Medical education’s front line: The GMC's review of training in seven emergency medicine departments

The General Medical Council (GMC) has today, 10 July 2013, published an in-depth overview of the current challenges in emergency medicine training and has made a series of seven recommendations on how these might be addressed.

In Medical education’s front line: A review of training in seven emergency medicine departments the GMC identified a number of common barriers to doctors entering and training in emergency medicine including continuing service pressures, understaffing, the need for staff to find new ways to manage risk, inconsistent supervision on night shifts and a lack of resources.

These barriers and the GMC's subsequent recommendations are based on the findings from its targeted checks of the emergency medicine departments in six local education providers (LEPs) in England (NHS trusts) and one in Jersey, which it carried out between December 2012 and February 2013.

In response to the GMC’s report, Mr Peter Lees FMLM Medical Director said: "This GMC report is far more than a report about trainees. The study of the challenges facing emergency medicine trainees highlights the complex inter-related challenges which collide in our stretched emergency departments.

"We have known about this for too long and it is time for action: time to end passing the blame between services and time for a collaborative solution. Above all, it is a time for effective system leadership."

The College of Emergency Medicine said: “We welcome this report which comes at a critical time for our members and for the specialty.

"The report, which is based on visits and discussions with doctors in training in a range of Emergency Departments, highlights the same issues that the College has documented in our recent publication The drive for quality - How to achieve safe, sustainable care in our Emergency Departments and is a good reflection of the staffing and workload crisis in the majority of our departments in the UK and Ireland."

The College fully supports the GMC’s call for improved training and support emergency medicine trainees and consultants: “The College believes we must find ways of agreeing, for us, and for other acute specialties, safe and sustainable working patterns for trainees and consultants to be able to provide clinical care, time for supervision and which reflects that intensity of work.”

ENDS

Notes

The GMC’s seven recommendations to improve emergency medicine training are:

1. Managing a patient’s care in the emergency department, and in subsequent departments, needs to be the collective responsibility of the trust, its board and senior management team.
2. The healthcare system at a national level needs to educate patients, the public and colleagues on the best care pathways for patients to address the overdependence on emergency medicine departments.
3. LEPs need to develop plans to address the current issues facing emergency medicine to ensure sustainable delivery of services. These plans should include an extended induction, more intensive shop floor teaching and use of simulation to develop the junior medical workforce’s confidence and competence in managing the care of acutely ill patients.
4. LEPs, deaneries and LETBs need to work together to ensure that they balance service and training appropriately in working arrangements to minimise burnout in the training workforce.
5. LEPs, deaneries and LETBs need to work together to ensure that they balance service and training appropriately in working arrangements to minimise burnout in the training workforce.
6. There appear to be significant advantages from combining services on to a single site. If this is possible, it can transform rotas and help to ensure safer care and better training.
7. There are real benefits to be gained from deaneries and LETBs working more closely with trusts to support doctors who are making transitions between stages of their training programme. This can help to make sure that there is guidance at each step and that the next level is achievable and appropriate.

Resources

The full GMC report Medical education’s front line: A review of training in seven emergency medicine departments can be downloaded here.

The full College of Emergency Medicine response can be downloaded here.

Further information on the College of Emergency Medicine's report The drive for quality: How to achieve safe, sustainable care in our Emergency Departments? can be found here.