Trainee satisfaction before and after the Calman reforms of specialist training: questionnaire survey

OBJECTIVES: To evaluate the impact of the Calman reforms of higher specialist training on trainee satisfaction. DESIGN: Questionnaire surveys using portable electronic survey units, two years apart. SETTING: Postgraduate, teaching, district general, and community NHS trusts in North Thames. North Thames deanery includes London north of the Thames, Essex, and Hertfordshire. PARTICIPANTS: Trainees in all grades and all specialties: 3078 took part in the first survey and 3517 in the second survey. MAIN OUTCOME MEASURES: Trainees' satisfaction with training in their current post, including educational objectives, training agreements, induction, consultant feedback, hands on experience acquired, use of log books, consultant supervision, and overall satisfaction with the post. RESULTS: In the second survey respondents were more likely to have discussed educational objectives with their consultant, used a log book, and had useful feedback from their consultant. They were more likely to give high ratings to induction, consultant supervision, and hands on experience acquired in the post. Each of these elements was associated with increased satisfaction with the post overall. Improvements were most noticeable at the level of specialist registrar, but changes in the same direction were also seen in more junior grades. CONCLUSIONS: After the reforms of specialist training, trainees in all grades reported greater satisfaction with their current posts. The changes required extra training time and effort from consultants.