Training 'fails to prepare' doctors

Is training too theoretical?

Over 40% of newly qualified doctors say their medical training did not fully prepare them for work as a junior hospital doctor, a survey has found.

And a separate survey has found that future GPs feel they are treated as "second-class citizens" compared with other junior doctors during the hospital part of their training.

Researchers at the University of Oxford surveyed 3,446 doctors who graduated from UK medical schools in 1999 and 2000. Their findings are published in the British Medical Journal.

Just 36% said that their training had properly prepared them for their role as a pre-registration house officer (PRHO).

Not enough emphasis on real-life situations

Respondent to survey

The level of satisfaction varied greatly between different medical schools. At one, the dissatisfaction rating was 73%.

Critics said that their training was strong on theory, but did not place enough emphasis on dealing with real-life situations.

Since this survey, curriculum changes have been introduced to place greater emphasis on practical experience.

However, the researchers say it is important that graduates are asked for feedback so training courses can be tailored to meet their needs.

Lead researcher Professor Michael Goldacre said: "The feeling was not that there was a lack of preparedness in basic medical knowledge, but in the practicalities of work.

"Of course, the findings may simply reflect the natural concern of a group of people starting a new and very arduous job.

"But there is such a big difference between graduates of different medical schools that it must be more than a general anxiety."

GP survey

Not enough time shadowing PRHO prior to commencing work

Respondent to survey

The second survey, of 160 GPs, was conducted by the British Medical Association.

Doctors wanting to become GPs spend some of their training in hospitals alongside other junior doctors, so they can learn about different specialities and gain skills.

But the survey found half thought being a GP trainee affected the training they received.

And seven out of 10 felt general practice had been portrayed in a negative light during their hospital training.

Dr David Wrigley, chairman of the BMA's GP Registrars sub-committee, said: "Many said general practice had been portrayed as second-best, end of the line or a cop out.

"We need to do everything we can to increase the numbers of junior doctors choosing family medicine as their career.

"These problems must be put right and the fundamental importance of general practice to the NHS recognised."

The Department of Health said its new modernising medical careers initiative would improve doctors' training.

A spokeswoman said: "As part of this process, we will be working closely with the profession, competent authorities and other stakeholders to examine the arrangements for training in general practice to ensure they do provide trainees with the most appropriate preparation for their future careers, including addressing the issues highlighted by the BMA survey."

The research is published in the British Medical Journal.