|........................||What will be the implications of MMC (Modernising Medical Careers) on ophthalmic training?|
|As far as can be judged at the moment,
it is likely that specialist training in ophthalmology will be of 6 years
duration. The SPR and SHO grades will be merged into a single run-through
training grade. Years 1 and 2 would correspond to SHO training, Years 3-5
to core SpR training, and year 6 would be reserved for sub-specialty training.
This will make little difference to the SPR part of the training programme,
but will make the learning curve a lot steeper in the SHO part of the programme,
It will, for instance, leave limited scope for re-sitting exams. I have
flagged up already the fact that the immediate consequence of a run through
grade is that SHO and SpR numbers will have to be balanced up. Even allowing
for projected expansion of consultant numbers, will need only 192 SHO posts
nationally to form Year 1 and 2 of the run-through training grade. We currently
have about 420 SHO posts nationally, so you can see that around 228 SHO
posts will be surplus to our training requirements for consultant posts.
This may seem shocking at first sight, but in reality it brings into the
open a situation which already exists and has existed for many years. Fewer
than 50% of ophthalmology SHOs currently in post will even be appointed
to a UK SpR post in ophthalmology. What will happen to the 228 surplus
SHO posts? There are a number of possibilities. We could apply for some
posts to be converted into foundation year 2 posts in ophthalmology. These
would then be filled by trainees new to ophthalmology who would stay for
no more than 4 months at a time. Some posts might be converted into non-trainnig
posts (trust grade). Some posts might be reserved for GP vocational training.
Some posts might become part of a medical ophthalmology training programme.
Some posts might be upgraded to SpR posts. We are relatively fortunate
in Oxford Deanery that our SHO and SpR numbers not too far out of balance,
so this might not hit us too hard, but it is not too early for units to
prepare contingency plans for ‘rebadging’ some SHO posts.