Efforts to grow the number of postgraduate medical trainees must go hand in hand with investment in the clinicians who teach them, according to a policy-focused blog from the Royal College of Physicians (RCP).
Teaching capacity is the bottleneck, not only trainee numbers
The RCP deputy registrar argues that concentrating solely on expanding the number of training posts overlooks a crucial element: the capacity of experienced doctors to provide high-quality supervision and education. Across hospitals, teaching frequently competes with heavy clinical workloads, meaning instruction often happens in spare moments between ward rounds and clinics rather than as planned, protected activity.
That squeeze raises a central question for policymakers and health educators: how can systems scale up the number of training positions while ensuring trainees receive consistent supervision, structured feedback and opportunities to develop independence?
Evidence from an emergency medicine pilot
The blog highlights a clinical educator model trialled in emergency medicine as an example of how dedicated teaching roles can change the training experience. Between 2018 and 2021, a programme supported by Health Education England and participating trusts was piloted across 54 trusts in England. Under the initiative, consultants were allocated time specifically for education rather than being expected to balance teaching with full service responsibilities.
According to the account of the pilot, trainees reported improvements in several areas where supervision had previously been inconsistent. The model aimed to ensure learners had clearer access to skilled teachers who could create learning opportunities, offer supervision, and support professional development.
| Feature | Detail |
|---|---|
| Years piloted | 2018–2021 |
| Number of trusts | 54 |
| Funding partners | Health Education England and participating trusts |
Why clinical educators matter
Clinical educators perform multiple roles that extend beyond classroom-style teaching. They supervise trainees on the frontline, design and protect learning opportunities, identify and support those who are struggling, and help internationally trained doctors integrate into the service. These contributions are pivotal to turning a junior doctor into an independent specialist.
But when education is left to happen in downtime, it becomes vulnerable to the pressures of service delivery. The RCP commentary stresses that expanding training without creating the capacity to teach risks producing graduates with gaps in supervision, experience and confidence.
- Supervision: Structured, regular oversight improves trainee competence and patient safety.
- Protected time: Dedicated hours for education ensure teaching is not displaced by clinical demands.
- Support for educators: Funding and role recognition help sustain teaching activity within pressured services.
The RCP blog also noted that models focused on embedding educational roles into clinical teams can benefit both learners and educators, offering a potential template for other specialties and jurisdictions aiming to expand training capacity while maintaining quality.
For health systems planning to increase the number of doctors in training, the message is clear: simply adding posts without resourcing the people who train those doctors is unlikely to deliver the desired improvements in competence or confidence. Deliberate funding and time allocation for clinical educators is presented as an essential element of any sustainable expansion of postgraduate medical education.
As governments and health education bodies consider workforce growth to meet future patient needs, the experience from the emergency medicine pilot underscores a broader lesson—investing in teachers is an investment in the quality and safety of future clinical care.
