Medical graduates are 'poorly prepared' to become doctors

Newly-qualified medical graduates seem to be poorly prepared to work as trainee doctors, according to researchers.

Trainee doctors scores were low against GMC criteria
Trainee doctors scores were low against GMC criteria

The findings are based on 228 senior doctors' critical assessment of a wide range of core skills and competencies among trainee doctors at two major teaching hospitals in the east Midlands.

Trainee doctors now complete a two-year generic foundation programme, which forms the bridge between medical school and specialist or general practice training.

The senior doctors were asked to score how well prepared their foundation year 1 postgraduate trainees were to work as doctors, six months after they had graduated medical school, using a five-point scale.

They scored the juniors below three on 48 of the 70 items assessed against GMC criteria and above the midway point for only six of the 20 clinical and practical skills. Carrying out basic respiratory function tests, prescribing and more advanced communication skills were some of the area where juniors performed below par.

The research is published in the BMJ's Postgraduate Medical Journal.

A GMC spokesperson said: ‘It is important not to jump to conclusions from this study. Much has changed in the two years that have elapsed since the original research questionnaires were conducted. In particular, following extensive consultation and in-depth research, the GMC re-launched Tomorrow's Doctors which sets the standards for undergraduate medical education in the UK.

Tomorrow's Doctors will require that students have more opportunity to apply their medical knowledge and skills in hospitals and surgeries before they graduate. ‘Student assistantships' will be rolled out to help prepare medical students for the Foundation programme. Student assistantships are work placements where students will undertake most of the duties of an F1 doctor before they start their first job. This will help them get to grips with practical tasks such as ordering blood samples and filling in prescription forms.

‘During the development of Tomorrow's Doctors a lot of work was undertaken to map F1 outcomes to the undergraduate competencies, including clinical and procedural skills. The GMC also agreed a revised Foundation programme curriculum and specific outcomes for F1 doctors which will give medical schools a clear understanding of what they should be preparing medical students for in the workplace.

‘It is important to remember that the point of the first year of the Foundation programme is for the new doctor to build on, under supervision, the knowledge and skills they learnt as a medical student, demonstrating performance in the workplace. It is inevitable that it will take some time for certain skills, such as advanced communication, to develop, that is why a whole year is allowed for the process. GMC guidance The New Doctor sets out what F1s are expected to be competent at demonstrating in the workplace before being eligible to apply for full registration.'


Neil Durham

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Postgrad Med J 2009; 85: 582-9

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