Training the ideal hospital doctor: the specialist registrars' perspective

Background When training for junior doctors is being planned, little discus sion is focused on what outcomes hospitals are trying to achieve with regar d to education/ training, i.e. on what makes the ideal hospital doctor. Ins tead, the primary focus is on the requirements of the syllabi of the Royal Colleges (credentialing) and the requirements of service delivery (job desc ription). Current literature has no qualitative studies of any longitude in which middle-grade doctors are asked about their vision of the ideal hospi tal doctor, what they feel can be done to help realize this vision, and how they feel about their own training. Methods This study examined data principally collected through a series of semistructured interviews conducted with eight specialist registrars (SpRs) , four each from the North Trent and South Thames rotations over a period o f 18 months. Additional information was taken from focus groups, interviews with programme directors, and questionnaires. Findings A model was created of the SpRs' perceptions of the key attributes of an ideal hospital doctor and of how these may be achieved in training. Eight broad areas were identified: clinical knowledge and skills; key clini cally related generic/non-clinical skills; self-directed learning and medic al education implementing change management; applying strategic and organiz ational skills in career planning; consultation skills; research; and key p ersonal attributes. Conclusions SpRs are articulate in expressing their own expectations of the ir training and have considerable insight into the components of good train ing. Further improvement could be made and will require significant commitm ent from both trainees and trainers.