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Patients at risk as doctors face ‘inadequate’ training

Dr Paul O'Reilly, doctor at the Dr Hickey surgery, London.  Dr O'Reilly is also a priest.
Dr Paul O'Reilly, doctor at the Dr Hickey surgery, London. Dr O'Reilly is also a priest.

Patients will be put at risk because staff shortages at hospitals will lead to a “generation of inadequately trained doctors,” the country’s leading medical associations have warned.

The Royal College of Physicians of Edinburgh (RCPE) claims problems in the medical training system have the potential to “seriously undermine” patient safety unless the incoming Scottish Government takes immediate action.

According to the RCPE, many trainee consultants are required to “plug gaps” in hospital rotas at the expense of training.

A recent survey by the Scottish Academy of Medical Royal Colleges found that less than half of trainees (42%) believed they would receive enough training to become a consultant by the end of the process.

It also claims some hospitals are not training enough doctors and that many consultants are too busy to give trainees adequate supervision.

The RCPE also warns that the full impact of the European Working Time Directive, which enforced a maximum working week of 48 hours and came into effect into July 2009, is yet to be felt.

The organisation recommends measures including guaranteeing protected training time for trainee doctors and consultants involved in supervision, and taking training time into account when planning future workforce numbers.

RCPE president Dr Neil Dewhurst said, “It is essential that we safeguard the future ability of the NHS in Scotland to deliver safe, high quality, patient care.

“To do this, we need to ensure an adequately planned, trained and resourced medical workforce.

“Failure to do so could lead to a generation of inadequately trained doctors and, in turn, compromise patient safety.

“Increasing pressures on the NHS also threaten to reduce patient access to consultants and the RCPE believes strongly that such access should be protected for the benefit of patients.”

Dr Kerri Baker, chairwoman of the RCPE trainee and member committee, said, “Trainee doctors report feeling disillusioned and let down by their training experience gained with the NHS.

“Many believe they are gaining insufficient training to enable them to function safely and efficiently as the consultants of the future, and are also increasingly used to plug gaps in hospital rotas, often being forced to sacrifice quality training for service provision.”

Dr John Colvin, chairman of the Academy of Medical Royal Colleges and Faculties in Scotland, said, “We share the belief that the balance between service provision and training has been eroded and that protected time for training and integrated clinical experience is essential to produce fully-trained doctors.

“More effective workforce planning requires to be undertaken to ensure a stable high-quality medical service for the future.”

The British Medical Association Scotland, which represents doctors across the country, backed the college’s call.

Dr Lewis Morrison, chairman of the BMA Scottish Consultants’ Committee, said, “We share many of the concerns raised today by the college.

“A balance needs to be struck between delivering patient care and time for learning. Junior doctors need to have time to train and it is important that consultant teachers are available to support this learning process.

“We strongly support the college’s call for increasing patient access to patient care delivered by consultants.

“We should be expanding the consultant workforce and investing in a trained doctor delivered service this would allow doctors in training to learn more from their time on the wards or in clinic.”