The pre‐registration year: A suitable case for a strategic review

Objective — On the basis of previous research funded by the NHS Executive into management education for clinicians it seemed possible that a gap existed between the house officers' perceptions or experience of the pre‐registration year and the educational objectives of the GMC. This study explores the nature of the gap between house officers' perceptions and the GMCs expectations. Design — Observation through job‐shadowing of two individual housemen covering surgery and medicine and in‐depth semi‐structured interviews. Setting — Five hospitals in five regions of which three are teaching hospitals. Subjects — Twenty houseman comprising ten from medicine and ten from surgery, four ward nurses, a Trust Hospital Chief Executive, two Medical Directors, one clinical tutor and a clinical sub dean. Conclusions —The picture of haphazard training and education opportunities of pre‐registration house officers suggests that there are two fundamental problems to be addressed. One is, how best to generate a sense of ‘ownership’ by and ‘affinity’ to a corporate organisation. The second is even more fundamental and requires a strategic review of the purpose of the pre‐registration year and strongly suggests the desirability of re‐profiling the house officers job in order to close the gap between expectations and the reality of current experience and produce better medicine.