Foundation doctors’ experience of their training: a questionnaire study

Abstract

ObjectivesWe set out to evaluate the impact of Foundation Year (FY) training on the doctors who had been through this training system.DesignDoctors in training were surveyed using a structured web-based questionnaire.SettingPostgraduate training in the UK has been the subject of much upheaval in recent years.ParticipantsA total of 1065 doctors in training were surveyed in late 2011 and early 2012, of which 638 were current FY doctors.Main outcome measuresThe survey was both quantitative and qualitative, focusing on selection, working hours, training quality, training assessments and the regulation of training.ResultsA majority of current FY trainees worked extra weekly hours with the breakdown being: 5–10 hrs (54%), 10–15 hrs (17%), >15 hrs (9%) and no extra weekly hours (20%). All current FY trainees wanted to work for more than 40 h a week with the following breakdown of desired hours: per week 40–48 (22%), 48–60 (50%) and 60–70 h (19%). The average hours per week spent clerking emergency admissions by current FY trainees were as follows: zero hours (11%), 0–5 h (37%), 5–10 h (30%), 10–15 h (11%) and greater (11%).A large majority (90%) felt that it was possible for incompetent trainees to obtain satisfactory results from assessments and that the FY training program was poor at identifying failing trainees. There were high levels of dissatisfaction with the selection process.ConclusionsFY training appears to be failing in several key areas with the lack of emergency exposure a particular area of concern. It is essential that any future reforms of training address these problem areas.

Competency based surgical training

“…16 Other factors that might or could have contributed towards the introduction of competency based training includes, lack of time to train doctors due to "EWTD," the "new deal document," reduction in continuity of patients care due to shift patterns, significant reduction in personal reflection on part of the healthcare professionals due to increased intensity and work load, poor quality of feedback from colleagues and patients. [5][6][7]17 In the UK competency-based training has been introduced since 2005 for its trainee doctors as part of the modernising medical careers (MMC) changes and currently is at the center stage of both the government policy makers and the media. This recent trend towards the direction of a competency-based system or training is not new or distinct only to the UK; in the United State of America (USA) the American Council for Graduate Medical Education has planned its postgraduate medical education as competency based and in other developed countries there has also been an ongoing growing pressure on governments to not only strengthen health related accountability but also to formalize the way doctors learn and practice at the same time.…”

“…6 A number of supervising consultants observe and make global impressions of trainee doctors over a specific period of time during their clinical rotations through WBAs. The main aim of these WBAs is not only to assess and monitor the progress of a trainee doctor in a real clinical setting but also to improve clinical learning through reflective practice; WBAs tools include mini-CEX, CBD, DOPS, 360° appraisals in the form of mini-PAT and the recently added WBAs tool on how to be a good clinical teacher.…”

“…The main aim of these WBAs is not only to assess and monitor the progress of a trainee doctor in a real clinical setting but also to improve clinical learning through reflective practice; WBAs tools include mini-CEX, CBD, DOPS, 360° appraisals in the form of mini-PAT and the recently added WBAs tool on how to be a good clinical teacher. 6,[29][30][31] Trainees receive different constructive comments on the WBA performed from their assessors or evaluators in a formative way that is then compiled together with other WBAs and uploaded onto an online portfolio by the trainee; In the UK, WBAs are currently being used in both formative and summative way, that is to say that when assessed by their assessor alone it works as a formative assessment tool that is to help a trainee learn by reflection and through constructive feedback given by their assessors, however at the end of the year placement when combined with other WBAs it is assessed in a summative way (summative assessment of learning) by the educational supervisor through ARCP that is a pass or a fail affair.…”

“…The aim of such WBAs tools is to not only provide evidence on a trainee's ability to perform in clinical practice but also some authors are of the view that it can show improvement in the quality of workplace training through supervised reflection and feedback. [5][6][7][8] This article is about the use of WBAs in improving trainee doctor's competence and workplace performance; explore why they are so unpopular amongst both trainees and trainers and what can be done to improve their work based learning.…”

Viewpoint: Is our profession in need of occupational therapy?

“…Research findings from a sample of 1065 doctors suggest that working un-rostered hours is common practice. 2 Knowing GPs who work 12-hour days 5 days per week has not increased my faith that a medical career can offer work-life balance. Antisocial working hours and poor worklife balance have been linked to stress, anxiety, depression, cardiovascular risk, gastrointestinal disorders, obesity in men, and workplace accidents possibly due to sleep and circadian rhythm disturbances, social marginalisation and poorer dietary habits.…”