Article
I recently attended the BOS Trustees meeting and was surprised to learn that, for half a dozen senior registrar jobs, there were only two or three applicants. This is not the first time that training posts have been left unfilled, and this certainly does not bode well for the future. All of the stakeholders involved, either directly or indirectly, in training the next generation of specialists: the Postgraduate Deans, the SAC and the Consultant Orthodontic Group, urgently need to find out from the Training Grades Group what would make these training posts much more attractive.
To avert this impending crisis we certainly need to think of innovative ways of making the Senior Registrar posts more accessible and more attractive to the many young specialists who are completing their basic specialty training, so that we do not lose this entire pool of talent to the undeniable lures of specialist practice.
I ran the very first couple of part-time training courses in Manchester when I was Training Programme director in the 1990s. These were incredibly well received by the successful applicants and involved training three days a week over a four-year period. A similar model has already been successfully run at Senior Registrar level and perhaps we should be positively encouraging trainees to follow this model. They would have the opportunity to sample life in specialist practice as well as learning to treat the more complex multidisciplinary cases. The quality of the overall training should be far superior to the traditional 2-year programme, due to the longitudinal nature of orthodontic treatment.
We also need to consider moving away from the National Recruitment model where trainees are just randomly posted to centres between Truro and Inverness, with no real regard to their geographic preferences, nor indeed the location of their families and friends. The old system at least allowed the potential trainees to visit the areas of the country in which they had a potential infrastructure and allowed them to meet the people with whom they might be training side by side, for the next few years of their lives.
I was Chairman of the Senior Registrars group, a life time ago, where I was assured that the newly introduced ‘exit exam’ was going to be merely a ‘fireside chat’ between colleagues about clinically relevant challenges, that we all face on a day to day basis. Nothing could be further from the truth! We all hear stories of examiners grilling candidates on their favourite, unbelievably complex case, expecting a definitive treatment plan to be produced in an instant, or discussions on once in a lifetime syndromes, that any of us would just look up on the internet if we wanted to know more. Has the world gone completely mad? I think we all know the answer to that one.
Certainly the ‘powers that be’ should be listening to the concerns of the current trainees, as to why the current training package is obviously so unattractive as to not even pique their interest.
Having been presented with the reasons, a concerted effort should then be made by all those with influence, to ‘fix the problem’, if we are going to continue to have a rosy future for the secondary care sector.