Mark Macaskill
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THREE-QUARTERS of junior doctors say they are putting the safety of patients at risk because they have not been trained to prescribe drugs properly, says a new report.
In a survey of 2,400 junior doctors by scientists at Edinburgh University, 74% said the teaching of drug prescription was inadequate and more than half said their training failed to test their knowledge and skills.
More than 40% said they were not confident they would achieve minimum prescribing competencies set out by the General Medical Council (GMC).
Almost two-thirds said they were not confident about prescription writing and barely a third had filled in a hospital prescription chart more than three times during training.
“Our study suggests that a large proportion of medical students and recent graduates from UK medical schools who responded believe that their teaching and assessment in this area was inadequate,” said Dr Simon Maxwell, a clinical pharmacologist at Edinburgh University and co-author of the study.
The report, to be published in the British Journal of Clinical Pharmacology, has prompted calls for the GMC to conduct an urgent review of undergraduate training.
It is believed that mistakes in prescribing, most of which are avoidable, kill dozens of patients every year.
A study published in The Lancet in 2002 found that, of 88 serious medication errors in a UK hospital, deficits in “skills and knowledge” were a factor in 60% of cases.
An Audit Commission report suggested that adverse medication events were responsible for the deaths of 1,100 hospital patients in 2001 in the UK, a fivefold rise on the previous 10 years.
Across the UK, adverse reactions to medicines are estimated to account for one in 15 hospital admissions at a cost of about £470m a year.
The National Patient Safety Agency database receives 40,000 reports annually of medication incidents from acute and general hospitals.
“The medical curriculum as far as pharmacology is concerned is substandard,” said Robert Cumming, chairman of the Scottish Health Campaign Network.
“This problem has been around for a while and it still hasn't been solved. This requires students to be taught pharmacology in a rigorous fashion. There are significant problems and complaints being raised by patients.”
Last week, the GMC insisted that there were no proven links between patient deaths and the standard of medical training.
However, it is carrying out a £100,000 study to investigate the prevalence and causes of errors in doctors' prescribing.
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