Modernising Medical Careers (MMC) was launched
in 2003 and it was set up as an initiative so that career pathways
for doctors would meet a national standard. The MMC website states
that the doctors training in the old system (then known as Senior
House Officers or SHOs) ‘had no clear educational or career
pathways, no defined educational goals, no limit to time spent in
the grade and a lack of distinction between service and training’.
MMC is a radical programme and it was introduced so that these
issues could be resolved.
The foundation programme
The foundation programme for doctors was first
introduced in 2005. The foundation programme is a generic medical
training programme and it encompasses the first two years of
training for doctors, after the trainees have successfully
completed medical school. During these two years the foundation
doctors complete rotations in various specialties, usually three
different specialties per year. During the second year of
foundation the trainees have to make the decision about which
specialty they would like to apply to train in.
Before the changes in MMC doctors did not have
to make this choice until a much later stage. Previously trainee
doctors were able to road-test many different specialties before
coming to a decision on which to select. Therefore providing
medical students and postgraduate doctors with careers information,
advice and guidance has come to the forefront in recent years.
Specialty training
With the introduction of MMC a curriculum for
each speciality was devised so that training could be more focussed
and the idea is that the trainee will reach consultant-level
earlier than previously, after a minimum of seven years training
(but this varies from specialty to specialty). For GPs the minimum
training pathway is three years. Specialty training can
consist of run-through training or uncoupled training.
Run-through training
Some trainee pathways are such that once the
trainee starts a pathway, provided they meet the Annual Review of
Competence Programme (ARCP), they will continue on that pathway
until they reach the end of their training. If they have reached
this stage, and they have passed their membership exams they will
be awarded a Certificate of Completion of Training (CCT) and will
be put on the specialist register of the appropriate Royal College.
This will mean that they can apply for consultant posts, or GP
posts if that is the training pathway they have taken.
Uncoupled training
Not all specialities have run-through
training; more now consist of uncoupled training. Uncoupled
training is where the postgraduate doctors have a training
programme called ‘core training’ for 2 or 3 years depending on the
specialty. After this they will have to apply to higher specialty
training. Depending on which higher specialty pathway they choose
competition for places can be high. The specialty trainees will
then train in higher speciality training for another 4 to 5 years
(again depending on the specialty). The procedure for gaining CCT
is the same as that described above.