Doctors in the UK are feeling under siege in a rapidly evolving National Health Service (NHS), and it is commonplace to debate the whys and wherefores of rock-bottom morale in the profession. A common thread is a real or perceived loss of control by doctors.At hospital level, this notion is often a loss of control of individual consultant's practice through increasing control of consultants' work plans and the requirement for hospital management to hit performance targets. At a national level, theprofession has lost control of the training of doctors, watching almost powerlessly as the government-initiated Postgraduate Medical Education and Training Board (PMETB) and Modernising Medical Careers3 run their courses. Furthermore, there is a perceived lack of medical engagement with government, which results in an apparent inability to influence wide-ranging, and sometimes contradictory, reforms irtthe NHS.
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