Abstract
Rowena Viney et al. 1 have done wonders in highlighting trainee perceptions of the Annual Review of Competence Progression. One particular finding that I would like to focus on was the conclusion that such a process led to minimal competency as opposed to excellence. This is a particular concern and one that I would agree with.
When I was a core medical trainee, I was enthusiastic about innovations in the medical field. Supervisors, while acknowledging my interest, were unable to offer me movements in this regard. No fault of their own, I might add. We have to admit that, as students, we were fascinated by the complexities of clinical medicine. Yet, when I began to practise, I felt intellectually suffocated with a need to simply follow protocols as patients were admitted. My mind switched into autopilot. My love for learning vanished. And I had to make steps to rediscover it. I left the UK in awe of tech-based advances in my field in Asia and the USA. I was encouraged to pursue my interests and regained intellectual freedom. Critics may argue that medicine is simply about treating patients. I would agree this is certainly an element. However, a protocol-driven approach is not the essence of treatment. And neither is the lack of innovation or creativity. We are witnessing the downfall of trainee morale in the NHS and I suspect along with the increasing patient admissions and lack of resources, the overtly controlled approach to medicine is accountable for this.