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Credentialing to have important role in modernising doctors’ training

The development of credentialing in training is important to ensuring that medical education and training responds to the needs of patients going forward.

This is the conclusion of the UK Shape of Training Steering Group, which has identified a method whereby the process of developing post-CCT credentials could begin.

Credentialing refers to the accreditation of a doctor’s competence and capabilities at given points in their career.

The UKSTSG proposes that the medical Royal Colleges develop the educational content based on the sub-specialty components of their current curricula, the GMC as the regulator approve and quality assure them, and the four UK statuary post-graduate medical education bodies implement and quality manage them in the same way that they deliver pre-CCT training.

It says the determination of the number and type of credentials should be informed by local patient and service needs.

This the next step to the Shape of Medical Training Review, which was established to consider how medical training could better meet the needs of patients and service providers over the next 30 years – with more people surviving into older age with multiple comorbidities.

The resulting report made 19 recommendations that were accepted by ministers in November 2013.

The UKSTSG was convened to advise on implementation.

The review concluded that, in future, doctors must be able to adapt to this rate of change by having the flexibility to acquire new skills, change careers and participate in career-long learning.

Changing demographics and the need to deliver more services in the community, mean that more doctors will be required who have general rather than specialist skills.

The need for specialists will remain but the number and type of specialists should be determined by patient need and sub-specialist training should be dealt with as a post-CCT credential.

The original review said most trained doctors will be required to contribute to the acute unselected take within their broad clinical discipline. And it advocated a return to a more apprenticeship-style based on the attainment of competencies and generic capabilities rather than being time based.

The UKSTG said submissions of new curricula or major revisions of existing curricula will be submitted to a review group in the first instance and thereafter to the GMC for regulatory approval.

It also called on medical Royal Colleges and employers to work collaboratively with others to deliver a more formalised system of supportive mentoring for doctors at the transition points of their careers.

Dr Jeeves Wijesuriya, BMA’s junior doctors committee chair, welcomed the “pragmatic” approach of the UKSTSG “which has listened to, rather than undermined, professional bodies for doctors in the UK”.

He added: “We have argued robustly to preserve the current specialty training structure, and for maintaining the Certificate of Completion of Training (CCT). We insisted that amendments to training pathways, if needed, should be made by the Royal Colleges and Faculties. We have also argued for a model of credentialing that does not undermine the CCT or the coherence of training programmes.

“Any move that weakens the current standard of specialty training risks reducing the quality of patient care, and is therefore unacceptable to doctors.”

Read the report.

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