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Neurology postgraduate training: what is to be done?
  1. M Giroud
  1. Correspondence to:
 M Giroud
 Dean of the Faculty of Medicine, Boulevard Jeanne D‘Arc, 21000 Dijon, France;

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Improving neurology postgraduate training

In the paper by A J Wills (page 1513, this issue), an evaluation of the results of the Calman reforms on medical postgraduate training in the UK is reported. The Calman reforms were introduced in the UK in 1997 and the current evaluation is useful from both a UK and a European perspective.

The objectives of the reforms were to improve the structure, and to supervise the quality of medical learning, competency, and training programmes. The reforms were developed in response to changes in Public Health policy, to public criticism, and to a perceived erosion of trust in the medical profession. The first consequence of this project was to improve the training of junior doctors, which led to structured teaching and supervised learning. Each specialty now has a more clearly defined core curriculum, trainees can receive regular advice and support from an educational supervisor, and accreditation is given after evaluation of competency. The reforms improved, standardised, and coordinated teaching, and supervised learning to encourage autonomy in self learning—leading to better theoretical learning and practice. Neurology training was structured according to these reforms with a 5 year higher medical education. A curriculum is defined in a document that is regularly updated, includes the sub-specialties of the neurological field, and relies on rotations between several teaching hospitals.

These reforms could be generalised within the European Union leading to several recommendations. The first advantage of these reforms would be to standardise European medical training, allowing mobility of medical trainees and doctors within Europe. The medical training could be adapted to the new European Master Programme. New learning methods2–4 would be developed as well as problem based learning, e-learning, video taping, and simulated consultations.

The main point would be the need to improve the training and the evaluation of the trainers themselves, who must be full time qualified medical professionals and medical teachers. The formal qualification of medical teachers—with an evaluation—would be generalised and standardised within European Union.

In addition, two other criteria are very important: (i) the development of self training could be an excellent way to improve autonomy and to continue medical training; (ii) research programmes would be developed during medical training because research is critical for medical progress and quality of care. Such reforms would carry a financial cost but would and also require a cultural change.

Improving neurology postgraduate training


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