Increasing the flexibility of training pathways

Ultimately, it is patients who will benefit most from changes to training, by having doctors who can care for patients with conditions that cross specialty boundaries.

In March 2017, we delivered a report called Adapting for the future: a plan for improving the flexibility of UK postgraduate medical training to the health ministers of the four UK governments. The report made a number of commitments, including our intention to introduce educational reforms that would support greater flexibility through outcomes and more generic professional and transferable skills.

In addition to implementation of our reforms in 2017, including the Generic professional capabilities framework and related new guidance for the development of postgraduate specialty curricula, we’ve taken action to increase flexibility on a number of other fronts.

We’ve updated our guidance to give greater clarity and support for those who cannot or do not wish to do full-time training – while making sure standards for training are maintained. In May 2019, we published revised advice to support medical students and trainees with health conditions and disabilities.

We also recognise that doctors are making choices about their careers and work–life balance, including moving to different specialties which may be more suited to their skills, taking time out from training to develop new skills and gain experience in other healthcare systems. As part of our review of flexibility in postgraduate training, our intention is to make sure that training pathways are as flexible as possible, they are attractive to doctors and that the integrity of workforce and service planning are protected.

In addition to this, we’re working with the Academy of Medical Royal Colleges, which has developed new guidance to better support doctors who transfer between specialties, and take away the need to start from the beginning again – the ‘snakes and ladders’ effect as it’s sometimes called. We expect the new guidance to be implemented in early 2020.

We are also working with education bodies across the UK to make sure there are safeguards for doctors who take a break from training, so they can have relevant time counted towards their UK training when they return. And we’re exploring where elements of training are common, so they can be shared between specialties and reflected in curricula. 

We are also keen to explore how flexibility could help other doctors, including those in non-training roles.