Over the last two decades, there has been a paradigm change in the structure of healthcare and the practice of medicine in the United Kingdom. Following a number of inquiries - such as those into practice at Alder Hey Children’s Hospital and Bristol Royal Infirmary, the criminal behaviour of Dr Harold Shipman, the Francis report into failure of care and, more positively, Lord Darzi’s report on NHS reorganisation - the NHS has placed greater emphasis and increased scrutiny on clinical governance. Increasing costs of healthcare, an ageing population and the increased role of clinical governance have led to the development of National Service Frameworks and the National Institute for Health and Care Excellence (NICE). These changes have directly and indirectly impacted upon the practice of clinical medicine by bringing into focus the use of evidence-based medicine to inform decision-making across the field. The changing medical environment has been reflected in the evolving structure of Specialist Medical Training in the United Kingdom. Recommendations from a number of major recent reviews have influenced the structured development of Specialist Medical Training. These, alongside other factors such as the implementation of the European Working Time Directive (EWTD), which has enforced a maximum 48-hour working week at trainee level, have played a major role in the current shape of Specialist Medical Training. The arguments for and against the various changes in medical training are outside the scope of this chapter but certainly, as a result of all the changes, the training pathway now has a greater emphasis on research and academic medicine. The biggest testimony to this is the fact that there is a separate academic training pathway which runs parallel to the clinical pathway to offer motivated trainees structured training to develop their careers. After completing their undergraduate degree, newly qualified doctors in the United Kingdom are required to complete a two-year foundation training programme. Those who wish to embark on an academic career may apply for one of the Academic Foundation training posts, providing them with an opportunity to experience research as a foundation doctor. All doctors then apply for their preferred speciality medical training programme.
|Title of host publication||Introduction to Research Methodology for Specialists and Trainees|
|Publisher||Cambridge University Press|
|Number of pages||7|
|Publication status||Published - 1 Jan 2017|