Modernising Medical Careers

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Modernising Medical Careers (MMC) is a new programme for postgraduate medical training being introduced in the UK from 2005 onwards. The programme will replace the traditional grades of medical career before the level of Consultant. The different stages of the programme will contribute towards a Certificate of Completion of Training (CCT).

1 The new program
2 Criticisms
- 2.1 External links
- 2.2 References

[edit] The new program

A two-year Foundation Programme has now replaced the former one-year Pre-registration house officer term and the first year of the former Senior house officer term. The title "Pre-registration house officer" has been replaced by "Foundation House Officer 1", but they are still only provisionally registered with the General Medical Council during that year. Full registration takes place at the end of the first year of the Foundation Programme similar to before. From 2007, this will change as the GMC will award full registration based on the achievement of the outcomes required in the foundation curriculum.

The Foundation Programme consists of two years training divided by rotations of 4 months in different specialties. The two year programme is marked by continuing assessments and intends to provide a more comprehensive exposure of different clinical/ academic fields in healthcare. The biggest difference in training is the introduction of a national curriculum and explicit assessment processes. In addition, every participant will need to maintain a national learning portfolio and will have formal access to careers advice and support.

On successful completion of the FHO1 year, doctors will move straight into the FHO2 year without having to compete again as they have been accepted on a 2 year programme. Under the previous system, doctors applied for SHO jobs within 6 to 8 months of beginning work as a PRHO.

Graduates from the Foundation Programme are eligible to apply for either specialist or general practice CCT training. This will be divided into Basic Specialist Training programmes and Higher Specialist Training programmes. These applications will be under the newly created Medical Training Application Service. On completion of these training positions, trainees will be awarded a CCT and will be entitled to enter the Specialist Register or the General Practitioner (GP) Register as appropriate.

**NHS** **Medical Career Grades**
	Old System		New System (Modernising Medical Careers)
Year 1:	Pre-registration House Officer (PRHO) - one year		Foundation Programme - 2 years
Year 2:	Senior House Officer (SHO) a minimum of two years, although often more.		Foundation Programme - 2 years
Year 3:			Specialty Registrar (StR) in a hospital speciality: six years	Specialty Registrar (StR) in general practice: three years
Year 4:	Specialist Registrar - four to six years.	GP Registrar - one year
Year 5:		General Practitioner total time in training: 4 years
Years 6-8:				General Practitioner total time in training: 5 years
Year 9:	Consultant total time in training: minimum 7-9 years		Consultant total time in training: 8 years	General Practitioner total time in training: 5 years
Optional	Training may be extended by pursuing medical research (usually two-three years), usually with clinical duties as well		Training may be extended by obtaining an Academic Clinical Fellowship for research.

Change in an organisation on the scale of the NHS is always difficult. Concerns have been expressed by the British Medical Association, among others, that the reforms have not been fully thought through, and may worsen the training situation for many junior doctors.