Cuts hit specialist trainee posts

24 May 2010

CUTS are being made to as many as a third of specialist trainee posts across the country.

Reductions will be phased in over the next three years, according to a report by BMJ Careers. The move follows an increase in the number of medical student places in 2004 which was partly introduced to cope with the demands of the European Working Time Directive, but also allowed the NHS to train its own doctors.

The Department of Health confirmed that specialist trainee posts in England are being reduced to help avoid future unemployment amongst doctors. They also want to make sure deaneries are training doctors in the right specialties to meet NHS demand.

The DoH admitted there will be reductions as high as 30 per cent in specialties such as surgery core training and trauma and orthopaedics core training. A spokesman said: “This will lead to reductions in numbers for some areas – for example, surgery – but will also mean increases in others, like general practice. Strategic health authorities are implementing this to match the specific local needs of their region.”

Surgeon David Mahon, from Musgrove Park NHS hospital in Taunton, told BMJ Careers that the South West deanery was facing a 14 per cent budget cut for trainees. He fears cuts will fall disproportionately on some of the larger specialties, such as medicine and surgery, where there is greater room for manoeuvre.

Mr Mahon has been told the 30 per cent reductions in surgery and trauma and orthopaedics will affect specialist training year 1 and 2 in posts for both of these areas. General surgery faces a 10 per cent cut but obstetrics and gynaecology only four per cent.

Mr Mahon said: “This is unprecedented. Trainee numbers have increased year on year for as long as I can remember. My specialty is going to be harder hit than many other specialties.

“Trainees, although obviously in a training placement to be trained, also carry out a lot of service work. Much of this service is staffing the hospital 24 hours a day to receive emergency patients. The European Working Time Directive, with its maximum of 48 hours per week, has ensured that this cannot be carried out by a small number of doctors.

“A loss of trainees will mean that the work has to be taken on by someone else,” he warned, suggesting this would mean “either spreading the remaining doctors more thinly, which is potentially dangerous; using consultants, possibly unnecessary and definitely expensive; or using non-training grade doctors or non-medical staff.”

The reductions are affecting areas across England, with one dean claiming strategic health authorities are facing 15 per cent budget cuts over the next three years. These cuts are expected to be passed on to deaneries.

The main reason for the cuts is an attempt to match the number of specialist training posts with the number of foundation year 2 doctors. The DoH want to avoid future unemployment amongst doctors and are making cuts to areas with lower expected demand.

Remedy UK head of policy Richard Marks claimed the move would mean “coercing more people to go into general practice.” He added: “Doctors in specialty training posts are not only getting trained, they are doing work for the NHS. Who is going to do the work those people were going to do?”