Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
MTAS and MMC-Comparing new and old systems
- Surya Panicker Rajeev (24 March 2007)
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Dennis Healey's Rule of Holes
- Chris Maimaris (25 March 2007)
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If not degree class what else?
- Michael Reschen (26 March 2007)
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Good candidates may be covering clinics.
- Andy Wood (26 March 2007)
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MTAS Review Findings
- Michael V Holmes (26 March 2007)
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Nightmare on MTAS street?
- Pir Shah (26 March 2007)
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Lets get it right
- LM Tho (26 March 2007)
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missing the point
- benjamin dean (27 March 2007)
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MTAS, is it really worse ?
- Anjana Satpathy (27 March 2007)
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Re: MTAS, is it really worse ?
- Sachin Jauhari (28 March 2007)
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Successful interview process!?
- Tanya de Weymarn (29 March 2007)
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Too Many Juniors?
- Clive A T Wiggins (29 March 2007)
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A different prospective on MTAS
- Dr Chris S Flannigan (6 April 2007)
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Surya Panicker Rajeev, SHO North Glamorgan NHS Trust, Wales
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I read with interest, responses about MTAS and MMC in the BMJ every day.It is natural that people who have three and four interviews will favour the new system while those who are not short listed will point out the faults with the MTAS and MMC because at the end of the day, a training job in UK with career progression is what every one need. But how fair was the old system? I know about people who have not bothered to apply for numbers(the previous SpR grade), but got calls from short listing pannels after the closing date of application forms, persuaded them to apply and finally got the job while people who worked for it with research degrees and other honours were not given the same job. I have also heard about people who have got numbers in competitive specialities like cardiology with out a single publication, but people who have good CVs were still doing non training jobs.Whatever people say about academic achievements, every body knew that academic achievements and publications were considered for entry into competitive specialities and `good doctors' were not considered for SpR jobs based on how much time they spend in ward with patients unless they are in the good books of and are friendly with shortlisting consultants. An example of a question in the old style application form- `please describe your experience of clinical governance?' Most of the other questions were similar to the MTAS form. And then came the MMC to restructure training in UK, a month to fill the application forms, a month to wait for short listing results, a month of interviews now and a further month of wait for interview results. Inspite of claiming to be a national recruitment system, the interviews differ from deanery to deanery.Some deaneries have videoclips, some have the old style interview questions, few are assessing candidate's skills in relation to person specifications. I attended an interview in a deanery where there was no question about your CV and it was like a PACES exam. Candidates who applied for ST2 are those with 12-36 months of experience.How can any body compare a candidate who should have 12 months of experience by August2007(which means that at the day of interview, they will have 6 months experience)with people who have 36 months of experience and most of them who might have done PACES(waiting for results)? Does this mean that candidates in the first category are not `good doctors'? Is this fair? Consultants are now telling that the new system is not fair and pointing out the faults. But the MMC was not launched recently.There were no responses in the BMJ about concerns regarding the new system then.If this was pointed out at that time, the future of thousands of doctors (including those who had three or four interviews)would not have been uncertain. Competing interests: None declared |
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Chris Maimaris, Consultant in Emergency Medicine CB2
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Dear MTAS Review Group, I would like to give you one piece of advice for your deliberations on what to do with MTAS: Follow Dennis Healey’s well known first rule of holes: "If you are in one, stop digging." The decent thing to do to get us out of the MTAS hole is to suspend it immediately. NB: I resigned from the Chair of the Emergency Medicine Regional Training Committee on the 11th of March in protest over the MTAS fiasco. Competing interests: None declared |
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Michael Reschen, SHO general medicine The John Radcliffe, Oxford, OX3 7AX
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Dr Borland asks whether performance in an intercalated degree at medical school is a predictor of professional excellence. Clearly degree class is a major predictor but not an overarching trump card. We should remember that an intercalated degree at medical school is not based solely on a period of time spent doing a research project, rather it encompasses marks built up throughout the 3 year undergraduate course. For example performance in the anatomy course forms a component of the final bachelor of medical sciences degree at Nottingham University. Sadly the value of knowledge is often overlooked, especially pre-clinical knowledge which is fallatiously regarded as irrelevant. Dr Borland suggests that good performance at the interview stage is a more important factor. However, an interview is but a 15 minute performance with predictable questions. Also, all previous medical interviews have been based in some part at least on the candidates' curriculum vitae. I would suggest that a candidate with good social skills can perform well at interview whilst potentially being rather lazy in his day to day clinical activities. I believe that academic performance and interview performance must be balanced together when selecting a candidate - this has always been the case previously. The benefit of using a curriculum vitae is also that candidates with a poor degree class can go on to demonstrate further experience and qualifications. In that sense I agree with Dr Borland - degree class should not necessarily be used to reject candidates without considering their CV further. However, degree class remains a tangible unfalsifiable discriminator unlike many of the MTAS questions. Competing interests: None declared |
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Andy Wood, SHO Ophthalmology Glasgow
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I am in the rather peculiar position of tomorrow covering an Ophthalmology clinic with another SHO on behalf of a Consultant who will be interviewing prospective candidates for MTAS. Neither myself nor the other SHO involved received any interviews via the MTAS system, yet we are both though capable enough to cover a clinic in that consultants understandable absence. I have to smile, it would appear that something has gone very wrong. Competing interests: None declared |
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Michael V Holmes, F2 SHO Emergency Medicine Royal Free Hospital, London, NW3 2QG
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Sir, I was one of the 'lucky' candidates and was offered three out of four interviews in my MTAS application. The MTAS review panel’s latest findings, that "the shortlisting process was weak and we will therefore eliminate this part of the process immediately" with the introduction of a "guaranteed interview scheme", whereby "every long listable applicant who applied through MTAS and meets the eligibility criteria for their relevant specialty will be invited for an interview" [1] severely penalises all candidates that have been offered more than one interview. We all now have a 'one-shot' 30 minute interview in which to hope to be successful with the result of being offered a job in August. I for one do not see how this is a fair alternative. Anyone that was offered more than one interview has had their chances of being successful and offered a post reduced by at least one half. Yours sincerely, Michael Holmes
Reference: [1] Update from the Review Panel: 23 March 2007, Professor Neil Douglas, Review Group. URL: https://www.mtas.nhs.uk/info/review_panel_2303.html Competing interests: None declared |
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Pir Shah, Junior Doctor In Public Health Walsall Teaching Primary Care Trust
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Over the last few months I have consistently gone through the following: felt sad, loss of interest, inability to sleep, agitated, fatigue and worthlessness. I know it sounds like clinical depression and this may well be the case; However, I am a Foundation Year 2 doctor applying for an ST1 post through MTAS and this may well be the real reason for this clinical picture. I have no doubt that the reasons for my symptoms are numerous: the untimely information, the lack of quality information, the process of application for short-listing, ignoring any evidence collected by doctors over the foundation years, the poor use of references and interviews and the reactionary approach to everything. What I have seen over the last few months has been disturbing and a level of incompetence that is equivalent to the ‘C.R.A.P.’ statement made by a famous jewellery retailer. The collection of evidence as a foundation doctor should be an invaluable tool used for the selection process as it is collected over 18 months and is not a snapshot such as a badly designed application form or a mystery-laden interview process. The foundation year 1 and 2 doctors have been told at every opportunity to collect evidence of our competencies and now that we have done that a number of deaneries don’t feel the need to look at this evidence or only want to look at a value added piece. The process designed and implemented by MTAS has been very ad-hoc as if a number of people in a room completely detached from reality are making decisions using a Tom-bola. Very little thought has been given to: appropriate use of time-frames, the role of the application form and the interview process, and the use of available evidence (portfolios). I am very passionate about being a medical doctor and am happy to do this for the rest of my working life. The work is very satisfying and the rewards are instantaneous, meaning the ‘thank you’ from the patient or the family. However, was changing careers from being scientist to a medical doctor the worst decision I ever made? Competing interests: going through the MTAS process |
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LM Tho, Clinical Oncology Research Fellow Beatson Institute G61 1BD
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This new system clearly has teething problems, but Dr Rajeev is right to point out the deficiencies of the old system. It is not uncommon for there to have been a lack of transparency in the interview selection process and appointments being influenced by personal bias. It is a fallacy to think that the best persons ended with the job. An across-the- board measure of career progression was urgently required. Media headlines proclaiming that MTAS resulted in “the best doctors are not getting interviews”, in my opinion should have been reigned in by the BMA and training boards. The truth is probably that no one really knows, anecdote is inadequate – still a bit of headline grabbing attention can be expedient. It is also commendable that an effort is being made to try and objectify “soft” skills eg. communication skills, personal insight, form filling, precise writing (all crucial in the target driven NHS) by incorporation into the selection process. Unfortunately, the balance has clearly been difficult to achieve to the detriment of academically inclined candidates (a PhD scoring only one point out of 45 is frankly ridiculous), those with poor bureaucratic skills (who have actually spent time on the wards talking to patients instead of endlessly form ticking and filling out competency log-books) or poor communicators. I have worked with exemplary physicians who may not be the most organised of people, whose thought were a tad flightly and who required some patience when teasing out what they meant – yet were brilliant academics, inspiring individuals and performed their jobs with unquestionable skill and complete dedication towards their patients. MTAS would have done a good job in weeding out these “underperformers” I’m sure. Finally I would like know whether the MMC have considered that the personal statement format of MTAS will quickly become predictable and consequently, lose its discriminatory value. Creativity only allows one to ask “Why you want to be a ENT surgeon” or “How do you cope with a stressful situation” in so many variations, before it becomes intangibly convoluted or frankly ridiculous. Moreover, I can assure you that the “best” candidates are already acquiring model answers for next year’s rounds as we speak. Competing interests: LMT is a product of the pre-MTAS selection process. |
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benjamin dean, sho oxford
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These arguments are of very little relevance to the main issues around MMC and MTAS. MTAS has been shown to be unfair, flawed and corrupt. As a result of this round 1 must completely scrapped, there is simply no fair alternative other than interviewing all candidates for all their choices of job. It is all very well to argue about the validity of different selection methods, however these are arguments that should have been had several years ago and they should have been listened to then. This would have meant that a selection process with no evidence base that had not been validated or quality assured would not have been rushed through and inflicted upon a group of junior doctors who deserve much much better. It is rather symptomatic of a government and DoH who railroad through ideological policy with no evidence base without ever ensuring that the grass roots affected are consulted. No wonder their policies are always expensive failures that meet large amounts of resistance from the very people on the ground who they claim their policies are meant to help! This is unsurprisingly what happens when 'reform' is deeply undemocratic by nature. f the politicised individuals who work high up in organisations such as AOMRC, PMETB, DoH and the Royal Colleges actaully listened to those on the ground more often then we might not find ourselves in this current pickle. Competing interests: a dislike of MTAS |
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Anjana Satpathy, registar CW1 4QJ
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I read so many responses about comparing the old system and new systems.I am working as a registrar in a deanery for approximately three years. I have got all the criteria which shows career progression, but unfortunately did not get shortlisted for numbered post after first LAT job. My SHOs got shortlisted(more than once) and all got the job at some stage. I always got the feedback that the competition is tough and it is difficult to shortlist everyone when hundreds of people apply for 4-5 jobs. On the otherhand, some of the SHOs got shortlisted even before completion of their MRCS! These people did not get any opportunity outside the region, so they had to be accommodated!!. I had one interview for ST3 , but that also got cancelled.What was fair then and what is not fair now? We are suffering the result of inaccurate planning, lack of transparency in the system . In a purely national selection process, the deaneries should not get involved. We designated the MTAS as national selection process, and given the power to the deaneries to select people. When trainees could not make it to the interview, we named the whole system as shambolic and flawed. It is for sure that one system suits some and others do not. In this situation, there whole recruitment process should be delayed until proper review is completed. Competing interests: None declared |
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Sachin Jauhari, SHO Psychiatry St. Luke's Hospital, Middlesbrough TS4 3TF
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I read with interest the article “Your views on MTAS” [334:593 No 7594, 24th March 2007]. I am an international medical graduate and I appeared in the interview for ST3 in Psychiatry in my third preference UoA in Northern Ireland. I have to admit that the interview was very well structured with questions involving probity, team work, managing stress, conflicts etc. We have to understand that an interview can never be a flawless process; it will always retain the element of subjectivity. It is impossible to judge a candidate’s ability in half an hour no matter what the questions. The thing which I find very disturbing about MTAS is the rushed implementation. In my opinion MMC should have started from the fresh F2 graduates primarily because of two reasons, the F2 candidates are much better acquainted with this system than the old style SHOs and it would have been easier and less traumatic for the candidates in SHO training, who actually face the risk of having their career nipped in the bud itself. The whole MTAS process is being reviewed now, which inadvertently will cause more pain to the already demoralised doctors. The whole process needs a detailed rethink so that all contingencies are accounted for. Competing interests: None declared |
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Tanya de Weymarn, Clinical Research Fellow Emergency Medicine Alexandra Hospital, Redditch, B98 7UB
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I wish to complement the North Western Deanery on their interview process for ST3 in Emergency Medicine. Unlike other UoA’s the interview process did not include OSCE style clinical scenarios (something which is examined in various other settings which should be trusted to maintain high standards). Instead the process consisted of three stations each with 2 panel members. All stations took the form of discussions and were based around various clinical, management, political and communication topics. The number of questions meant that there was time for a detailed answer but still enough questions on different topics so that if a candidate ‘dug themselves a hole’ there was scope for them to recover either on the next question or the next station. The portfolio was considered by one member of the panel in one station but did not take over the station. I feel that any candidate will have had the chance to sell themselves in this interview but also suspect it will have differenciated clearly between candidates. I am not sure whether I will have secured a post but I do feel that the panel had a realistic impression of me, If I am not offered a post I feel sure that the UoA will have correctly identified strong candidates from the interview! This is not something that we are hearing much of at the moment. I feel that other UoA’s should follow North Western’s example and look to structure their interviews in a similar way. Competing interests: None declared |
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Clive A T Wiggins, GP St Johns Medical Centre SE13 7 SX
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Sir, Would the Department of Health be advised not to completely lose the investment of the training of so many young doctors by enabling Hospital Trusts to employ them. Reducing shift hours and actually meeting Labour Government targets like the 4 hour waits in A&E by increasing doctor provision? 8000 doctors added into acute care would make an enormous difference and stop some of the mass exodus abroad or out of health care altogether. The increased costs of medical student places over the last decade should be reconsidered and possibly shut down the new schools that are only just producing graduates. There seems to be a lot more behind the debacle than the race to get interviews. Competing interests: None declared |
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Dr Chris S Flannigan, F2 Doctor Ulster Hospital Dundonald BT16 1RH
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I’m sick to death of reading complaint letters about MTAS being unfair. I know the questions used for short listing were different to the normal way of applying for jobs, but as doctors we are meant to be among some of the brightest people in the country and as our job often requires we should be able to adapt as the situation changes. Realising the importance of the shortlisting process on the rest of my medical career I spent the 2 weeks we had to complete the form researching the questions, referring to the published personal specifications and writing draft after draft, till after about 15 hours of work I was completely satisfied with my answers. My delight of being shortlisted for my first choice was quickly erased with today’s announcement that everyone will get an interview in every specialty they applied for even if they were unsuccessful in being shortlisted. Not only was my hard work for nothing, but I now feel at a disadvantage compared to people who have been handed an interview on a plate. When I did my interview I had no idea of what to expect. However people who were unsuccessful in the shortlisting process now know the format of the interview and what questions came up. Combining this useful knowledge with the extra preparation time means these people have no excuse for not achieving a better score than I did. I can’t help thinking if these people had applied themselves and put as much time into their application forms as they did marching and complaining that we wouldn’t be in this mess. The BMA recently announced that there are 32,000 junior doctors chasing 18,500 jobs. So what are we going to do when 13,500 doctors end up without specialty training posts, decide the interview process was unfair and scrap it? At these competition ratios there will be good doctors who don’t get a specialist training job. All today’s announcement has done is increase the chances of doctors who worked to get shortlisted becoming one of the unfortunate ones. Competing interests: None declared |
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