FOUNDATION year doctors are not given enough exposure to emergency medicine and believe incompetent trainees are not identified by the assessment system, according to new research.
The survey of more than 1,000 trainees delivered stinging criticism of the foundation programme with researchers concluding it “appears to be failing in several key areas”. The lack of exposure to emergency medicine was described as “a particular area of concern.”
Results, published in the Journal of the Royal Society of Medicine, also found “high levels of dissatisfaction with the selection process” with 90 per cent of trainees believing “incompetent” trainees could still obtain satisfactory results from assessments.
Other findings highlighted the lack of emergency exposure, with 11 per cent of trainees saying they spent no time each week clerking emergency admissions while 37 per cent spent an average of zero to five hours per week. One trainee commented: “Where I work FY1s clerk very little, they get terrible experience. We have utterly lost our way in educating doctors.”
Researchers said the data suggested the lack of experience in the specialty could be attributed to “the shift of regulatory responsibility to the GMC, in combination with an over emphasis on chronic disease management”. They suggested the reintroduction of “routine regulatory workplace visits” to ensure trainees gain enough experience of emergency medicine.
The survey found all the trainees wanted to work more than 40 hours a week. Of those, 22 per cent preferred to work 40-48 hours, half were happy to work 48-60 hours and 19 per cent wanted to work 60-70 hours. This is despite the average working week being limited to 48 hours under the European Working Time Directive (EWTD).
One doctor commented: “Please put an end to the EWTD as it is severely detrimental to our Foundation training.”
Positive feedback showed doctors were generally happy with formal teaching, levels of supervision, the training content of jobs and their level of clinical autonomy. There were notably high levels of engagement with the e-portfolio and e-learning systems.
It was also acknowledged that issues with the selection process were being addressed with the introduction of a situational judgement test (STJ) and an educational performance measure (EPM).
Foundation doctors' experience of their training: a questionnaire study
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