Junior doctors attack government抯 training reforms
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《英国医生杂志》
Britain抯 junior doctors have attacked government reforms that would shorten the length of their training by several years and radically alter the career path of future consultants.
At the BMA抯 annual meeting for junior doctors last week delegates unanimously supported a vote of no confidence in the government抯 "modernising medical careers" initiative.
Medical students who decide to boycott the new "foundation" training programmes will have the full support of the BMA, pledged Mr Simon Eccles, chairman of the BMA抯 Junior Doctors Committee.
The BMA will now lobby for a delay in implementation of the programme.
A Department of Health spokeswoman said the team running the initiative was "surprised and disappointed" at the vote. A consensus meeting with trainee doctors in March had produced positive agreements, she said.
While junior doctors generally agreed that the current system of medical education was in need of an update, there was a strong feeling at the conference that the reforms were being rushed through piecemeal for political reasons.
"Why the rush?" asked Mr Joseph Huang, a specialist registrar at Addenbrooke抯 Hospital, Cambridge, and president of the Association of Surgeons in Training. "We抮e convinced it抯 a political timetable."
Mr Angus Robertson, a specialist registrar at Hull Royal Infirmary and secretary of the British Orthopaedic Trainees Association, agreed: "I think the government wants to meet its election promises to produce large numbers of specialists rapidly, irrespective of the quality of those specialists."
Under the reforms, from August 2005 the first two years of a junior doctor抯 training will be replaced by a foundation programme. Work during these two years will be formally assessed, but the standards have not yet been published.
Some medical students are already applying for new style training posts that will start in August this year, as part of a pilot scheme. These students have no guarantee that their posts will receive educational accreditation.
Speakers at the conference warned that the reforms—which also include alterations to the post of specialist registrar—would lower professional standards in the United Kingdom. Taken together, the changes in the modernising medical careers initiative could shorten a surgeon抯 training after medical school from around 10 years to six.
This comes on top of the changes under the European working time directive, which is already reducing the amount of time that junior doctors spend with their patients.
"To call someone a consultant at the end of four years of specialist training requires a complete redefinition of the term," Mr Huang said. "That can only lead to a decrease in the quality of consultants. This new look consultant will have much less training and experience."
However, the health department is "adamant that nothing will happen that undermines the standard of medical training at any level."(London Colleen Shannon)
At the BMA抯 annual meeting for junior doctors last week delegates unanimously supported a vote of no confidence in the government抯 "modernising medical careers" initiative.
Medical students who decide to boycott the new "foundation" training programmes will have the full support of the BMA, pledged Mr Simon Eccles, chairman of the BMA抯 Junior Doctors Committee.
The BMA will now lobby for a delay in implementation of the programme.
A Department of Health spokeswoman said the team running the initiative was "surprised and disappointed" at the vote. A consensus meeting with trainee doctors in March had produced positive agreements, she said.
While junior doctors generally agreed that the current system of medical education was in need of an update, there was a strong feeling at the conference that the reforms were being rushed through piecemeal for political reasons.
"Why the rush?" asked Mr Joseph Huang, a specialist registrar at Addenbrooke抯 Hospital, Cambridge, and president of the Association of Surgeons in Training. "We抮e convinced it抯 a political timetable."
Mr Angus Robertson, a specialist registrar at Hull Royal Infirmary and secretary of the British Orthopaedic Trainees Association, agreed: "I think the government wants to meet its election promises to produce large numbers of specialists rapidly, irrespective of the quality of those specialists."
Under the reforms, from August 2005 the first two years of a junior doctor抯 training will be replaced by a foundation programme. Work during these two years will be formally assessed, but the standards have not yet been published.
Some medical students are already applying for new style training posts that will start in August this year, as part of a pilot scheme. These students have no guarantee that their posts will receive educational accreditation.
Speakers at the conference warned that the reforms—which also include alterations to the post of specialist registrar—would lower professional standards in the United Kingdom. Taken together, the changes in the modernising medical careers initiative could shorten a surgeon抯 training after medical school from around 10 years to six.
This comes on top of the changes under the European working time directive, which is already reducing the amount of time that junior doctors spend with their patients.
"To call someone a consultant at the end of four years of specialist training requires a complete redefinition of the term," Mr Huang said. "That can only lead to a decrease in the quality of consultants. This new look consultant will have much less training and experience."
However, the health department is "adamant that nothing will happen that undermines the standard of medical training at any level."(London Colleen Shannon)