Training of junior doctors: the responsibility of consultants and trainers

Abstract

With 31 000 doctors currently in training programmes or placements and 23 000 consultants1 it should not be considered surprising that the vast majority of consultants working in the National Health Service (NHS) are involved in training. This role has been emphasised with the incorporation of “teaching and training” as a key attribute by the General Medical Council2 and formalised by the publication of The Doctor as Teacher. 3 Teaching and training has become an integral part of the role of the consultant. Is such an approach right? If it is, what exactly are the responsibilities that this places on a consultant? And how might this role develop in the foreseeable future? In The Doctor as Teacher the General Medical Council states that “all doctors have a professional obligation to contribute to the education and training of others . . ..”, and that “every doctor should be prepared to oversee the work of less experienced colleagues”.3 This clearly articulates obligations for the senior professional in relation to those less experienced. But this responsibility should not only be seen as an issue of professional obligation between members of the same profession. These elements are surely also crucial if patients are to receive care that is safe. We owe it to the patients of today to ensure that the care they receive is adequately supervised by an appropriately experienced clinician; we owe it to the patients of the future that those who will be consultants at that stage have learnt how to provide safe care from observation of their seniors. For these reasons any consultant who relates to doctors-in-training must be in a position to provide effective supervision of their clinical activities including the explicit modelling of good clinical care—that is, to …