Universities should take over the work co-ordinating postgraduate medical training in England, a report on modernising medical careers has recommended.
Sir John Tooke's paper says that new graduate schools could be set up to take over the work currently done by National Health Service deaneries. It says they should be trialled where there is local support.
As well as handling applications by junior doctors to specialist training, the new schools could oversee career development of trainee clinical academics and clinical managers.
Sir John, dean of the Peninsula Medical School, says the move is necessary to address the "suboptimal" relationship between deaneries in England and universities.
"There is little relationship to local universities/medical schools ... in the majority of deaneries in England despite clear demands throughout the history of the NHS for close collaboration," he said.
Sir John says: "Such arrangements are in marked contrast to the situation in many other developed countries." Improved relationships would provide obvious value in terms of access to educational expertise and bespoke courses that reflected local needs, he suggested.
Sir John criticises "expensive, poorly evaluated healthcare training initiatives" of recent years that had been developed without proper support from higher education institutions.
Michael Rees, chairman of the British Medical Association's medical academic staff committee, said he "wholeheartedly supported" the recommendations.
"One of the major issues in postgraduate education has been the exclusion of the universities - it's high time that they were more involved," he said.
As well as specialist training for junior doctors, universities with graduate schools could provide the means for other clinicians, such as trust grade doctors, to increase their skills and qualifications, Professor Rees suggested. Courses could include training on technical clinical education and medical management.