Vincent Argent supports the idea of a new approach to training doctors and producing skilled practical medical practitioners required by the NHS
The time has come for a new approach to the training of doctors to address the needs of the future health service.
We need an Apprentice Medical School.
The Apprentice is the height of fashion.
Health secretary Jeremy Hunt has promised an expansion in conventional medical school places by pledging to train up to 1,500 more British doctors a year in a bid to tackle the recruitment crisis in the NHS
Health secretary Jeremy Hunt has promised an expansion in conventional medical school places by pledging to train up to 1,500 more British doctors a year in a bid to tackle the recruitment crisis in the NHS. He also considers that NHS England should become “self sufficient” by training enough numbers of its own medical workforce rather than the huge reliance on colleagues from the European Economic Area and International Medical Graduates.
This is not to doubt the NHS does benefit from the contribution of international colleagues.
But is there a need for an alternative avenue to medical practice?
The need for an alternative avenue
The recent Royal College of Physicians report: Underfunded – Underdoctored – Overstretched – The NHS in 2016 - Mission: Health states clearly that the UK does not train enough doctors. This has led to major problems such as hospitals failing to fill two out of every five consultant physician posts that they advertise.
The RCP Report also acknowledges that medical careers should be accessible across society. Mr Hunt also stated that he will ensure that all young people with the capability to train as a doctor have the chance to do so.
The cost of medical education is very high with many students facing debts in excess of £50,000. This may deter many candidates who cannot afford this burden. It is clear that some UK communities are barely represented at current UK medical schools despite attempts to increase diversity. Ironically, many of these students will opt for an apprentice career in another field where they can work, study and be paid from the beginning.
The great demographic change has led to many more doctors working part time and there is an increasing trend to early retirement. Many students would find that local apprentice training would fit in better with family commitments and uncertain geographical moves.
The recent Sunday Times Supplement on Apprenticeships showed that many professions now have an apprentice entry route as an alternative to the traditional university education eg banking, law, engineering and accountancy. It is the new modern way.
Apprentices would acquire practical skills by the end of their five year apprenticeship. This would mean that the current Foundation Year One and Foundation Year Two competencies should be acquired in the final two years of the five year apprenticeship.
This is a great advantage in recognition that trained apprentices can get on with the job subject to senior supervision, ongoing training and life long learning. It would also be reasonable to adhere to the health secretary’s proposal that the apprentice doctors trained on the NHS to continue working for it for up to four years after graduation.
1. The Apprentice Medical School (AMS) will produce the skilled practical medical practitioners required by the modern NHS.
2. It will increase diversity so that the medical profession is truly representative of the communities served.
3. The students will be subject to the same academic standards as conventional medical schools. The teaching is by practical bedside and consultation tuition in hospitals and the community and by e-learning.
4. The student will be paid as apprentices and will not accumulate large debts. They will work as ward and clinical medical orderlies from day one. They will get to know the health care systems really well and will be a great asset to the health care teams that they work with.
The NHS could consider its own ”in-house Apprentice Medical School”.
The school will be called the John Snow Apprentice Medical School after the famous Victorian doctor who was the father of modern epidemiology and infection control. He removed the water pump in Soho during a major cholera epidemic. He also was a pioneer of anaesthesia giving chloroform to Queen Victoria when she was in labour. These were two of the greatest events in medical history when medical apprenticeships were the norm.
The circle has now fully turned and apprenticeships are the new modern way.
Dr Vincent Argent is consultant, emergency medicine, London, and founder of the Trinity Brain think tank using the best minds to plan for the future