In our latest next generation blog, RCP deputy registrar Dr Ben Chadwick explores why clinical educators must be central to the future of postgraduate medical education, and why expanding training places will only succeed if doctors are given the protected time and support to train the next generation well.
When we talk about improving postgraduate medical education, we often focus on training numbers, competition ratios, curricula and assessments. These are all important. But there is another part of the system that receives far less attention, despite being fundamental to the quality of training: the doctors who teach.
Across the UK, clinical educators play a critical role in helping resident doctors develop knowledge, skills and confidence. They provide supervision, create learning opportunities, support doctors who are struggling, help international medical graduates navigate the NHS, and foster the professional development that transforms a resident doctor into an independent consultant.
Yet education often competes with intense service pressures. Teaching happens in the margins of the day, squeezed between clinics, ward rounds and managing growing patient demand. Consequently, one of the biggest questions facing postgraduate medical education is not simply how we train more doctors, but how we create the capacity to train them well.
This issue was discussed at a next generation oversight group meeting last year, where we heard from Dr Maya Naravi, vice president at the Royal College of Emergency Medicine (RCEM) about a pioneering clinical educator model developed in emergency medicine. The model offers a compelling example of how dedicated educational capacity can improve the training experience for both learners and educators alike.
Investing in education
Between 2018–21, RCEM piloted a clinical educator programme across 54 trusts in England. Funded jointly by Health Education England and participating trusts, the initiative gave consultants dedicated time on the shop floor to support learning and development rather than being wholly focused on service delivery.
The results were striking. Learners reported improvements in confidence, supervision and access to workplace-based training. Educators became more visible and accessible. There were also reported benefits for educator wellbeing, with some participants describing the role as helping them reconnect with the aspects of medicine that had originally motivated them to become trainers.
Importantly, the role was not limited to formal teaching. Clinical educators supported simulation training, bedside learning, return-to-training programmes, and the induction and development of international medical graduates. They created opportunities for learning that might otherwise have been lost amid the pressure of a busy clinical environment.
Why this matters now
The conversation comes at a critical moment for medical education.
The NHS is seeking to expand training opportunities and address workforce shortages across multiple specialties. At the same time, training pathways are becoming more flexible. More doctors are choosing to train less than full time, educational needs are becoming increasingly diverse, and the expectations placed on trainers continue to grow.
Against this backdrop, there is a risk that educational capacity becomes an afterthought. Expanding the number of training posts without investing in the people who supervise, mentor and teach residents risks stretching an already pressured system.
The next generation oversight group heard strong support for the principle that investment in training should include investment in educators. Several members highlighted the importance of protected time for educational activities and the need to recognise teaching as a core part of delivering high-quality healthcare, rather than an optional extra.
Supporting learners and tackling differential attainment
Dedicated educator roles may also have an important role to play in addressing some of the wider challenges facing postgraduate medical education.
For many resident doctors, learning opportunities can be inconsistent. Feedback may vary between placements, while opportunities for observation, coaching and professional development are often dependent on local capacity.
Clinical educators can help bridge these gaps. By spending dedicated time on supervision and development, they can provide structured support, identify issues early and help create a more equitable training environment.
This is particularly relevant when considering differential attainment and the experiences of doctors who may need additional support, including international medical graduates, those returning from leave, and doctors training less than full time. The time and space to provide personalised educational support can make a significant difference to individual progression and confidence.
A model worth exploring
The emergency medicine experience is not a ready-made solution for every specialty. Local services, workforce models and educational needs differ. Sustained funding remains a challenge, and there are important questions about how educational roles are embedded within job plans and protected from service pressures.
However, the principles behind the model have broad relevance.
If we want postgraduate medical education to thrive, we need to think not only about the number of doctors entering training but also about the quality of the educational environment they enter. That means recognising the value of educators, investing in protected teaching time, and ensuring that education is treated as a core component of healthcare delivery.
As discussions continue about the future of medical training, workforce planning and the forthcoming NHS 10 Year Workforce Plan, the clinical educator model offers an important reminder: great training depends on great trainers. Creating the time and capacity for them to do their job may be one of the most effective investments we can make in our future medical workforce.
Dr Ben Chadwick
Deputy registrar
