ABSTRACT
Until the Calman reforms of 1996 most British medical training was based upon an apprenticeship within a consultant ‘firm’. Trainees spent 10-15 years as a ‘junior’ before obtaining their consultant post, which typically became a job for life. A high proportion of the work during these training years was routine ‘service’ and only a small proportion of cases had high educational value. This prolonged gestation nevertheless meant that consultant applicants were very experienced; usually with extensive knowledge of several specialist fields and an expertise in research. British doctors were highly regarded and the system seemed to work effectively Despite its effectiveness, there were several reasons why the old system was discarded and ‘structured training’ adopted:
• All European Economic Community (EEC) countries have agreed that their professional qualifications should be equivalent. Under European legislation, ‘specialist’ is the title given to a fully trained doctor. Specialists must hold a CCST and European law states that doctors should be able to obtain their CCST within 6 years of full registration. British apprenticeship training usually took more than 6 years and the system had to be changed to comply with European legislation.
