The Royal Colleges of medicine, deaneries and health trusts need to work together if the 1996 Calman reforms of higher training for specialist registrars are to work, an Open University report says, writes Claire Sanders.
An Evaluation of the Reforms to Higher Specialist Training, 1996-99 , by the OU's Centre for Education in Medicine, says that the separation of education and training for planning and monitoring purposes "afforded the opportunity for perhaps inappropriate separation of the costs of training and service".
The Department of Health is merging training levels for undergraduate and postgraduate doctors, nurses and professionals allied to medicine.
Janet Grant, director of the centre, said: "It is important to ensure that service and training are still treated as a whole." She said the framework proposed by Sir Kenneth Calman had been "overinterpreted... to mean structured training, with seminars and organised modules that take the doctors away from the patients".
The report also says: "The Royal Colleges have done a brilliant job introducing these reforms, but need to ensure that their methods of assessment are adequate."
Sir George Alberti, president of the Royal College of Physicians, said: "We need to move to a system of assessment that is competency-based, rather than based on the amount of time spent in the job."
Trainees used to arrange their own training programmes, applying for posts first at registrar, then at senior registrar level. The reforms created a unified grade of specialist registrar.