British postgraduate medical training and inpatient medical care in the United Kingdom.
British postgraduate medical training practices are reviewed. Because of the method of appointment and the type of positions available, there is a tendency toward fragmentation of training experience and of doctor-patient association in the early period of training. The commitment of the National Health Service to provide junior hospital staff to each senior clinician taking care of patients, combined with the scarcity of senior positions in the National Health Service, tends to increase the influx of junior trainees from outside Great Britain. These immigrant physicians are frequently responsible for the bedside care of patients, but they have only a minimal hope of progressing to a permanent senior post in the National Health Service. As a result, patients receive a good deal of the care from clinician-trainees who will never qulify at the top level of British medicine. On the other hand, the organization of the inpatient training program provides a high degree of flexibility for the trainee, and a better chance to follow patients through the vicissitudes of their disease than does the American system.
D003266:Continuity of Patient Care; D004503:Education, Medical, Graduate; D006801:Humans; D007396:Internship and Residency; D008505:Medical Staff, Hospital; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D013222:State Medicine; D006113:United Kingdom; D014481:United States