Written evidence submitted by Dr Raymond Godwin (FGP0375)

 

Dear Sir,

 

RE:-  Changes in medical education that might be considered to manage the worsening medical staffing problems within the NHS

 

              I am a retired NHS Consultant with thirty years of experience, as a head of department, NHS Trust medical director and founding member of the development and management team for the Graduate Entry Medical School at the University of Cambridge, where I was director of studies in medical sciences and Fellow of Hughes Hall, one of the four Colleges currently offering places on the course.

 

              The current medical practitioner manpower problems within the NHS could be summarised as :-

 

-          more doctors are leaving the NHS than entering from initial UK training.

-          doctors are retiring early partly due to burn out and pension changes.

-          doctors are not choosing, or being able, to come into the NHS from other countries, as they have in previous years.

-          newly qualifying doctors are not choosing to go into General Practice

-          doctors cannot be made to work as GPs.

-          GPs are retiring early or going part time.

-          women doctors are leaving for family reasons.

-          I also suspect that more doctors will be going into Private (non NHS) practice) in the coming years.

 

None of these is likely to resolve with time, or recovery from the Covid pandemic.

 

What might we consider altering to improve this situation?

 

Given the built-in lag time in medical training from leaving school to qualifying, these major problems of medical manpower could be helped by considering the successful fast track medical training as adopted on the Cambridge Graduate Course and changes to early years training options, as outlined below.

The Graduate Course has been running successfully since 1986, training graduate students from all areas of academia in relatively small numbers, over a shortened four year course (actually three and three quarter years) rather than the usual five or six.

During the Second World War the urgent need for more medical staff lead to a urgent shortening of medical training programmes and the use of medical students in front line work. One of my Consultant trainers and mentors was, as a student, drafted to the south coast to work in operating theatres during the D Day landings and then in the newly relieved Belson concentration camp.

On the Graduate Course it has also became clear that students, who went on elective periods in some USA cities (e.g. Chicago), returned impressively equipped to handle medical/surgical emergencies, having been exposed to them early on and given significant clinical responsibilities.

We have also found that rather than producing a less capable form of quickly trained doctor, the graduate course consistently generated a much higher percentage of individuals with distinctions awarded at their final examination, despite having taken the same exam at the same time as standard course candidates.

 

              Whilst recognising that there is no magic wand that might solve all of the above stated manpower problems at once, might I suggest some changes that could be relatively quickly employed to ameliorate the situation?

 

-          increasing the number of fast track (four year) medical students and courses using graduate entry to encourage mature proven individuals to enter medicine (we admitted arts graduates as well as those from the sciences)

-          involve students in far more practical training in the General Practice setting, there-by exposing them to the GP environment and at the same time adding to GP practice manpower at low cost, and, perhaps, attracting more of them into that area of medicine

-          making it a requirement to work in General Practice in the first two years post initial qualification prior to full registration

 

 

I hope you might consider the above thoughts, and I am, of course, very happy to discuss this matter further if you wish.

 

 

Yours Sincerely

 

 

Raymond Godwin

-           

Jan 2022