........................ 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.
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