PT - JOURNAL ARTICLE AU - Laura Watts TI - Now I know what I don't know: how to reform the foundation years to fit 21st-century medicine AID - 10.7861/clinmedicine.13-2-163 DP - 2013 Apr 01 TA - Clinical Medicine PG - 163--165 VI - 13 IP - 2 4099 - http://www.rcpjournals.org/content/13/2/163.short 4100 - http://www.rcpjournals.org/content/13/2/163.full SO - Clin Med2013 Apr 01; 13 AB - The two-year Foundation Programme was introduced in the UK as a structured way to deal with the lack of training, support and difficulties with career progression associated with the old senior house office (SHO) grade. Although it provides a clear curriculum and structure for career progression, there is growing dissatisfaction among participants about the difference between the aspirations of the Foundation Programme and the realities of working as a foundation doctor. In particular, the erosion of the traditional team structure, difficulties with the system of assessment and a feeling that the career structure is now too rigid has led to a situation where doctors are being forced to choose their specialty training too early and often with little experience in the specialty. To what extent is the Foundation Programme fit for purpose? This will be considered together with suggestions for future reform.