Change medical training so all doctors can be generalists, says GMC

All doctors should be trained using a 'more flexible approach' so that they could work in general practice and help meet growing demand from older patients with multimorbidity, the GMC has said.

GMC chair Professor Terence Stephenson
GMC chair Professor Terence Stephenson

GMC chair Professor Terence Stephenson has warned that it would be ‘rash’ to train people today for ‘fixed roles’ in 2030, arguing that training for doctors must be more flexible to meet the need for more generalist and primary care doctors.

In a blog summing up evidence he gave to a House of Lords committee on the long-term sustainability of the NHS, Professor Stephenson warned that 90% of NHS patient contacts are with a GP. He added that demand for these services will rise further as the population becomes older with more co-morbidities.

‘It’s clear that an older population with more co-morbidities means we’ll need more generalists and more people in primary care,’ he told peers.

‘So I think it would be rash to train people today for a fixed role in 2030; we need to train doctors in a more flexible way, and for doctors to take a more flexible approach. The GMC is looking at that with our review of flexible training and our framework of generic professional capabilities which will launch next spring.’

He added that pathways should be opened up to enable doctors to more easily retrain for different medical roles.

Medical training

He also aired plans for medical training to become more focused and shortened by cutting down on how much trainees are relied on to prop up services.

‘Our approach to training is not helped by the reliance of the NHS on trainee doctors,’ he said.

‘There is no country in the world that takes as long to train as us because there is no country in the world that is so dependent on its trainees for delivering the service.

‘In most countries, training is much more formalised and structured. We have to recognise that we have 55,000 trainees out of a workforce of 150,000 and that, for much of the time, their training is long because they are not being formally trained, they are providing a service.

‘Do we have the capacity to change our approach to training? Yes, we will be working closely with the medical royal colleges to adapt their curricula for post-graduate training and with postgraduate deans to ensure there is flexibility in the journeys that doctors will take through training.’

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