The past and the present

From a trainee's perspective, the past 10 years have seen a tidal wave of changes in both gastroenterology and general medical training, driven by factors within the specialty and powerful external influences, which combined have moulded the way trainees develop into the consultants of the future. This is best demonstrated by the introduction of the European Working Time Directive, which has fundamentally altered the landscape of UK gastroenterology training—increasing the complexity of on call rotas, endoscopy list coverage and overall training provision.1,–,3 Less time for trainees on the ‘shop floor’ has led to concerns over the quality of training and the development of a ‘subgrade’ of future consultants. However, electronic portfolios, such as the NHS e-portfolio and the Joint Advisory Group Endoscopy Training System e-portfolio, have been designed with the aim of facilitating and supporting training by ensuring clinical and practical competencies are recorded and assessed in a systematic manner. Essentially trainees have less exposure to patients, but better assessment of their training and progression. Closely linked to the competency-based assessments, has been the restructuring of the pathways into gastroenterology training—from foundation training, core training and then entry into specialty training. A …