Lessons from the disaster

doi:10.1136/bmj.39234.460440.3A

BMJ 2007;334:1180 (9 June), doi:10.1136/bmj.39234.460440.3A

Letters

MTAS

Lessons from the disaster

Some lessons must be swiftly learnt from the Medical TrainingApplication Service (MTAS) experience.¹ The BMA and the Academyof Medical Royal Colleges have been made to look feeble andineffectual after entering into "partnership" roles with theDepartment of Health. The postgraduate deans have been notablysilent and have behaved as willing accomplices in the promotionof MTAS. The deaneries have declined as an independent forcein medical training and are struggling to fulfil their correctrole in providing quality educational leadership because ofover-dependence on political approval linked to their fundingmechanism. The reputation of UK medical training has taken adamaging hit.

The royal colleges, threatened by loss of power and influenceand undermined by the emergence of the Postgraduate MedicalEducation and Training Board (PMETB), seem to have been alltoo easily lured into partnership agreements, using a set ofdesirable motherhood and apple pie objectives that were seductivelyeasy to sign up to. The trap was then sprung and the poorlydrafted and unworkable operational details released deliberatelylate in the process. The timetable of the action plan becamea higher priority than the quality of the project itself. Websitedesign and selection procedures were unfinished, and consultationon details was token or non-existent. Bullying tactics createdan unstoppable momentum for MTAS implementation, regardlessof the obvious problems piling up and the well based objectionsof a majority of consultants. The colleges are protesting thatthey have been misrepresented, although manipulated would bemore accurate with junior doctors feeling disconnected and unsupporteduntil it was too late. The government, anxious to displace blameelsewhere, insists they were fully on board.

These "partnership" arrangements have become a damaging formof pseudo collaboration. The end result has been a major systemcrash between the Department of Health and the profession, whichis now much deeper than the single catastrophe of MTAS.

John J Turner, consultant physician

University Hospital Aintree, Liverpool L9 7AL

john.turner{at}aintree.nhs.uk

Competing interests: JJT is a consultant and educational supervisor.