A revamped programme for training junior doctors, which emphasises areas including communication and safety, has been introduced in the UK this week.
The two-year foundation course follows medical school and replaces the house officer years.
The British Medical Association has welcomed the changes to training, but warns that some doctors who remain in the old system cannot find jobs.
But the Department of Health said there is always competition for posts.
Just less than 5,000 trainee doctors will start the Foundation Programme this week. The first year will require them to show they are competent in areas including communication and consultation skills, patient safety and teamwork, as well as the more traditional clinical skills.
The second year will include opportunities for experience in primary care and areas where there may be a shortage of doctors.
Once they have finished the programme, doctors will take up specialist training posts, where they choose which area – such as gynaecology or surgery – they are going to focus on.
Health minister Lord Warner said: “This is just the beginning of a much wider ranging change in medical training, driven by the needs of patients and the NHS.”