UK governmental interference in surgical training

Abstract

On April 14, 2007, the officers of the European Federation of Surgical Specialties (EFSS) of the European Union of Medical Specialties met their UK equivalents, the Federation of Surgical Specialty Associations (FSSA), and representatives of the surgical Royal Colleges to examine the change of statutory authority in the UK in 2005. The Postgraduate Medical Education and Training Board (PMETB), a quango or agency of Government, was created after remarkably little public and medical debate, is appointed, funded, and functionally part of Government, and oversees surgical training and education in place of the medical profession. It consists of 17 medical members, but not all surgical specialties are represented. The FSSA reported examples of candidates who fell below the standards set by surgeons and failed the Certificate of Completion of Training (CCT), yet who were passed after appeal to PMETB. On occasions, surgical assessors have detailed areas of weakness in a candidate requiring a year of additional training, only for it to be overturned by PMETB. The following principles were agreed to ensure a high standard of care and patient safety: (1)Surgical training for each specialty should be done within an approved surgical training programme. This should include a clearly defined competency assessment by the surgical trainers. A robust quality assurance system of assessment of all training programmes is of paramount importance.(2)The content of each surgical training programme should be defined by surgeons in that specialty.(3)Only surgeons in that specialty should assess proficiency and competency.(4)Only proficient and competent surgeons should be licensed for independent surgical practice, either with a CCT at an agreed standard to be able to practise across the European Union, or with an equivalent award. It was regretted that PMETB reports to the Secretary of State for Health (ie, one political party) not to parliament (cross-party). It was felt that party politics has no role in surgical standards. The EFSS supports the call of the Royal College Presidents1Gilmore I Ribeiro B Modernising Medical Careers: a response from two Presidents of Royal Colleges.Lancet. 2007; 369: 1513Summary Full Text Full Text PDF PubMed Scopus (4) Google Scholar for independent review by Sir John Tooke to include PMETB and for postgraduate training to be professionally led. Because CCT or its equivalent is needed for practice across the European Union, the EFSS expressed concern to their UK colleagues that in the interest of patients' safety across Europe, each member state should aim to fulfil the four principles summarised above. I declare that I have no conflict of interest.