“Although a deeply damaging episode for British medicine, from this experience must come a recommitment to optimal standards of postgraduate medical education and training. This can only occur if a new partnership is struck between the profession and the DH [Department of Health], and between Health and Education. Each constituency has been found wanting thus far. In future, each must play its part. An aspiration to clinical excellence in the interests of the health of the population must be paramount.”

So concludes Professor Sir John Tooke's inquiry into Modernising Medical Careers (MMC).1 2 This initiative, “an honest attempt to accelerate training and assure the fundamental abilities of the next generation of doctors” almost foundered over the failure of its main component, the centralised selection into run-through specialist training. In response, the government announced an independent inquiry into MMC, the interim report of which was released this week. While Tooke's report runs through the reasons for the failure of the Medical Training Application Service (MTAS), these have been extensively covered in a previous report.3 Sir John's canvas was much wider. His panel “explored the background and context—in medical terms the predisposing or aetiological factors—that may have contributed to the perceived problems with MMC, rather than simply focusing on MTAS.”

So, what went wrong? Wherever Sir John shone his torch he found debilitating vagueness and frailty. He found no evidence of a consensus on the educational principles guiding postgraduate medical training and that mechanisms for …