When you’re training to be a doctor and you’re coming up to the end of your medical school education, there are multiple training pathways to choose from. Which option is best for you, depends on your circumstances, goals, and your learning style.

Pathways tend to change each year, with multiple different entry points to consider depending on each individual organisation. Following medical school, whether your course lasted for four or six years, you’ll eligible to apply for foundation training and have gained provisional GMC registration. Of course, some foundation programmes require certain speciality training pathways and may have required you to study another degree subject for a year alongside traditional medical school. This isn’t an essential step, but it can help to improve your career prospects, particularly if you have a certain medical field in mind that you would like to pursue.

Foundation years

If you’re preparing to enter foundation years, you need to apply this autumn to begin in the summer of 2019. It’s the most common step from medical school, lasting two years and aims to give you an opportunity to experience a range of medical or surgical specialities. It’s a chance to find which career path is the right option for you and where your interests lie.

Over the two years, you’ll experience between six and eight rotations. Foundation Year 1 enables you to begin supervised responsibility for patient care and to bring together the skills you’ve learnt during your time at medical school. By the end of year one, you should expect to obtain your full GMC registration. Foundation Year 2 builds on the skills learnt in the previous year, such as making management decision, but you’ll still remain under clinical supervision. On satisfactory completion, you’ll receive Foundation Programme Certificate of Completion (FPCC), formally known as the Foundation Achievement of Competency Document (FACD), which indicates you’re ready to enter a core, speciality, or general practice training programme.

Speciality training pathways

When it comes to your next training pathway, you’re free to choose your speciality, this will define whether you enter uncoupled training or run-through training programmes. Training programmes differ in length and structure depending on the area you’re focussing on if you choose to enter general practice the programme will last for three years, while other specialities can range between five and eight years.

Uncoupled training programmes – Uncoupled training programmes consist of core training and then entry into a higher speciality training. Core training is either two years, for core medical and surgical training, and three for core emergency medicine and psychiatry.

Run through training programmes – For a run through programme you apply once and are recruited for the entire duration. You begin with an overview of the speciality and gradually specialise more over the duration.


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Whether you’re training to become a healthcare professional or you’re a veteran of the industry, you’re likely to be frequently using evidence based practice medicine. It’s an essential way for ensuring that patients always receive the best level of care with their situation in mind.

What is evidence based practice medicine?

Evidence based medicine, or EBM, is an approach to optimise the multitude of decisions healthcare professionals have to make on a regular basis. EBM aims to ensure that the decisions taken are based on reliable, up to date research, reflecting how quickly medical care can change.

It’s an approach that’s important to all healthcare fields, from doctors making decisions about the treatment a patient will receive to policymakers considering industrywide changes. EBM places an emphasis on using scientific research that’s relevant to those in your care and have the understanding to know when they should be applied to your patients to influence decisions, taking into account the patient’s individual needs, values, and interests.

Why is it used?

EMB is widely used because it’s an effective way to make decisions. It takes into account that there is often a collection of studies with a differing range of patients – urging healthcare professionals to select those that are most relevant to their decision. For example, two patients that have the same conditions could benefit the most from widely different treatment courses due to their age, with aggressive but effective treatment preferred for a young person while someone who is elderly may obtain a better quality of life by not having treatment at all.

The EMB approach takes the information found in trials, research, and studies and applies the results to be effectively used in a clinical practice setting. It bridges the gap between research and action to deliver improved outcomes to patients.

While EMB is regarded as the gold standard of clinical practice and used widely, there are, of course, limitations too. Recognising the criticism the approach faces gives practitioners an opportunity to reduce or mitigate them. For example, how well EMB works depends directly on the quality of research that it’s based on, which can contain bis, conflict of interests, or simply inaccuracies. There’s often a significant lag between when the research is conducted and published, meaning it can be difficult for healthcare professionals to be working in line with the latest best practices in mind.

Not too long ago, gene therapy would have sounded like something out of science fiction. But it’s a process that’s rapidly becoming viable to treat a huge range of conditions. The potential successful gene therapy holds means it could unlock a whole new chapter in modern medicine.

What is gene therapy?

Gene therapy uses nucleic acid as a drug to treat disease by introducing it into a patient’s cells. The first attempt to modify human DNA took place almost four decades ago but the first successful nuclear gene transfer in humans didn’t occur until nine years later in 1989, while the first therapeutic use of gene transfer and the first direct insertion of human DNA into the nuclear genome occurred just a year later. It led to a boom in the research being conducted into gene therapy, with over 2,300 clinical trials taking place over the last 25 years.

Gene therapy is designed to compensate for abnormal genes, giving it plenty of scope to treat and cure a range of different conditions. As with all new medical developments, gene therapy has encountered obstacles along the way, but it could be about to take centre stage.

So, what can gene therapy do?

As gene therapy introduces altercations to a patient’s genetic make-up, it’s potential has been linked to a vast array of results, among them:

  • Genetic engineering – Gene therapy could hold the key to eradicating diseases that we’re born with through being conducted on each foetus, but it can also prevent or cure those that occur later in life. While genetic engineering can tackle disease, in theory, it can also be used to alter other areas in a foetus, such as appearance, intelligence, and memory, making it a highly debated ethical topic.
  • Cancer treatment – A cure or improved treatment for cancer is being explored from multiple avenues, including gene therapy. Gene therapy aims to improve the body’s ability to recognise and attack cancerous cells, enhancing the patient’s natural abilities through adding genes to their immune system.
  • Tackle infertility – Were patients suffer from infertility, early stage research indicated that gene therapy could be used to re-establish fertility. The trials have yet to be approved for humans, but the early results suggest it could be a promising route for researchers to continue exploring.