need?
13. How easy is it to get access to the library services
you need?
0
5
10
15
20
25
30
35
40
45
50
Very difficult Moderately
difficult
Neutral Moderately
easy
Very easy
%respondents
14. Access to Library Services 'moderately' to 'very'
easy
0 10 20 30 40 50 60 70 80 90
London
Northern Ireland
Trent
Yorkshire
North Western
Northern
Mersey
SYSH
Severn and Wessex
Scotland
Eastern
Oxford
Penninsula
KSS
West Midlands
LNR
Wales
% respondents
15. Access to Library Services 'moderately' or 'very'
easy
0 20 40 60 80 100
Emergency Medicine
General Practice
Paediatrics
Psychiatry
Anaesthetics
Radiology
Medicine
Obs and Gynae
Pathology
Surgery
Ophthalmology
Public Health
% respondents
16. Do you have access to the
Internet at your place of work?
17. Do you have access to the internet at ypour place of
work?
0
10
20
30
40
50
60
70
80
Not at all Not always Yes, usually Yes, always
%respondents
18. Access to Internet at Work 'usually' or 'always'
75 80 85 90 95 100
Northern Ireland
Wales
Eastern
KSS
North Western
SYSH
West Midlands
London
LNR
Northern
Severn and Wessex
Scotland (East)
Yorkshire
Oxford
Penninsula
Mersey
Trent
$ respondents
19. Access to Internet at Work 'usually' or 'always'
82 84 86 88 90 92 94 96 98 100 102
Emergency Medicine
Psychiatry
Ophthalmology
Anaesthetics
Surgery
Medicine
Paediatrics
Obs and Gynae
Radiology
Pathology
General Practice
Public Health
% respondents
20. Do you currently have access to
e-learning material relevant to
your training?
21. Do you currently have access to e-learning material
relevant to your training?
0
10
20
30
40
50
60
70
80
No, not aware of any
relevant material
No, there is relevant
material but I cant
access it
Yes, there is relevant
material and I can
access it
%respondents
22. Access to relevant e-learning
0 10 20 30 40 50 60 70 80 90
Severn and Wessex
Eastern
SYSH
Trent
London
Yorkshire
KSS
Northern Ireland
Penninsula
North Western
West Midlands
Oxford
Northern
LNR
Wales
Mersey
Scotland
% respondents
23. Access to relevant e-learning?
0 20 40 60 80 100
Surgery
Ophthalmology
Medicine
Emergency Medicine
Radiology
Psychiatry
Paediatrics
Pathology
Anaesthetics
Obs and Gynae
Public Health
General Practice
% respondents
24. The Challenge:
• To train specialists in a shorter working
week…
• …while shortening the duration of training
• …maintaining educational standards
• …and improving the quality of patient care
• …while at the same time reducing the
hours of consultants…
A tall order
25. No Time to Waste
• Trainees at best service-neutral
• Eliminate duplication, waiting around,
inappropriate duties
• Wet-labs, drills, rehearsals, simulators
• Easy access to e-learning material
• Trainees learning whenever they are
working
26. The Role of the Doctor
• Diagnosis and skilled clinical interventions
• Handling the unknown, uncertain and
high-risk aspects of patient care
• Critical appraisal of available evidence -
seeking evidence where there is none
• Leadership, innovation and research
• Championship of change
• With a depth and breadth of education and
training to support all the above
27. Specialty Schools
• Bringing colleges, deanery, medical
schools, service and trainers together
• Joint (college/deanery) appointments of
school heads
• Financed by & accountable to deaneries
• Manage selection, training, quality
control, assessment
• Educational governance stakeholder
boards
28. Trainer Development and
Support
• Training and role clarity for supervisors,
assessors, appraisers, tutors,
mentors,coaches, career advisors,
educational leaders
• Time to do the job
• Tools to support the various activities – e-
portfolios, courses, assessment
instruments etc
• Educational technology
29.
30. What’s Happening in London?
• Restoration of medical education funds
• Closer working with SHA and Trusts
• Infrastructure for deanery
• Investment in training for trainers
• Medical education fellows
• Distributed simulation technology
• Investment in e-learning and PDAs
