Shape of Training: the right people with the right skills in the right place

A medical student entering medical school in 2014 will become a consultant sometime around 2027. The whole face of healthcare will have changed by then. The population is ageing, there are increasing numbers of people with multiple comorbidities and patients are increasingly demonstrating greater expectations of the quality of healthcare they receive. In addition, rapid technological and therapeutic advancement is counterbalanced by growing financial pressures. How we best adapt our workforce development and education strategies to be able to meet the future healthcare needs of the population is a huge challenge. The training of doctors has received a lot of public and professional attention in the last decade with a series of in-depth reviews of various aspects of medical training both in the UK and internationally.1 ,2 A common thread in each of these has been to highlight the lack of flexibility in medical training and the slow response of the profession to change. Where change has been introduced, problems with consultation, implementation and other process issues3 ,4 have led to a sense of suspicion, if not outright resistance to change, among some medical professionals. It is against this backdrop that the most recent review of medical training in the UK, the Shape of Training Review (SOT), chaired by Professor David Greenaway, was published in November 2013.5 The key messages for postgraduate medical education from this review are the following: