Rapid Responses to:

OBSERVATIONS: Fiona Patterson Fiona Patterson replies to Parashkev Nachev BMJ 2007; 335: 802 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Re: Editor's comments

Parashkev Nachev   (21 October 2007)

Re: Editor's comments 21 October 2007
Parashkev Nachev, Academic Clinical Fellow Imperial College London Send response to journal: Re: Re: Editor's comments	The editors have seen it fit to declare that two assertions in my original article—“that the criteria and procedure for selection in MTAS were principally designed by a handful of organisational psychologists” and that “the selection methods they have developed have never been used to select specialist trainees”—are factually inaccurate. In relation to the former, they cite the Tooke report; in relation to the latter, Professor Patterson’s articles in the BMJ and elsewhere. To take the second point first, the studies referred to in these articles only deal with trainees in general practice and trainees at the senior house officer level. Neither of these two groups are ordinarily considered to be specialist trainees, the former because they are undergoing training to be general practitioners, the latter because they are undergoing training prerequisite to both general and specialist training. If I am perverse in my use of the term, then so is both the majority of practising doctors, and the law of the land as enshrined in statute (see Statutory Instrument 2003 No. 1250, The General and Specialist Medical Practice (Education, Training and Qualifications) Order 2003, http://www.opsi.gov.uk/si/si2003/20031250.htm#20). Readers may also wish to consider what is more misleading: my failure to clarify the use of "specialist trainee" or the tacit implication in the editor's comments that the methods have been comprehensively tested within specialist medicine? Regarding the first point, I may quote directly from the Tooke report (page 129, section 6.1): “Selection for specialist training. The method used for shortlisting and selection in 2006/7 was adapted from one developed and piloted by Work Psychology Partnership in consultation with a small group of deaneries and Royal Colleges.” It is difficult to see how Professor Tooke—or anyone else—could have concluded otherwise given that the only publications cited in support of the new methods have been authored by Professor Patterson and her colleagues. Since the methods employed are essentially identical with those in the published papers, and the papers presumably credit everyone who has contributed intellectually to the enterprise, it is difficult to see in what sense my assertion can be interpreted as being factually inaccurate. My article was not concerned with who deliberated on the choice of method, but with the principal source and nature of the intelligence contained in the final product. Of course, I do not deny that other groups, such as the Royal Colleges, were involved in the decision-making. Indeed, my point was precisely that the Royal Colleges—more than any other institution—should have upheld the evidential standards which our profession insists on in clinical practice. That the evidence falls disastrously short of these standards is not in dispute. Competing interests: None declared