Examination of Witnesses (Questions 318-319)
Dr Mark Levy, Dr Susan Leech, Dr William Egner and
Dr Pamela Ewan
17 JANUARY 2007
Q318Chairman: Could I thank you for coming today.
Perhaps I could just remind you that this session is webcast,
so that it is out in the public domain. Members of the Committee
have prepared their interests on a paper available to the public,
so those declarations of interest will not occur during this session.
Any over and above will be recorded. Perhaps it is worth just
recording now that Viscount Simon has encountered Dr Ewan in a
professional capacity, so that we have that recorded and declared.
Could I ask you at the beginning of this fifth public hearing
of our inquiry into allergy if you could introduce yourselves.
I am Lady Finlay and I am chairing this inquiry and the other
members of the Committee will be introduced as we go through the
questions. Perhaps, Dr Ewan, you would like to start.
Dr Ewan: I am Pamela Ewan. I am a consultant
allergist working in Cambridge, running a very large allergy service.
I am also Co-Chair of the National Allergy Strategy Group, which
is a group which has tried to drive forward the need for allergy
services.
Dr Egner: I am William Egner. I am a Consultant
Immunologist working in Sheffield. I am also Chair of the Standing
Advisory Committee of the Royal College of Pathologists for Immunology
and I am a practising immunologist who also provides an allergy
service from my unit in Sheffield.
Dr Leech: I am Susan Leech. I am a Paediatric
Allergy Consultant working at King's College Hospital. I am the
allergy representative on the College Specialist Advisory Committee
for Allergy, Immunology and Infectious Diseases of the Royal College
of Paediatrics and Child Health and the allergy representative
of the British Paediatric Allergy, Immunology and Infectious Diseases
Group of the same organisation.
Dr Levy: Good morning. I am a general practitioner
in Harrow. I have had a specialist interest in respiratory disease
for nearly 30 years, including allergy, asthma and chronic obstructive
pulmonary disease. I edit the Primary Care Respiratory Journal,
which is a PubMed listed primary care journal. I am also a part-time
academic at Edinburgh University, I am a clinical research fellow
at Edinburgh, and I am representing the Royal College of General
Practitioners at this Committee.
Q319 Chairman: Thank you. Perhaps
I could start by asking you how the Royal Colleges work together
to maintain standards in allergy training and developing the allergy
curricula.
Dr Ewan: The Royal College of Physicians, through
the Joint Committee on Higher Medical Training, has devised an
allergy curriculum which is a very detailed curriculum, setting
out what trainees should do. They have a log book in which the
trainees record their experience during the duration of a five-year
training period. That is controlled by the college. The college
also have a system in place where they can review training posts,
both where there are centres suitable to have trainees and, also,
once trainees are in post there is a system to review trainees
as they go through. I think it is perhaps important to point out
that there are certain requirements for training, in that you
have to have appropriate consultants to provide the training—usually
two consultants in the specialty—and you have to have an
appropriate clinical practice or experience for the trainees to
provide the training required—mostly at the main centre
but some trainees might rotate to other centres. It is well regulated
from the college point of view.
Dr Egner: Yes, that is correct. The same committee
oversees the immunology and the allergy curricula. It receives
input from both the SAC of the Royal College of Pathology with
regard to immunologists' views of how the curricula should develop,
and the Joint Committee for Immunology and Allergy, which is an
intercollegiate Committee of the College of Physicians and the
College of Pathologists, which provides input and liaison between
immunologists and allergists and provides input into the JCHMT
and they balance the different views there are regarding the curriculum.
Dr Leech: The College of Paediatrics and Child
Health has a similar structure, both for supervising and training,
and there is an allergy curriculum which was developed based on
the allergy curricula of the European Union of Medical Specialists
who have a curriculum for paediatric allergology. We have developed
an allergy training curriculum based on that with input from the
adult allergy curriculum as well. Paediatric allergy training
for paediatricians comprises of two years of what we call "higher
specialist training"—which is SPR training which all
paediatricians do—followed by three years' sub-speciality
training in paediatric allergy. There is a college specialist
advisory committee which monitors training centres and approves
training centres. It devises the curriculum and it also supervises
training.
Dr Levy: The Royal College of General Practitioners
has developed a curriculum and within the respiratory extension
of the curriculum it is probably fair to say that allergy is mentioned
not in very much detail. I do not believe that the Royal College
of General Practitioners oversees the quality of training. The
problem for GPs is really access to good quality training.
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