The role of the clinical tutor.

graduate dean and the chief executive in an NHS trust to oversee the provision of education for doctors in training and to ensure that this is carried out to a satisfactory standard. Many clinical tutors are, in practice if not in name, directors of medical education with a position on the trust board or trust executive committee. They are able to inform trusts about the effect of organisational changes within a trust on the training of junior doctors, and they also advise trusts on national initiatives and trends that have implications on doctors who train. The development of the post mirrors changes in the provision of postgraduate medical education that have been brought about by government initiatives, inquiries, and legislation. The first clinical tutors and postgraduate education centres were established in hospitals in the early 1960s after concerns were raised by Sir Robert Platt, chairman of a government joint working party, about the standard of training for junior doctors in the newly created senior house officer and registrar grades. The Pickering report in 1963 recommended that within each district the provision of postgraduate medical education be supervised on behalf of the postgraduate dean by a clinical tutor, who was usually chosen from among the consultants. Subsequently, the Royal Commission on Medical Education, chaired by Lord Todd in the mid-1960s, reported that doctors in training required consultant supervision and formative assessment and that clinical tutors would coordinate the supervision of all trainees within local health districts. The Merrison Committee of Inquiry into the Regulation of the Medical Profession in the 1970s again recommended close supervision of trainees and said that the General Medical Council should be responsible for standards of specialist education. The GMC delegated the monitoring of these national training standards and accreditation to the royal colleges and joint committees rather than postgraduate deans, who acted at a more local level. This was enshrined in the Medical Act of 1978 and led to the formation of college tutors in health districts and to the inspection of posts by colleges. In 1980-1 the Social Services Committee of the House of Commons, chaired by Renee Short, inquired into medical education with special reference to the number and career structure of doctors in training. Careers advice and counselling were to be organised by postgraduate deans and clinical tutors. In 1987 the paper Achieving a Balance recommended careers counselling for all trainees (again!), but …