How one cardiology team transformed the quality and experience of local medical training, using the GMC national training survey as a catalyst for change

The GMC NTS is a powerful tool that can be used as a lever for change

At one cardiology department in Manchester which serves over 3 million people, disappointing results in the 2022 GMC survey prompted decisive action. What followed was a blueprint for improving training experience that any department can learn from.

In 2022, resident doctors in this cardiology team reported alarmingly low levels of satisfaction, particularly in local teaching (23.67), rota design (19.79) and overall satisfaction (48.33). These scores placed the department in the lowest national quartile. But rather than defending the status quo, the team took the feedback seriously – and used Kotter’s 8-step change model to transform their culture and outcomes.

The first step was listening. Through local surveys and feedback meetings involving both resident doctors in training posts and clinical fellows, the team mapped out the underlying issues. These included rota inequities, unpaid overtime and minimal access to structured teaching.

Building a coalition that included consultants, clinical fellows, education leads and rota managers, the team focused on solutions. They redesigned the rota to make it fairer and more sustainable, implemented realistic working hours, and introduced regular journal clubs and teaching sessions.

Resident doctors were central to the process – they were involved in designing, voting on and rolling out the changes

By 2024, GMC survey scores had improved across the board – with overall satisfaction jumping to 82.22, local teaching to 77.14 and rota design to 62.5. Crucially, the score in every category that had previously been flagged to be below the interquartile range had improved and was now either within or above it.

Describing the project, Lamprou et al said, ‘we felt that achieving small victories allowed us to successfully overcome resistance and proceed with the change.’

What makes this case study stand out is its relevance across specialties. Resident doctors training in cardiology, like so many across the NHS, face rising service pressures, increasing burnout, and training experiences that often fall short of what’s needed to become confident, competent consultants. This team showed that structured change – grounded in the resident voice, clinician ownership and a recognised improvement model – can drive measurable results.

This approach aligns with what we’re hearing through the RCP’s next generation campaign: that medical training can and must be better, and that listening to resident doctors is the first step towards delivering the supportive, high-quality education they deserve.

‘Our 2025 next generation survey found that only 44% of respondents were satisfied with their clinical training, with many highlighting that a lack of access to senior clinical and educational supervision is affecting their learning and confidence,’ said RCP president Professor Mumtaz Patel.

‘The new 10 Year Workforce Plan and the national review of medical training are both crucial opportunities to make change,’ she added. ‘We now need the UK government to tackle competition ratios and solve the bottlenecks in medical training as soon as possible.’

At the RCP, we’ll continue to champion resident doctor-led improvement and call for systems that enable local teams to act on feedback. This case study shows that with leadership, collaboration and accountability, meaningful change is possible – and that the GMC survey, far from being a tick-box exercise, can be a springboard for transformation.

Read the full case study in the September 2025 issue of the Future Healthcare Journal.