Learning how to work and train in a world that is different

Dear Colleagues,

Over the past two years, HEE has worked closely with patients, doctors, partners and stakeholders, seeking to understand the role of the future doctor in ten, twenty, and thirty years’ time. However, some of the future has come sooner than we thought.

In fact, one of those responding to our Future Doctor engagement believed that, despite the need for change, our aspirations for reform within a few years would fail without some significant event, commenting:

“A geopolitical crisis, major global recession or cataclysmic pandemic will be the most likely driver of change. With all the will in the world, without a step-change in the money and power available, current planned changes in how health and social care in the UK will be delivered will be at best partial.”

Whilst there is no doubt that the COVID-19 pandemic has posed real challenges to health and care services, we have also seen that the workforce can become more flexible, responsive, empowered and motivated. We’re now looking forward to ensuring that new courses, training programmes and jobs can be started, and students and trainees can move forward with their careers.

We’ve listened and learnt a lot throughout the pandemic, hosting webinars and engaging students and trainees. We’ve also worked together to test new ways of learning and working. We’ve successfully recruited trainees without the risks of large face to face recruitment events, we have continued to monitor the quality of teaching and education using different processes, as well as enabling Foundation Year One trainees to join the NHS workforce early, supporting a different route to starting their career as a doctor. Important new resources for trainees have been introduced including the Foundation Toolkit and roll out of BMJ Best Practice Clinical Guidelines App to support doctors and build confidence at the start of their careers.

The COVID-19 global pandemic has brought into sharp focus how crucial generalist skills are in enabling doctors to manage complex patient care across all specialties. And our vision for the future doctor outlines how we can reform medical education so doctors better understand population needs, develop generalist skills and work effectively in multi-professional teams.

By learning from the experience of these different approaches, particularly from those who graduated early and experienced a very different introduction to the NHS, we are keen to work with medical schools and Royal Colleges and Faculties to evaluate new models and positively change education and training in the future.

If we are to embed the attributes and skills that the Future Doctor Programme and the COVID-19 pandemic have highlighted as being critical, we must emphasise these in curricular outcomes from medical school, foundation and early core training, through to higher specialty training. To bridge the gap between the present and the future, we are developing plans to support local health and care systems to establish the infrastructure for ‘Generalist Schools’ with new training opportunities in place by August 2021.

We want to support our young professionals (final year medical students and the first 4 - 5 years of postgraduate specialty medical training) within the communities where they learn and train, enabling them to develop the key generalist skills together with other health and care professionals and to build an understanding of local service and population need.

Restarting careers and building hope for the future and confidence in education and training is incredibly important for us all.

Kind Regards

Sheona MacLeod

Director of Education and Quality and Medical Director