title: Implications of aligning full registration of doctors with medical school graduation: a qualitative study of stakeholder perspectives.
abstract: OBJECTIVE
  The Shape of Training report recommended that full registration is aligned with medical school graduation. As part of a General Medical Council-funded study about the preparedness for practice of UK medical graduates, we explored UK stakeholders' views about this proposal using qualitative interviews (30 group and 87 individual interviews) and Framework Analysis.
  
  
  METHODS
  Four UK study sites, one in each country.
  
  
  METHODS
  185 individuals from eight stakeholder groups: (1) foundation year 1 (F1) doctors (n=34); (2) fully registered trainee doctors (n=33); (3) clinical educators (n=32); (4) undergraduate/postgraduate Deans, and Foundation Programme Directors (n=30); (5) other healthcare professionals (n=13); (6) employers (n=7); (7) policy and government (n=11); (8) patient and public representatives (n=25).
  
  
  RESULTS
  We identified four main themes: (1) The F1 year as a safety net: patients were protected by close trainee supervision and 'sign off' to prevent errors; trainees were provided with a safe environment for learning on the job; (2) Implications for undergraduate medical education: if the proposal was accepted, a 'radical review' of undergraduate curricula would be needed; undergraduate education might need to be longer; (3) Implications for F1 work practice: steps to protect healthcare team integration and ensure that F1 doctors stay within competency limits would be required; (4) Financial, structural and political implications: there would be cost implications for trainees; clarification of responsibilities between undergraduate and postgraduate medical education would be needed. Typically, each theme comprised arguments for and against the proposal.
  
  
  CONCLUSIONS
  A policy change to align the timing of full registration with graduation would require considerable planning and preliminary work. These findings will inform policymakers' decision-making. Regardless of the decision, medical students should take on greater responsibility for patient care as undergraduates, assessment methods in clinical practice and professionalism domains need development, and good practice in postgraduate supervision and support must be shared.
authors.affiliation: Centre for Research in Professional Learning, Graduate School of Education, University of Exeter, Exeter, UK.
authors.forename: K L
authors.initials: KL
authors.lastname: Mattick
authors.affiliation: Cardiff University School of Medicine, Cochrane Medical Education Centre, Cardiff, UK.
authors.forename: K
authors.initials: K
authors.lastname: Kaufhold
authors.affiliation: Department of Psychology, University of Exeter, Exeter, UK.
authors.forename: N
authors.initials: N
authors.lastname: Kelly
authors.affiliation: School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Cole
authors.affiliation: Royal College of Physicians, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Scheffler
authors.affiliation: Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia.
authors.forename: C E
authors.initials: CE
authors.lastname: Rees
authors.affiliation: Cardiff University School of Social Sciences, Cardiff, UK.
authors.forename: A
authors.initials: A
authors.lastname: Bullock
authors.affiliation: School of Medicine, Dentistry and Biomedical Sciences, Centre for Medical Education, Queen's University Belfast, Belfast, UK.
authors.forename: G J
authors.initials: GJ
authors.lastname: Gormley
authors.affiliation: Chang Gung Medical Education Research Centre, Chang Gung Memorial Hospital, Chang Gung, Taiwan.
authors.forename: L V
authors.initials: LV
authors.lastname: Monrouxe
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000592:standards* / Q000706:statistics & numerical data*; D036301:Qualitative Research; D006113:United Kingdom; D055815:Young Adult
keywords: MEDICAL EDUCATION & TRAINING; QUALITATIVE RESEARCH; full registration; medical school graduation