From the Editor: The chapterhouse

doi:10.7861/clinmedicine.9-2-100

Worcester Cathedral has one of the earliest circular chapterhouses dating from Norman times with later additions, including the decorated rib vaulting of the roof. The roof is supported by a huge central Norman pillar. Discussions and debate have taken place in this cathedral over many centuries and throughout time this pillar must have impeded the view of both speaker and listeners alike.

The Royal College of Physicians (RCP) is fortunate to have its own modern version of a chapterhouse, the Council Chamber, designed by Denys Lasdun and built in reinforced concrete. While some architects are of the view that the introduction of this construction material marked the end of architectural history, no one can dispute that this development has removed the need for a central pillar. Visibility for all council members at the RCP is greatly enhanced when compared with the cathedral's original chapterhouse. Members can listen to any speaker in the College Council and look them straight in the eye. The wide-ranging expertise around the table is always impressive.

Regular discussion in the Council Chamber has considered the proposals for the appointment of training grade doctors to take up their posts in August 2009. This is a sequel to Modernising Medical Careers (MMC) and when this editorial sees the light of day in April 2009, the process will be well advanced. It is perhaps of value to document the current plans to fully appreciate the expertise, time and effort that has been invested to ensure a successful outcome.

Academic clinical fellowships are offered in a wide variety of specialties and deaneries for those aspiring to, or considering, a career in academic medicine. Applications were conducted via the Academy of Medical Sciences website with interviews and job offers completed in January 2009. Those unsuccessful in this round can apply to the clinical training programme.

The MMC website includes an excellent (if lengthy) Reference guide for postgraduate specialty training in the UK, more commonly known as The gold guide. The site includes details of the application process, vacancies and competition, the recruitment process, interview and offer arrangements. Deaneries or colleges are responsible for specific training opportunities with easy access to all sites. The recruitment process is clearly outlined with the eligibility criteria and choice of specialty. Job advertisements will run from January to May 2009 with clear timelines. The application is CV based with a standard shortlisting and interview process and agreed scoring mechanisms. For many specialties applications for the core medical training (CMT) programme (CT1–CT3) after completing foundation years 1 and 2 are separate from the subsequent specialty training (ST3–ST6).

The RCP is responsible for running the appointment system for CMT.¹ The website provides access to register for CMT by downloading an application form which can be completed and submitted online. Applications can be made to a maximum of four deaneries with a system for linked applications for ‘medical couples’.

Many individuals have had major input in the planning of the revised scheme. On behalf of the College, Bill Burr, working with Liz Berkin and Peter Belfield, has developed the standardised national recruitment system. The 2009 system will include a pilot online knowledge test for applicants which will be evaluated over the course of the year but will not contribute to the scoring system. The recruitment project team has drawn on the expertise of a wide range of individuals to ensure an improved system.

In a recent issue of the Clinical Medicine (2008;8:589–91) Mary Armitage, until recently Clinical Vice President at the RCP and now Clinical Advisor to MMC at the Department of Health (DH), emphasised the importance of collaboration between the profession and the DH. In the same issue, Margaret Turner-Warwick (2008;8:573–5) also reminded us of the importance of the patient–doctor relationship and the links between the professions and government. The omens for August 2009 look promising but continuing constructive debate within and outside the chapterhouse will still be needed.