Last reviewed 12 November 2013

The final report of an independent review into possible reform of the structure of postgraduate medical education and training across the UK has been published.

The Shape of Training Final Report, commissioned by Medical Education England and chaired by Professor David Greenaway, found that, with a growing number of people with multiple co-morbidities, an ageing population, health inequalities and patient expectations, more doctors were needed who are capable of providing general care in broad specialties across a range of different settings. It also concluded that the public will continue to need doctors trained in more specialised areas based on local patient and workforce needs.

It goes on to say that medicine has to be a sustainable career with opportunities to change roles and specialties throughout a doctor’s career. It also recommended that doctors within academic training pathways have a training structure flexible enough to allow them to move in and out of clinical training while meeting the competencies and standards of that training.

Full registration, it argued, should move to the point of graduation from medical school, provided there are measures in place to demonstrate graduates are fit to practise at the end of it.

The British Medical Association’s General Medical Committee (GMC) chair Professor Sir Peter Rubin said: “We particularly welcome the idea of a more flexible training structure for doctors and for doctors to be able to change roles and specialties throughout their career so we can continue to attract and retain the best doctors in the profession.”

He also highlighted the importance of ensuring that steady progress is made towards these reforms while maintaining stability in a system that has already had a great deal of change and pressure in recent years.

The Academy of Medical Royal Colleges expressed strong support for the underlying principles of the report and particularly welcomed the move towards generalism and greater flexibility in the context of maintaining a UK wide system of medical education, “whilst still appreciating the outstanding improvements that have been made to patient care through specialisation over the previous decades”.

Health Education England (HEE) agreed with the report that there needs to be sufficient flexibility in the system to meet changing needs and that there needs to be a greater focus on the development of generalist capabilities.

The report will now be presented to ministers in the four UK health departments for their response and recommendations on implementation.