Doctors' training meeting
On 29 January 2008, I represented the BSS at a whole day event at the Postgraduate Medical Education and Training Board (PMETB) in London. This organisation trains doctors after their initial 5 years at medical school, when doctors usually start to specialise.
The event was over-subscribed with organisations wanting to attend and give their views on matters that may affect the training of future doctors. The meeting was part of a review of how future doctors will be trained in certain specialist areas such as surgery, general practice or managing chronic illness.
The idea of the day was for the PMETB to have a greater understanding of how patients’ expectations and wishes can be met through doctors’ education and training. They wanted to try to identify any common issues across different medical specialities and medical conditions that could be tackled through changes to medical training. They also wanted to encourage an increased awareness among patients of how they can influence and contribute to the development of postgraduate training and to learn how doctors can be more responsive to patients’ needs. PMETB aim to create a network of groups that they can consult on future policy development.
This was the first meeting of its kind at which a wide variety of groups had been asked to contribute. These included trainee doctors, consultants, patient groups and organisations connected to the medical professions. About 60 people attended. The morning started with four speakers: Paul Streets, Chief Executive of PMETB; Dame Jo Williams, Chief Executive of Mencap; Professor Angela Coulter of the Picker Institute; and Dr Chris Clough, Medical Director of the Joint Royal College of Physicians. They each gave their own perspective on doctors’ training for the future, with an emphasis on working in partnership with patients.
In the morning session, we broke into small groups and had to discuss “Managing long-term conditions”. We had to consider partnerships and professionalism; communication skills between doctor and patient; information and health literacy; chronic disease and self-care; patient pathways and multidisciplinary working; and involvement of patients in the teaching and assessment of postgraduate medical training.
In our small groups, we were asked to consider a list of questions that related to partnerships between doctors and patients, whether patients could be used as teachers to help train doctors, whether doctors should receive specialist communication skills training, and what additional skills doctors should have to be able to help patients with self care. There were also questions posed about whether and to what level patients should be involved in doctors’ training and whether trainee doctors should be involved in patient education events.
The other two groups considered questions on matters that would relate to surgery and GP duties, and the skills that might be important to their training and skills.
The afternoon session was started with a talk by Neil Betteridge, Chief Executive of Arthritis Care. He gave his perspective on how service users can influence training. We also had talks from a trainee doctor, a patient with a long-term condition and a consultant.
The afternoon session followed on from the morning sessions, and again I was allocated to the chronic conditions group. We were split into groups of five or six people and discussed various questions. It was interesting to learn that 55% of GP appointments and 68% of outpatient and accident and emergency attendances are for people with long-term medical conditions. Staggeringly, 77% of inpatient bed days are for people with long-term medical conditions.
The three main questions we had to discuss were about care being provided by several practitioners and multidisciplinary teams and what joint training would need to be undertaken to aid this; what skills doctors need to get the balance right between self-care and managed care; and, as more patient care is provided outside traditional hospital/clinics, whether the training of doctors should involve more exposure to the delivery of care in different surroundings.
All the groups had feedback forms that were used to give individual views on the day. The PMETB is going to evaluate the feedback and then produce a document about the day’s events and ideas.
It was a very useful and interesting day, and whenever I could I mentioned Behçet’s so that people asked the usual question of what it is. One comment made to me on the day was that Behçet’s doesn’t neatly fit into the NHS boxes – I could only agree with this.
Please take a look at the PMETB website (www.pmetb.org.uk) for more information.
Richard West, Secretary
