Generations divided on whether today’s medical training is up to the job
Authors: Matthew Limb
Publication date: 17 May 2017
A new study finds a generational split in attitudes to the quality of current medical training. Matt Limb reports
Junior doctors are increasingly satisfied with the quality of the training they receive, but many senior doctors think that current training is inadequate, a study has found.
A team from Oxford University analysed how different generations of UK doctors view the quality of their training. The researchers found that only 16% of all juniors surveyed thought that they had had to perform clinical tasks for which they felt inadequately trained. Of the most recent cohort (2012), the proportion who agreed had fallen to 12%.
However, 38% of senior doctors working in UK hospitals said that they did not think that specialty training enabled new consultants to practise adequately, and only 21% said they thought it was sufficient. Of practising senior GPs, 28% said that they did not think that general practice training was adequate for those taking up posts in general practice, while 41% said they thought that it was adequate.
Rose tinted view
Trevor Lambert, one of the authors, told BMJ Careers, “There may be a feeling that ‘younger people of today are not as well prepared as we were.’ It could be a sort of rose tinted view of their own training. But there could be an element here of concern, because some of these seniors will still be actively involved with training juniors.”
The researchers said that it was not clear whether the survey responses reflected actual levels of clinical experience, an element of “generational bias,” or an expression of the need for training to be adapted to tackle deficiencies. They also pointed out that many changes have taken place in the UK over the past decade that may have affected the training doctors receive.
Lambert said that the study had identified some areas of progress in medical training. “Overall, it’s a positive picture, I think, with caveats in one or two areas,” he said. “The good news is that the more recent [first year doctors] seem to report a better, more positive view of the quality of their training in the first year than their predecessors.”
Lambert said that shorter training periods might be a factor in lower levels of experience among doctors but that further research would be needed to examine whether that was significant in any clinical sense. The researchers concluded that it was for educators “to consider whether any adverse effects of recent changes to postgraduate training programmes can be minimised by further changes to educational delivery.”
The study was carried out by the UK Medical Careers Research Group at Oxford University’s Nuffield Department of Population Health and published on 8 May. It analysed the views of doctors at three stages: junior doctors towards the end of their first year after qualifying; middle stage doctors about 12 years after postgraduate qualification; and experienced senior doctors in their 50s or 60s. A total of nearly 19 000 doctors who graduated between 1974 and 2012 responded to eight different cohort surveys conducted between 2010 and 2014.
A third (36%) of trainees towards the end of their first year of medical work and training agreed that in their first year “training was of a high standard,” while 21% disagreed and 43% neither agreed nor disagreed. Most (83%) “middle stage” doctors agreed that their training had been “long enough and good enough” to enable them to practise adequately when they first became a consultant or GP, reflecting a “high level of confidence.”
Of respondents who believed that their level of training had been “deficient” on their first appointment to a senior post, 9.2% of surgeons (77 of 807 surveyed) thought that they lacked sufficient surgical experience, and 8.9% of GPs (189 of 2127) felt short of clinical experience. Lambert said that though the proportion of doctors who believed that their training had fallen short in these areas might seem small, it could indicate a problem in training requiring further investigation and, potentially, remedial action.
Matthew Limb freelance journalist BMJ Careers