Improving training opportunities for foundation doctors (FDs)
Contact Dr Aysha Nijamudeen (UKFPO fellow 2023/24) for any queries: Aysha.Nijamudeen@mft.nhs.uk.
The problem
- Mounting evidence demonstrates differential attainment in specialty training applications and post-graduate examinations
- There is much variation in foundation training jobs and opportunities for experience outside inpatient medicine
- Some points on CST/ST1 applications are for involvement in elective activity, for example, surgical logbook numbers
- Retention issues post-F2: Many doctors take additional years to pass exams, meet application requirements
- Protected training time is supported by the GMC and UKFPO, yet FDs often struggle to access this
The current state of play
A national survey of 701 FDs respondents demonstrates the majority do not have scheduled OR ad-hoc non-inpatient training activities.
Why should they be scheduled?
- Scheduling in advance allows for an equal baseline of access to training opportunities
- The doctor can prepare for the activity, increasing educational value
- Rota co-ordinators can ensure adequate staffing in advance
- Clinics/procedure lists can be planned accordingly for training
Is this the same as self-development time (SDT)?
- No, SDT is currently not available in all of the four nations
- These are clinical sessions, and so should be scheduled separately to SDT (in England)
- SDT can also be used for additional non-activities sessions if the doctor wishes
What other resources can I show my trust in to support this initiative?
- The GMC: Workplace Experiences, 2023
- The GMC: Tackling Disadvantage in Medical Education, 2023
- The UKFPO Curriculum: p88 “All FDs must have the opportunity to take part in outpatient clinics”
- BMA: Work Scheduling Guidance, 2023
- North West Foundation Forum: A pilot scheme to help NHS Trusts to incorporate scheduled activities into FD rotas
Exemplary practice: Spotlight on East Lancashire Hospitals Trust
- Scheduled non-inpatient clinical activities are provided as standard at ELHT to support FDs to meet their ARCP requirements.
- FDs have four scheduled clinics or theatre sessions per rotation
- Sessions are allocated at the start of placement therefore FDs can look up the patients in advance and prepare, increasing the educational value
- This was initiated by a previous FPD and has led to a culture shift that promotes training and education for FDs
- Having run for a few years, this is now ingrained into the training programme at ELHT and rota co-ordinators and clinical staff are supportive of the initiative
- This trust provides an excellent example of how training can (and should) be scheduled for foundation doctors
What does scheduling look like?
- Scheduling four days of non-inpatient activity only reduces time on the wards by 5%!
- These should be agreed with the CS at the induction meeting to ensure maximal educational value
Resources
GMC
BMA
UKFP Curriculum: p88 “All FDs must have the opportunity to take part in outpatient clinics”