The ED is medical education’s front line. St.Emlyn’s

GMCThis week the GMC has published a report on emergency medicine training in the UK (press release here). The report follows a series of visits to UK emergency departments looking at how training is delivered and how service change and delivery influences the effectiveness of education. The report was commissioned in response to concerns about the quality of training in EM, and in particular around the supervision of doctors in training.

You can download the report here: Medical education’s front line.

Whilst the title suggests that the report is about education, the remit is much wider. The GMC have looked at how education is delivered in a wide variety of settings and it is clear that the experience of trainees is closely linked to service delivery and pressure. EM training in the UK has huge numbers of unfilled posts which leads to those who remain in the speciality working harder. This leads to a vicious cycle that ultimately affects future recruitment and workload.

There are several themes in the document that will be relevant to all of us in emergency care

  • Increases in unfilled core training posts
  • Unsatisfactory outcomes in ARCP are increasing
  • Finding ways to manage risk
  • Tackling understaffing
  • Giving doctors in training the right supervision
  • Positive examples to promote learning
  • Sharing practice

From a personal perspective I think three broad headings that are closely linked  leap out at me. These are

  • Sustainability
  • Recruitment
  • Intensity

I would put these together graphically as something like this….

EM cycle

 

This is how some days feel. Wikimedia

This is how some days feel. Wikimedia

The GMC document is essential reading for all UK emergency physicians and also to our colleagues around the world who face similar challenges to their healthcare systems. The Emergency department is the barometer of the health service and those working and training within it are those that feel the pressure (Ed – I see what you did there).

Please read and disseminate this document as widely as you can. I am hopeful that this document can be used at all levels in the health service and in particular that Sir Bruce Keogh takes it into account in his review of emergency services in the UK.

[learn_more caption=”Individual site reports from the seven sites visited”]

 

Posted by Simon Carley

Professor Simon Carley MB ChB, PGDip, DipIMC (RCS Ed), FRCS (Ed)(1998), FHEA, FAcadMed, FRCEM, MPhil, MD, PhD is Creator, Webmaster, owner and Editor in Chief of the St Emlyn’s blog and podcast. He is Professor of Emergency Medicine at Manchester Metropolitan University and a Consultant in adult and paediatric Emergency Medicine at Manchester Foundation Trust. He is co-founder of BestBets, St.Emlyns and the MSc in emergency medicine at Manchester Metropolitan University. He is an Education Associate with the General Medical Council and is an Associate Editor for the Emergency Medicine Journal. His research interests include diagnostics, MedEd, Major incidents & Evidence based Emergency Medicine. He is verified on twitter as @EMManchester

  1. Haven’t gone through the report in detail, but at first glance I do not see any relation/ mention of the increasing work load with the 4 hour rule/ targets. has that aspect been overlooked or is it true, that there is no impact ?

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  2. […] Medicine in the UK has come under a great deal of scrutiny in the last few years, and the GMC has undertaken specific work to look at training in our speciality. Concerns have been raised about workload, work intensity and as a result there are well described […]

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  3. […] in getting the best out of their education. For example I was part of the team that put together this report on Emergency Medicine Education (worth a read IMHO)1. The team I work with are superb, some of the brightest and enthusiastic people I’ve met in […]

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Thanks so much for following. Viva la #FOAMed

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