Parenteral medications at Role 1: do doctors in the British Army require improved training and experience?

Role 1 doctors in the British Army work predominantly in primary healthcare, but also provide prehospital emergency care and administer potent parenteral medications in the field. Role 1 doctors have theoretical training in the use of these medications on short courses but then have little refresher training and use them infrequently in their routine practice, introducing the risk of skill fade. This may lead to higher rates of medication errors in an environment where the consequences may be significant. This article explores the current training of Role 1 doctors, the threat of skill fade and how the safety of drug administration can be improved. This includes recommendations for the development of training competencies, bespoke courses and clinical placements, e-learning and the use of new technology. Application of these recommendations has the potential to improve patient safety and the confidence of doctors in the use of parenteral analgesia.