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Implications of aligning full registration of doctors with medical school graduation: a qualitative study of stakeholder perspectives

Mattick, K. L., Kaufhold, Kathrin, Kelly, N., Cole, J. A., Scheffler, G., Rees, C. E., Bullock, Alison Deborah, Gormley, G. J. and Monrouxe, L. V. 2016. Implications of aligning full registration of doctors with medical school graduation: a qualitative study of stakeholder perspectives. British Medical Journal Open 6 (2) , e010246. 10.1136/bmjopen-2015-010246

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Abstract

Objectives The Shape of Training report recommended that full registration is aligned with medical school graduation. As part of a General Medical Council-funded study about the preparedness for practice of UK medical graduates, we explored UK stakeholders’ views about this proposal using qualitative interviews (30 group and 87 individual interviews) and Framework Analysis. Setting Four UK study sites, one in each country. Participants 185 individuals from eight stakeholder groups: (1) foundation year 1 (F1) doctors (n=34); (2) fully registered trainee doctors (n=33); (3) clinical educators (n=32); (4) undergraduate/postgraduate Deans, and Foundation Programme Directors (n=30); (5) other healthcare professionals (n=13); (6) employers (n=7); (7) policy and government (n=11); (8) patient and public representatives (n=25). Results We identified four main themes: (1) The F1 year as a safety net: patients were protected by close trainee supervision and ‘sign off’ to prevent errors; trainees were provided with a safe environment for learning on the job; (2) Implications for undergraduate medical education: if the proposal was accepted, a ‘radical review’ of undergraduate curricula would be needed; undergraduate education might need to be longer; (3) Implications for F1 work practice: steps to protect healthcare team integration and ensure that F1 doctors stay within competency limits would be required; (4) Financial, structural and political implications: there would be cost implications for trainees; clarification of responsibilities between undergraduate and postgraduate medical education would be needed. Typically, each theme comprised arguments for and against the proposal. Conclusions A policy change to align the timing of full registration with graduation would require considerable planning and preliminary work. These findings will inform policymakers’ decision-making. Regardless of the decision, medical students should take on greater responsibility for patient care as undergraduates, assessment methods in clinical practice and professionalism domains need development, and good practice in postgraduate supervision and support must be shared

Item Type: Article
Date Type: Publication
Status: Published
Schools: Cardiff Unit for Research and Evaluation in Medical and Dental Education (CUREMeDE)
Medicine
Social Sciences (Includes Criminology and Education)
Subjects: R Medicine > R Medicine (General)
Additional Information: Commons Attribution Non Commercial (CC BY-NC 4.0) license, which This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license
Publisher: British Medical Journal Publishing Group
ISSN: 2044-6055
Funders: General Medical Council
Date of First Compliant Deposit: 30 March 2016
Date of Acceptance: 30 November 2015
Last Modified: 14 Sep 2017 14:32
URI: http://orca.cf.ac.uk/id/eprint/87408

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