The majority of doctors in Harley Street will be consultants who have trained in and still work most of the time in the NHS. Their private Harley Street practice is a supplement to their work in the NHS.
In the UK, doctors study at university for a Degree in Medicine known as a Bachelor of Medicine or BM; the undergraduate course usually takes five years. It has a core curriculum which is overseen by the General Medical Council (GMC). To get into medical school, entrants must achieve high grades at ‘A’ level (or equivalent) and show evidence of their commitment to medicine, for example by doing work experience or voluntary work.
The GMC revised the undergraduate curriculum in 1993 and the programme is now an integration of the former ‘preclinical’ and ‘clinical’ courses (which involved two years preclinical and a three year clinical course where students worked in hospital wards under supervision) and includes dedicated time for other crucial competencies such as communication skills, problem-based learning and practical clinical tasks.
Upon successful completion of their degree doctors receive their primary medical qualification and are given one of the following abbreviations to denote this: MB, MBBS, MBChB, BM and BCh.
In 2005, a new two year Foundation Programme was introduced by the Modernising Medical Careers (MMC) initiative within the NHS for trainee doctors. Involving a series of placements within a variety of specialties and healthcare settings it provides a thorough grounding in practical medicine and the opportunity to develop core clinical skills. Placing more emphasis on communication, team working and IT skills within an NHS hospital, the first year, known as Foundation Year 1 (F1) is equivalent to the old pre-registration house officer (PRHO) year and the second year, or Foundation Year 2 (F2) is equivalent to the first year as a senior house officer (SHO).
Consultant and specialist training
After doctors have undertaken Foundation Years 1 and 2 (the old PRHO and SHO) they can undertake further specialist training in Senior House Officer (SHO) and then Specialist Registrar (SpR) posts. SpR training usually takes around four to six years, depending on the specialty. New training programmes for specialists are planned from August 2007.
The Postgraduate Medical Education and Training Board (PMETB) is responsible for all postgraduate medical training in the UK, including general practice. PMETB awards Certificates of Completion of Training (CCTs) to doctors who reach the necessary level of competence to be included on the Specialist Register which is maintained by the GMC.
General Practitioners (GPs)
Postgraduate training to become a General Practitioner (GP) involves the two-year Foundation Programme and at least three years' further training in posts approved by PMETB including a minimum of 12 months' vocational training (with this amount due to increase) as a GP Registrar. The PMETB awards CCTs to general practitioners.
In April 2006 the GMC introduced a new Register of GPs for doctors who have completed the appropriate training and all doctors working in general practice in the NHS (with the exception of doctors in training such as GP Registrars), must register.
Continuing Professional Development (CPD)
The education and training doesn’t stop once the text books have been closed and the final exam taken. After years of formal study doctors are expected to keep their knowledge and skills up to date through Continuing Professional Development (CPD) programmes. CPD helps doctors keep abreast of the constantly evolving world of medicine, changes to the profession or their environment and helps them to maintain good medical practice.