Doctors' career structure to be overhauled

The training and career structure of doctors is set to undergo its biggest reorganisation, under government plans to curb restrictive practices in the medical profession and improve accountability.

Doctors' training time will be halved to between five and seven years and the pool able to practice as NHS consultants or in the private sector will be widened. The expected growth in the supply of doctors considered competent for independent specialist practice could trigger a fall in private medical fees.

A blueprint for the overhaul has been agreed by a working party headed by Kenneth Calman, the Chief Medical Officer. The European Commission, which complained last year that UK practices were 'unfair and discriminatory', will examine the proposals this week.

Dr Calman will also recommend to Virginia Bottomley, Secretary of State for Health, that a new regulatory framework should be put before Parliament this summer to enable the new training and career structure to start in 1995.

The Department of Health established the review after the Independent disclosed EC complaints last spring about the UK's two-tier system of specialist medical qualifications. Among the bodies represented on the working party were the medical Royal Colleges, the General Medical Council and the NHS Management Executive.

Despite the advent of EC specialist certification in 1977, intended to allow the free movement of fully trained medical specialists across EC boundaries, Britain retained its own system of accreditation. Three doctors are known to have legal actions pending against the Department of Health, seeking damages over the non-recognition of their EC certificates.

Accreditation is a pre-requisite for appointment to most hospital consultant posts and has been criticised by juniors over the poorly- understood and apparently arbitrary criteria used by the Royal Colleges to award it. It will be phased out under the recommended reorganisation. Instead there will be the Certificate of Completion of Specialist Training, awarded after shorter, more intensive and better structured periods in training.

Doctors now spend between 10 and 15 years in training. As a result, junior doctors are the front- line troops of NHS hospital care, delivering the bulk of medical care and working on average a 75-hour week. They often spend long periods without direct supervision or structured training.

Senior registrar and career registrar grades should be combined to help streamline training and reduce bottlenecks, the working party concluded. The conversion of some SR posts into consultant posts, as vacancies arise, will help reduce delays faced by doctors trying to move up the career ladder. Already, the number of consultant posts has been growing at the rate of 2.8 per cent a year, or by about 300 to 400, to help cut junior doctors' hours.

The Medical Register, open to public inspection, will be amended to enable easy and reliable identification of fully trained specialists.

New statutory appeals machinery might be needed to resolve disputes about registration and specialist certification.

Dr Calman, whose proposals are to be published this week, believes the changes will help deliver better services. He said: 'The purpose of medical education and training is not simply about providing jobs for doctors, but improving services to the patient.'

Start your day with The Independent, sign up for daily news emails
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
ebooks
ebooksA special investigation by Andy McSmith
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Tradewind Recruitment: KS2 Teacher

Negotiable: Tradewind Recruitment: My client is a two form entry primary schoo...

Tradewind Recruitment: English Teacher

Negotiable: Tradewind Recruitment: My client is an excellent, large partially ...

Tradewind Recruitment: Science Teacher

£90 - £140 per day: Tradewind Recruitment: I am currently working in partnersh...

Tradewind Recruitment: Year 3 Primary Teacher

£100 - £150 per day: Tradewind Recruitment: Year 3 Teacher Birmingham Jan 2015...

Day In a Page

Isis hostage crisis: The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power

Isis hostage crisis

The prisoner swap has only one purpose for the militants - recognition its Islamic State exists and that foreign nations acknowledge its power, says Robert Fisk
Missing salvage expert who found $50m of sunken treasure before disappearing, tracked down at last

The runaway buccaneers and the ship full of gold

Salvage expert Tommy Thompson found sunken treasure worth millions. Then he vanished... until now
Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

Homeless Veterans appeal: ‘If you’re hard on the world you are hard on yourself’

Maverick artist Grayson Perry backs our campaign
Assisted Dying Bill: I want to be able to decide about my own death - I want to have control of my life

Assisted Dying Bill: 'I want control of my life'

This week the Assisted Dying Bill is debated in the Lords. Virginia Ironside, who has already made plans for her own self-deliverance, argues that it's time we allowed people a humane, compassionate death
Move over, kale - cabbage is the new rising star

Cabbage is king again

Sophie Morris banishes thoughts of soggy school dinners and turns over a new leaf
11 best winter skin treats

Give your moisturiser a helping hand: 11 best winter skin treats

Get an extra boost of nourishment from one of these hard-working products
Paul Scholes column: The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him

Paul Scholes column

The more Jose Mourinho attempts to influence match officials, the more they are likely to ignore him
Frank Warren column: No cigar, but pots of money: here come the Cubans

Frank Warren's Ringside

No cigar, but pots of money: here come the Cubans
Isis hostage crisis: Militant group stands strong as its numerous enemies fail to find a common plan to defeat it

Isis stands strong as its numerous enemies fail to find a common plan to defeat it

The jihadis are being squeezed militarily and economically, but there is no sign of an implosion, says Patrick Cockburn
Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action

Virtual reality: Seeing is believing

Virtual reality thrusts viewers into the frontline of global events - and puts film-goers at the heart of the action
Homeless Veterans appeal: MP says Coalition ‘not doing enough’

Homeless Veterans appeal

MP says Coalition ‘not doing enough’ to help
Larry David, Steve Coogan and other comedians share stories of depression in new documentary

Comedians share stories of depression

The director of the new documentary, Kevin Pollak, tells Jessica Barrett how he got them to talk
Has The Archers lost the plot with it's spicy storylines?

Has The Archers lost the plot?

A growing number of listeners are voicing their discontent over the rural soap's spicy storylines; so loudly that even the BBC's director-general seems worried, says Simon Kelner
English Heritage adds 14 post-war office buildings to its protected lists

14 office buildings added to protected lists

Christopher Beanland explores the underrated appeal of these palaces of pen-pushing
Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

Human skull discovery in Israel proves humans lived side-by-side with Neanderthals

Scientists unearthed the cranial fragments from Manot Cave in West Galilee