Over the past 30 years many attempts have been made to streamline medical training. In the early 1990s Sir Kenneth Calman looked to restructure specialty training to ‘produce a shorter, more structured and organised training pathway’. The Calman proposals also introduced the idea of regional programmes which required doctors in specialty training to rotate within a fixed geographical area as they worked through a specific curriculum. These ‘Calman Numbers’ were followed in 2005 by a challenging period in medical education triggered by the failed implementation of Modernising Medical Careers (MMC). MMC was a programme which re-classified the traditional grades of medical career before the level of consultant. It also cemented the principle of geographically focused training programmes within a region or nation. This change required the doctor to rotate through a variety of hospital settings, including District General Hospitals and Tertiary centres, whilst working through a competency-based curriculum. These training programmes would work towards a Certificate of Completion of Training (CCT) and entry onto the GMC Specialist Register.
Rotational training has now become commonplace in the delivery of medical specialty training. With training time reduced from pre-Calman days there has been a move to fixed, shorter placements, and regular rotations to move doctors in training through a number of hospitals to gain a wider range of experience and access to specific specialties to fulfil the requirements of the curriculum.
