On 12 March 2020 the trainee committees of the three Royal Colleges of Physicians came together to jointly publish the statement below to provide guidance to trainee doctors.
The next few weeks and months are set to become more challenging than ever for the NHS. The effects of winter are still being felt by us all. It now looks increasingly likely that we will soon formally move from the ‘contain’ phase of managing COVID-19 to the ‘delay’ phase. As the epidemic develops, it is clear that many doctors, including those in training and career posts, will be at the forefront of medical care for affected patients. While there is uncertainty about the scale of disease that the UK will experience, there is unanimity that this is a time for us to demonstrate those qualities that make us doctors: commitment, teamwork, flexibility, and compassion. We know that doctors will do everything they can to support patients, the public, and their colleagues over the difficult weeks and months ahead.
We must ensure doctors with the most appropriate skills are available to care for patients. No trainee or service grade doctor should feel that they are being asked to undertake work they are not able to do. Patient care will always be our absolute priority, but we should remain mindful of the potential impact of the outbreak on supervision, training, examinations and progression.
Employers will have pre-emptive plans in place, and doctors have a responsibility to find out about the COVID-19 plans where they work. Medical trainees and service grade doctors may be asked to work in another acute specialty, or doctors from other specialties may be asked to care for acute medical patients. Doctors should work at a level of seniority commensurate with their skills and experience. Appropriate induction and adequate clinical supervision is of even greater importance when working in unfamiliar settings.
It is highly likely that teaching and training will be disrupted as the NHS responds to increased pressures. When trainees miss progression assessments, examinations and training due to COVID-19 pressures, employers and training organisations should, in time, ensure that there are clear plans to deliver them once the pressure reduces. We welcome the letter from the Joint Royal Colleges of Physicians Training Board (JRCPTB) to all heads of schools asking annual review of competence progression (ARCP) panels reviewing trainee progression to be flexible and to help trainees through this period.
To allow trainees to focus on delivering excellent patient care during this epidemic, we have asked Health Education England (HEE), Health Education and Improvement Wales (HEIW), NHS Education for Scotland (NES), Northern Ireland Medical and Dental Training Agency (NIMDTA), the General Medical Council (GMC), and JRPCTB to ensure that they are taking a flexible and proportionate approach over the next few months. In particular, we are focusing on how applications and recruitment will be affected, how we can ensure trainees can progress if training opportunities and courses are cancelled, and we are seeking assurances that planned re-deployment continues to ensure that trainees and service grade doctors can work safely within their scope of practice. So far, the four education bodies in the UK (HEE, NES, HEIW and NIMDTA) have published joint guidance covering COVID-19 and medical education and training. In addition, HEE has sent a letter to trusts. We welcome these developments and the reassurances they provide.
As new information or guidance becomes available, we will share it with you. If you have any concerns, please contact your trainees committee representatives:
- Royal College of Physicians
- Royal College of Physicians and Surgeons of Glasgow
- Royal College of Physicians of Edinburgh
In settings around the world, it is clear that doctors of all grades are under intense personal stress as they deal with the consequences of the outbreak and make difficult clinical decisions. The more we can do to support one another, learn from each other and work collaboratively, the more likely it is that together we will meet the needs of patients through the challenges ahead. We will meet the demands that this epidemic places upon us, and as trainee representatives we will do all that we can to ensure that you are supported, both personally and professionally.
Royal College of Physicians Trainees’ Committee
Royal College of Physicians and Surgeons of Glasgow Trainees’ Committee
Royal College of Physicians of Edinburgh Trainees and Members’ Committee