Do you know who is treating you? A patient’s guide to doctors in training March 2010
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Foreword 04 A few key facts about doctors in training 06 Who is treating me? 07 Doctors in training: who you might meet 08 Finding out about the doctor treating you 12 How to get involved in training 15 About this guide 17
previous | next | contents | print | exit “A long overdue guide, telling patients and the public what they need to know about doctors in training.”
Professor Sir Neil Douglas Chairman, Academy of Medical Royal Colleges
previous | next | contents | print | exit Doctors in training have always Patients tell us that they are Foreword played a crucial role in the NHS. happy to be treated by doctors They join the NHS after university in training but want reassurance and begin the long journey to that doctors are appropriately becoming GPs, consultants or trained and supervised. This specialty doctors. They learn guide sets out what patients and by treating patients as well as the public need to know about from formal education. Without doctors in training. It explains these doctors in training, the NHS how trainee doctors start by would not be able to continue. typically undertaking a five year In recent years, doctors’ roles degree, followed by a two-year and training have changed Foundation Programme before to improve the quality of care moving into specialty training. they provide. However, some patients tell us that they do not understand the training path for doctors or what doctors’ new job titles mean.
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4 A patient’s guide to doctors in training Finally, we outline the active role that the public and patients can play in educating doctors. Doctors in training can learn much from sharing about a patient’s own experience of healthcare. We want you to share your views about what doctors should be taught during their training and have suggested practical ways to get involved. I look forward to hearing from you.
Professor Sir Neil Douglas Chairman, Academy of Medical Royal Colleges
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4 A patient’s guide to doctors in training A few key facts about doctors in training
There are around 50,000 doctors in the NHS working towards a higher qualification in a medical specialty or towards becoming a consultant
They are employed to treat patients, learning from this experience as well as on formal courses
All doctors in training work in teams with senior doctors who manage and supervise their work
previous | next | contents | print | exit Doctors in training may be known by a number of titles such as foundation doctor or junior doctor
A patient’s guide to doctors in training 7 Who is treating me?
Patients want to know who is treating them: “I’ve seen a number of trainee doctors in my GP surgery. Sometimes the trainee is listening to the GP and sometimes the other way round. I always prefer it when the receptionist lets me know in advance and asks if I am happy to have the trainee there. That gives me a chance to say no if I feel I want to.”
Female patient, London
Patients tell us that they want to know who is treating them but they are unsure of how doctors are trained, what qualifications they have and what their job titles mean.
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A patient’s guide to doctors in training 7 NHS patients are treated by • Typical titles are junior doctor, Doctors in doctors at different levels of foundation doctor, F1 or F2. training. Here are some basic A junior doctor is any doctor training: who facts to help explain the different who has completed medical stages of medical education school and is in training to be a you might meet and how doctors in training are consultant. supervised. At the end of two years, Foundation doctors foundation doctors decide • The first step after university whether to enter a specialist area for doctors is a two-year of medicine, such as surgery or Foundation Programme, psychiatry, or to train as a GP. At working in different medical the point of entering training they specialities under supervision become registrars. of senior doctors to gain Specialty registrars (SpR) practical experience and skills. • After the Foundation • Satisfactory completion of Programme, doctors enter the first year allows a doctor specialty or GP training. to apply to be added to the • They spend between three GMC Register. Satisfactory and eight years, depending on completion of the second year the specialty, completing this of the Foundation Programme training to become either a GP results in the award of the or consultant. This may take Foundation Achievement of previous | next | contents | print | exit longer if the doctor takes time Competence Document. out from training to do research
8 A patient’s guide to doctors in training A patient’s guide to doctors in training 9 Consultant
Foundation doctor Specialty registrar GP 2 year programme 3 - 8 years training
Specialty doctor
or have a family. Many doctors • They look after patients • Specialty registrars who also choose to work part-time. in clinics and perform successfully complete their • As they progress through procedures under the training can apply to become their training they gain more supervision of other senior a GP or a consultant. experience, knowledge and doctors and consultants, • Although typically these competence. increasing their knowledge doctors are known as and skills. • Registrars work in a specialist registrars, you may also see area, such as obstetrics or titles such as SpR1,SpR2,SpR3 surgery or anaesthetics. etc or StR1, 2, 3 etc where the number shows their years spent in specialty training. previous | next | contents | print | exit
8 A patient’s guide to doctors in training A patient’s guide to doctors in training 9 Specialty doctors Consultants • Some doctors do not complete Consultants are doctors who specialty training but can still are responsible for your care work as specialty doctors. and are responsible for all other They have a wide range of experience, and at least have doctors who you may see on his four years of postgraduate or her behalf. This is for both a training. patient staying in hospital and • The specialty doctor title was for an outpatient. These doctors introduced in 2008 to replace are on the GMC’s Specialist titles such as staff grade, Register and have completed all clinical medical officer and necessary steps in their training hospital practitioner. You may to work unsupervised still see these used. as specialists. • In many cases, specialty doctors are senior doctors. However, they will also be supervised and a consultant will have overall care of the patient.
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10 A patient’s guide to doctors in training As doctors progress through training they gain more experience, knowledge and skill
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10 A patient’s guide to doctors in training Finding out about the doctor treating you
previous | next | contents | print | exit “I think it is important that elements. However, there patients know when they are is a lot of difference in being treated by a trainee. competency and experience I am very aware that the between a first year trainee majority of patients have and a final year trainee and limited understanding of it is important to put the title the titles used by doctors, into context. other than consultant and I also think that it is GP. I therefore tend to important to emphasise that introduce myself as either a there is a senior doctor doctor / psychiatrist / higher supervising the care.” trainee currently working with my consultant. I would Doctor in training (SpR in Child & advise new trainees to try Adolescent Forensic Psychiatry) to emphasise that they are both a qualified doctor and a trainee. I think this is difficult to do as I suspect that patients often think that these are not mutually compatible. The term ‘junior doctor’ is often helpful for patients as it captures both previous | next | contents | print | exit Patients tell us that they are In your discussions with your happy to be seen by a doctor doctor, it is possible to ask them: in training but that they want to • What is your job title? know about the doctor’s level of training and experience. They • Where are you in your training also tell us that doctors who programme? explain their level of training, • How are you supervised? experience, competence and supervision are able to put them If you are not happy to see a at ease. However, when doctors doctor in training and wish to do not take the time to explain, see the supervising doctor with patients say that they feel unable to ask questions. more experience, this should be arranged for you although it may There is guidance for doctors take some time. on how they should introduce themselves and explain their level of training to a patient when examining or treating them. The doctor should check that each patient is happy with the situation and can answer any questions the patient may have about their doctor’s training and experience.
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14 A patient’s guide to doctors in training How to get involved in training Patients have a great deal to contribute to medical training - not just as “interesting cases” but as active participants sharing their experiences of healthcare. Some of the ways patients can get involved include:
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14 A patient’s guide to doctors in training Medical Royal Colleges Working with your doctor Department of Health • Patients can get involved in Share your personal experiences • Local Involvement Networks designing and delivering of healthcare by filling in the (LiNKs) are established in specialist training through the feedback forms provided by most local authorities in order medical Royal Colleges. Each hospitals and GP surgeries. to promote patient and public medical Royal College has a involvement. Find your local General Medical Council patient reference or liaison LiNK representative on the group which provides an The General Medical Council Department of Health website. opportunity for patients to be is responsible for the regulation Click here to find out more involved in the way doctors are of medical education and about LiNKs. trained. To get involved, contact training at all stages of a doctor’s the relevant communications career. To find out more about team to find out about the work of the GMC visit their patient involvement www.gmc-uk.org. You can also opportunities. A list is participate in GMC consultations available here. to support the development of guidance and standards, view information about forthcoming consultations and read about past consultations on the GMC’s consultations website.
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16 A patient’s guide to doctors in training A patient’s guide to doctors in training 17 About this guide
This guide was developed in The State of Postgraduate Patients role in healthcare - March 2010 by the Postgraduate Medical Education and the future relationship between Medical Education and Training 2009 patient and doctor Training Board (merged with (PMETB 2009) (PMETB 2008) the General Medical Council in April 2010) and the Academy of The State of Postgraduate The role of the patient in Medical Royal Colleges and its Medical Education and medical education Patient Liaison Group. Particular Training 2008 (British Medical thanks to Barbara Wood and (PMETB 2008) Association, 2008) Veronica Parker. Trust in Professions 2007 It draws on research (Royal College of commissioned by the PMETB in Physicians, 2007) January 2010 and a wide range of other publications including:
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16 A patient’s guide to doctors in training A patient’s guide to doctors in training 17