New doctors “poorly prepared” in acute care

NEWLY qualified doctors don’t feel prepared to look after acutely ill patients or prescribe drugs, a study has found.

Senior colleagues tended to share the trainees’ concerns, according to the study in the Postgraduate Medical Journal. It suggests recent changes in medical undergraduate training could be to blame.

The authors collated evidence from 10 relevant studies published since 1993 that examine the preparedness of UK medical graduates in acute care and other required competencies set out by the professional regulator in Tomorrow’s Doctors. Tomorrow’s Doctors sets out the standards and competencies expected of trainees and is designed to guide the content of medical school curricula.

Researchers found that UK medical graduates feel least prepared to look after seriously ill patients and to prescribe drugs. Trends in the ratings given by professional colleagues suggest that preparedness may have declined since Tomorrow’s Doctors was first published in 1993.

Competence in acute care is particularly important, say the authors, because it is relevant for all specialties, whether community or hospital based, and is key to helping to cut death rates. They explain that the complexity of acute care means new doctors are bound to feel more anxious about their abilities. From a patient safety perspective, they add, it is perhaps a good thing that they ask senior colleagues for help.

But the authors said: “[I]t is of concern that graduate preparedness in acute care, as perceived by their professional colleagues, compares so unfavourably with preparedness in other outcomes and appears to be trending downwards.”

The report concludes: “The results of this study suggest that recent changes to UK undergraduate training, while improving preparedness in some areas, may have neglected acute care skills.”