By the time doctors start to specialise in their mid to late 20s they have already undergone about 20 years of formal education—initially at school and then at university/medical school. They then have to undergo a period of postgraduate education, after which they face a lifetime of continued professional development as prescribed by the Royal College(s). Thus, by the time they start to specialise they are feeling somewhat jaded about the prospect of further education and teachers must be aware of this, especially if they want to inspire enthusiasm in trainees.

For many years “learning the trade” (or becoming a specialist) in any branch of medicine was done by experiential learning or, in practice, by trial and error. Experience is invaluable but, depending upon where a person works, it can be patchy. In addition, although experience is usually measured in years, in reality “five years' experience” frequently consists in essence of one year's experience repeated five times. This has been partially rectified by the Royal Colleges detailing what they consider specialist registrars must have as essential experience, and by the development of training rotations and structured teaching.

Structured teaching takes many forms. It can be done by individuals in a trust teaching their own juniors, and there are many committed consultants who do this extremely well. Senior specialist registrars are also a good teaching resource for their more junior colleagues. Structured training can also be done by specialty training committees arranging training days/half days on a regular basis for all the specialist …