Training of paediatricians in the UK

Abstract

Within the next 4 years there will be more change, and greater change, to the structure of paediatric training than has occurred in the whole of the last 40 years. The impetus for change has been developing gradually, but has been brought into sharp focus by the necessity to reduce the number of hours worked by junior doctors, and by the need to reduce the length of specialist training as well as the necessity to conform more closely with that in other European countries. The reduction of junior doctors hours to a maximum of 72 h and, as is likely in the future, to a lower figure means that the trainee will see fewer ill patients and have less clinical experience. Additionally he/she will often miss the continuity of patient care which provides such valuable learning experience. This diminution of clinical experience will have to be balanced by more structured and intensive formal training. If European legislation leads, as has been suggested, to senior trainees and to career grade doctors being limited to a maximum number of hours on duty or on-call, the remedies will be even more difficult. The ways in which the duration of training before becoming a consultant should be shortened in all specialities have been outlined in the report of the Chief Medical Officer’s Working Group on Specialist Medical Training (The Calman Report). By combining the registrar and senior registrar grades into a ‘seamless’ training grade, it is hoped that many trainees will achieve accreditation and the certificate of completion of specialist training (CCST) after only 4 years in the registrar grade. As is the case with shorter hours, so too a shorter duration of