Education--the concern of the profession? Early postgraduate medical education.

Overall what is suggested is a tried and proven apprentice type system, with continuing role models, more stable patient care teams, defined educational objectives, all with some flexibility and a reduction in the tendency to over supply in specific areas. The transition would be difficult, it could not happen without change (already suggested) in the undergraduate curriculum and it would also require changes in other areas, peripheral to the areas of hospital organisation already discussed. The changes necessary for the full effect of these proposals to be felt, will be those occurring in medical society. The changes will be in the methods of practice, in organisation and payment and in the relationship of different parts of the profession (aiming for abolition of the dichotomy existing between primary care and the hospital), all sections taking an active part in planning and delivering medical education. A clear commitment must be made to continually evaluate medical education's performance and relevancy, connecting this to institutions (medical schools, hospitals, colleges etc) geared and prepared to respond. A reconstituted and reorientated Medical Council would be pivotal to this being successful. This two year spell inflicted on the young members just entering our profession is inexcusable in humanitarian terms, wasteful in educational terms, and ineffective in management terms.