Modular credentialing has dominated discussions within the Academy Trainee Doctors Group over the past year. Credentialing refers to the accreditation of a doctor’s competence and capabilities at given points in their career.
The ATDG has particular concerns about pre-CCT credentialing. The CCT is a well-established level of achievement with recognised routes to achieving this standard. The concept of credentialing prior to CCT implies there would be alternative routes within the training structure to reaching this predetermined standard.
There is evidence that consultant-led care results in improved patient outcomes and efficiency of care. The British public have the right to receive healthcare that is always supervised, and usually delivered, by fully trained doctors who are on the specialist or GP registers.
We believe the introduction of modules and/or credentials would risk an increase in medical service roles below the CCT level (including a sub-consultant grade), resulting in a subsequent reduction in the quality of care provided within the NHS.
The end point of training should therefore remain the CCT.
Postgraduate medical education has recently undergone significant reform via MMC. The PMETB approved college curricula are designed to be completed in their entirety. The value of curricula is greater than the sum of their parts and dismantling them into credentials is likely to result in disjointed, uncoordinated training.
We believe that the current new curricula already allow for the clear demonstration of competencies throughout training. Furthermore, we believe that a period of stability is required to ensure that the changes implemented through MMC are fully evaluated.
Concerns that newly appointed consultants do not have sufficient experience should be addressed within existing training programmes.
We are aware that further work is required to effectively communicate the competency level of doctors to the general public but this does not require the fragmentation of training into credentials.
One of the frequently cited benefits of pre-CCT credentialing is that it would allow trainees to stop off on their training pathway. However, feedback tells us that the vast majority of trainees do not wish to take breaks in training for reasons other than research, out-of programme experience, or to have a family. The ATDG believes that sufficient mechanisms already exist to facilitate these without the need for modularisation of training.
Extracted from an article in The State of Postgraduate Medical Education 2009: Laying foundations for the future.
Read the whole report.
Read the rationale for credentialing.
The Academy Trainee Doctors Group is made up of junior doctors from the royal colleges who come together as an advisory group for the Academy of Medical Royal Colleges.
Tags: Credentialing, Training
