The Royal College of Ophthalmologists (RCOphth) recognises in its response that credentialing has the potential to ensure standard levels of practice in unregulated areas currently outside of training programmes. Examples in ophthalmic specialist training could include credentials around refractive surgery and interventions. There are however several issues around the GMC’s proposal which remain unaddressed.
The GMC has proposed introducing a framework of ‘credentials’, with a view to creating a modern, flexible, and evolving medical training programme which meets current workforce needs. These will be approved in areas where ‘there is a demonstrable need, based on patient safety, for consistent standards, training, experiences and assessments’.
In ophthalmology, where doctors naturally sub-specialise as the norm, such a framework could risk devaluing the Certificate of Completion of Training (CCT). Due thought must be given to the criteria by which credentials are deemed suitable for introduction and by which different credentials are evidenced. Furthermore, significant hidden costs are likely to be associated with the administration and additional training required to deliver a new framework of credentials. The GMC must be clear as to how costs will be allocated to Colleges, the NHS, as well as in areas where a credential may have cross over in more than one specialty.
As the RCOphth, and indeed all medical specialties, work towards introducing new curricula in 2020 there is an opportunity to think more widely about more regulated special interest training within the existing CCT. It is yet to be seen whether a framework of credentials, as outlined in the GMC’s original consultation, is the appropriate way of doing so.
The full RCOphth response and original GMC consultation can be accessed here.