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South Thames Foundation School www.stfs.org.uk
Foundation Training- Ten Years and Beyond
• Faculty Briefing 24 February 2015
• Dr Jan Welch
South Thames Foundation School www.stfs.org.uk
As we were . . . .
• Pre-registration year• 6 months medicine / 6 months
surgery• Deaneries• ‘hidden curriculum’• Paper
• Local matching schemes owned by medical schools– not open to ‘outsiders’– natural progression
• ‘Lost tribes’• Moving every 6 months• References not competency
South Thames Foundation School www.stfs.org.uk
No . . . .
• Structure• Curriculum / teaching• Reference guide• National recruitment process• e Portfolio• Core procedures / simulation• Supervised learning events• Academic foundation programmes• ARCPs• UKFPO
South Thames Foundation School www.stfs.org.uk
Making foundation better
• Tooke 2008
– Independent inquiry into Modernising Medical Careers
– Extended remit to foundation
– Suggested uncoupling F1 and F2 years
South Thames Foundation School www.stfs.org.uk
Collins report 2010
Keep 2 years, but recommendations about:• purpose and role • selection• careers• flexibility• curriculum• specialty distribution • approval of trainers • assessment • supervision • pastoral support • transfer of information
South Thames Foundation School www.stfs.org.uk
Shape of Training / Greenaway Report 2013
• Broader specialty training (building on FP)
• Sustainable with opportunities to change roles and specialties throughout career
• Full Registration should move to the point of graduation from medical school
South Thames Foundation School www.stfs.org.uk
Shape of Training / Steering Group February 2015
(4 nations)
• Changes should be measured and incremental• Changes must reflect UK basis and be approved by
GMC• More generic – to include curriculum mapping
exercise• Work across interfaces / flexibility in training• Career development for non-consultants outside
training• STSG will support GMC in credentialing pilots
South Thames Foundation School www.stfs.org.uk
Broadening the foundation programme 2014
Requirements• 4 month placements for
foundation doctors– psychiatry - 45%– community
• 80% by 2015• 100% by 2017
• Reductions in surgical posts• Repeated medical posts to
include community elements
Implications
• Development and education infrastructure for new posts
• Service pressures on acute trusts– surgical posts to go– other staff required
South Thames Foundation School www.stfs.org.uk
New foundation posts• New places• New roles eg perioperative medicine• New supervisors• Need for clear objectives eg mental health
competences• Need for excellent liaison eg patch meetings and
outcomes
South Thames Foundation School www.stfs.org.uk
Improving Selection to the Foundation Programme (ISFP)Project group led by Medical Schools Council
www.isfp.org.uk
Educational Performance Measure (EPM) • reflects educational performance at medical school up to point of
application to Foundation Programme • 50% of score
Situational Judgement Tests (SJTs) • extensive research and piloting • 50% of score
South Thames Foundation School www.stfs.org.uk
Pastoral support
Training Support Group
Further services by referral /
PSU
FTPD/MEM/ DME
Practitioner Health
Programme / Careers
Clinical supervisors Good placement
South Thames Foundation School www.stfs.org.uk
• Skip to content www.medical careers.nhs.ukto move to new multi-professional website
April 2015
South Thames Foundation School www.stfs.org.uk
Being multi-professional
• Need for workforce to meet workload– New roles
• Make some foundation developments available elsewhere – where feasible– Careers– Training support– Policies and procedures– etft– Quality
South Thames Foundation School www.stfs.org.uk
Transfer of Information
• National for medical school to F1• Local for F1 to F2
• And then?• 1 HEE• KSS / London
South Thames Foundation School www.stfs.org.uk
Destination data – national
Foundation doctors progressing directly into specialty training2011 71.3%
2012 67.0%
2013 64.4%
2014 58.5%
South Thames Foundation School www.stfs.org.uk
Understanding progression
• Gap years?• GP recruitment – 50%?
• GMC medical education database– Undergraduate and postgraduate– Data including exams/foundation ARCP/ FTP– Recruitment from foundation to core initially
South Thames Foundation School www.stfs.org.uk
Wish list
• Seamless portfolio• Seamless induction• Quality at a glance• Trained trainers with time• Open access blended learning
South Thames Foundation School www.stfs.org.uk
www.etft.co.uk
– Open access video-based training for trainers– GP, hospital and pharmacy– Increasingly widely used– Role in ‘Approval of Trainers’
South Thames Foundation School www.stfs.org.uk
www.etft.co.uk
• Currently 18 modules including SLEs, quality visiting, simulation, and managing trainees in difficulty
• In development:– Lessons learnt– ARCP – Foundation / GP / Specialty– Foundation supervisor