Survey of the career experience and postgraduate training of the 1965 and 1970 graduates of the Scottish university medical schools.
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Biomedical subjects
Publications and source records attributed to K M Parry.
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1. The purpose of the visit was to compare postgraduate medical education and training in the United Kingdom with that in France, the Federal Republic of Germany, and Italy. 2. Except in Italy, there appeared to be widespread agreement that specific postgraduate training for general practitioners was essential to improve the quality of practice and to relieve the undergraduate curriculum from the necessity to provide comprehensive medical training to prepare a graduate for independent practice. The main difficulty appeared to be the development of good 'teaching' practices. 3. Direct comparison between training programmes for specialist practice is not straightforward in view of the different staffing structure in continental hospitals and the existence of private specialist practice to which patients have direct access. Training appears to be generally longer in the United Kingdom, possibly due to the necessity of passing postgraduate diploma examinations, but outside the university hospitals the fully trained specialist (consultant) enjoys a higher status and independence than most hospital specialists in other countries. The absence of equivalent bodies to the Royal Colleges and Faculties places responsibility upon universities for specialist training on the continent; standards are not coordinated nationally, and vary significantly from region to region. 4. The need for continuing medical education for all doctors is accepted; this is essentially voluntary, although there are variable direct and indirect incentives. Programmes are organized on a local or regional basis in most countries, but in Germany and the U.K. there is a growing trend towards national coordination of both training programmes and the provision of continuing education. 5. The recent reorganization of the National Health Service in the United Kingdom provides opportunities for 'public health' doctors to become involved in the coordination of clinical services and to relate these to the needs of the public at large, as well as to provide preventive health services. These opportunities do not exist in France, Germany and Italy, where public health services remain discrete from clinical medicine, and postgraduate training is largely confined to formal teaching at designated institutes which are university based only in Italy. Opportunities for university staff to become involved in the organization and delivery of health care appear to be greater, therefore, in the United Kingdom than in other countries.
A survey was carried out of the career experience of the doctors who graduated from Scottish medical schools in 1962. Few of those in general practice in the UK had undergone the minimum period of vocational training now considered necessary for new entrants to practice. Of those in the hospital and specialist services, 53% were consultants. There was a tendency for early career decisions to be made, leading to an increasing number of doctors obtaining postgraduate training almost exclusively in one specialty. Many married women doctors were underemployed. A quarter of the doctors were living overseas, including those of the nonBritish nationals who had returned to their country of origin.
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