Further reading on postgraduate education and training
In this section
Research into the impact of the European Working Time Regulations on Postgraduate Training
The GMC sets standards for specialty including GP training. The GMC needs to ensure that the required training standards continue to be achieved following the final implementation phase of the health and safety directive leading to a 48-hour working week in August 2009. The directive is now referred to as the (European) Working Time Regulations (EWTR).
In 2011 the GMC began a programme of research to identify what impact the implementation of the European Working Time Regulations (EWTR) has had on the postgraduate training in the UK.
The first stage of the research focussed on exploring the experiences of other European regulatory bodies, among others, in implementing the European Working Time Directive (other restrictions on hours), and the outcomes and effects that compliance has had on specialty training. The research team were also asked to identify possible evaluation tools and mechanisms to assess the impact, outcome and effects of implementation of EWTR on specialty training.
The final report of this first stage of the research, The Impact of the implementation of the European Working Time Directive (EWTD) (pdf) is now available to read.
Building on the findings of this stage of the research we will commission a second stage, focussing on the impact of compliance, and non-compliance, with EWTR on rota design and fatigue among trainees.
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European Working Time Regulations
In August 2009, the Training Committee of PMETB, prior to PMETB's merger with the GMC, authorised the European Working Time Directive Panel to explore specific issues relating to the effect of the final phase of the implementation of the European Working Time Directive (EWTD) on specialty training. The EWTD panel received and considered a report which was published in September 2009.
View the report PMETB and the European Working Time Directive - September 2005 to September 2009 (pdf).
The Panel chaired by Professor David Haslam completed its work in July 2010. The report was discussed and agreed by the GMC Postgraduate Board in September 2010 and one of the outcomes is the GMC report for 2009-2010.
View the report GMC quality assurance of Specialty including GP training and the European Working Time Regulations - September 2009 to June 2010 (pdf).
The review presents a mixed picture of how training is being delivered and managed within the 48-hour week. Although many specialties raise no or few concerns, in some, implementing EWTR appears to be creating significant problems, including lost training time and difficulties in balancing training with the demands of delivering care to patients.
The report notes that rota gaps and vacancies are a key set of problems exacerbated by the 48-hour week but it is not a causal relationship. It points out that the new arrangements were introduced into a system already under considerable strain with not enough doctors to provide adequate cover in all areas.
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Selection into Specialty Training
A 2010 report was the outcome of a working group considering whether selection into specialty training is a form of assessment and if so, what are the implications for regulation. The group met in 2009 and reported to the PMETB Assessment Committee and the report was approved by the PMETB Board. GMC will consider the outcomes of the report alongside other factors.
Read the Final Report of the Selection into Specialty Training Approved by the PMETB Board March 2010 (pdf)
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Credentialing of medical practice
In December 2008 PMETB was invited by the Department of Health (England) to lead exploratory work on the possible credentialing of medical practice. The conclusions of this exploratory work, to which the GMC and others contributed, were set out in a report submitted to the Department in April 2010. You can read the complete report and related documents here:
Building on this earlier work, the General Medical Council (GMC) has now agreed to the piloting of credentialing in three areas of medical practice which currently have no formal recognition as specialties: breast disease management, musculoskeletal medicine, and forensic and legal medicine.
This early stage piloting is intended to test the principles and practicality of credentialing and help the GMC form a view as to its future feasibility.
The intention is to complete the pilots in January 2012. The conclusions will then be reported to the GMC to consider.
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