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Shape of Training: the right people with the right skills in the right place
  1. R E Klaber1,
  2. D E Lumsden2,
  3. C Kingdon3
  1. 1Department of Paediatrics & Child Health, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK
  2. 2Department of Paediatrics and Child Health, Evelina London Children's Hospital, London, UK
  3. 3Department of Paediatrics & Child Health, Evelina London Children's Hospital, London, UK
  1. Correspondence to Dr Robert Edward Klaber, Department of Paediatrics & Child Health, Imperial College Healthcare NHS Trust, St Mary's Hospital, London W2 1NY, UK; robert.klaber{at}

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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.

Key recommendations of the Shape of Training Review

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:

  • Patients’ needs are changing and the medical workforce needs to change to meet that demand—more doctors are going to need to have a ‘broad-based’ training that allows them to offer high-quality general care in varied settings.

  • Medical career pathways will need to be less rigid and allow doctors to change direction, acquire new skills and adapt over a working lifetime.

  • Academic and subspecialty training must …

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  • Competing interests REK is the RCPCH Officer for Educational Programmes, a Training Programme Director for paediatrics and child health in London and an Associate Editor for the Postgraduate Medical Journal. DEL is the Chair of the RCPCH Trainees’ Committee. CK is the Head of School for Paediatrics and Child Health in London.

  • Provenance and peer review Commissioned; externally peer reviewed.

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