Patients are being placed at “unnecessary risk” because junior doctors are told to work beyond their competence, a report said today.
A review of doctor training ordered by the Medical Education England (MEE) found trainees are often handling cases that go beyond their expertise.
It comes after several other reports and surveys have raised the issue of junior doctors working inappropriately to meet the demands of the NHS.
Today’s review, led by Professor John Collins at the University of Oxford, analysed the two-year foundation programme for medical training, which begins after students graduate from medical school.
The study found the programme - which was introduced in 2005 - was working well in some areas, with strengths including the creation of a national, standardised programme for entry into postgraduate medical education.
A clear, well defined and broadly supported national curriculum has been created, and trainees are exposed to a range of medical specialties.
But the review found several problems with the programme, including issues balancing the demands of the service with the fact doctors are trying to learn.
“In meetings with trainees across England, the evaluation panel heard the repeated theme of some trainees being asked to practise beyond their level of competence and without adequate supervision,” the report said.
While the panel acknowledged trainees must “step up” in their level of responsibility as they progress through the programme, this “must be undertaken under appropriate supervision”.
The report added: “We are extremely concerned that some foundation trainees are expected to practise outside their level of competence and without appropriate supervision.”
Health secretary Andrew Lansley welcomed the report.
He said: “I am clear about the purpose of foundation training.
“We need to equip medical graduates with the right skills to enter speciality training and to provide safe and high-quality patient care.
“A programme that exposes them to a range of different specialties will give medical graduates the transferable skills and competencies they need and allow them to direct their careers to a chosen speciality area.
“I have asked Medical Education England to work with the profession, the service and medical Royal Colleges to take forward the recommendations as swiftly as possible.
“This will fit with Medical Education England’s ongoing work to improve the quality of training, ensuring that trainees have appropriate supervision and are not undertaking tasks for which they are not yet competent.”
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