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Summary
Key points from the responses are highlighted below:
Governance
A majority of respondents thought that governance arrangement were sufficiently robust, although , many also had suggestions as to further improvements that could be made. The need for better communication and a need for better representation within the governance structures were frequently mentioned issues in this respect.
A commonly expressed view by respondents was that consistency at UK level was required in PGME so as not to reduce opportunities for trainees or to risk the movement of trainees within the UK.
The role of the doctor
All respondents offering a view thought that there was a need to review the role of the doctor before it would be possible to move to a healthcare system delivered by trained doctors- although a number of respondents stressed the urgency of this work. A majority of those offering a view disagreed with the proposal that doctors in training should be " supernumerary to service requirement", arguing that service provision was in fact central to training. A small majority of respondents agreed that a 'judgment safe'/ 'unsupervised' doctor was needed for all services, although a number questioned these actual concepts. The majority of respondents agreed with the Scottish Government's approach towards defining the role of a trained doctor.
Medical workforce planning
The majority of respondents agreed that it was appropriate for the Scottish Government to determine the level of controlled medical training numbers. There was no consensus with respect to whether Scotland should try to align the number of training places with the number of trained doctors required by NHS Scotland, with a range of views being expressed.
Role of the Scottish Advisory Committee on the Medical Workforce
A majority of respondents disagreed with the suggestion that the remaining roles of the SACMW could be remitted to NHS Boards, with a number of respondents stressing the importance of central scrutiny and/or national responsibility for these posts.
Commissioning and management of PGME
The majority of respondents agreed that the development of DMEs and flexibilities around regional arrangements will add value and clarity to responsibilities for postgraduate medical education at service level.
The majority of respondents expressed support for the proposed role of NES.
Streamlining regulation
The majority view was in favour of merging the GMC and PMETB but some concerns were expressed about this. Amongst the concerns raised were that combining training and regulatory functions would have the potential to result in a conflict of interest, and that the new structure must take into account Scotland's devolved healthcare system.
The structure of PGME
The majority of respondents agreed with the proposal that changes to the structure of postgraduate medical training should await further discussion on the future shape of the medical workforce and that change should be minimised until that is clearer.
GP Training
A majority of respondents agreed with RCGP's proposal to work towards an extension of mandatory training for GPs from 3 years to 5 years. The view was expressed that changes to the complexity of GP practice in recent years necessitated an extension of this training period.
Equality issues
Most respondents did not feel that the proposals would raise specific issues for equality groups, although possible gender equality implications, particularly around the issue of flexible working, were noted by a small number of respondents.
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