Observations The week in medicine

How specialist training reform sparked crisis of confidence

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39146.640613.59 (Published 08 March 2007) Cite this as: BMJ 2007;334:508
  1. Rebecca Coombes, journalist, London
  1. rcoombes{at}bmjgroup.com

    Computer crashes, 8000 angry junior doctors fearing unemployment, and talk of a shambolic and corrupt selection process have dominated recent coverage of Modernising Medical Careers

    What's happened?

    Last month an estimated 30 000 junior doctors became the guinea pigs for a new and untested system for filling specialist training places within the NHS. Around 20 000 are UK doctors either currently employed as senior house officers or emerging from the foundation stage. The remaining 10 000 who have registered for training places are from the European Union or other overseas candidates.

    All junior doctors have had their contracts terminated from August and have had to apply for jobs through the online service MTAS (Medical Training Application Services), which by last week had descended into “pandemonium,” according to the BMA.

    Emotions were running high even before the service went live at the end of January. With only 22 000 posts available, and 30 000 eligible candidates, 8000 doctors faced an uncertain future. The BMA's beef is not with the number of posts, which is roughly the same as before, so much as with what it perceives as the unfairness of the new system—it claims the system seems to be a lottery rather than one based on merit.

    On Monday a panel of consultants in Birmingham refused to conduct job interviews on the grounds that they felt the process was unfair. Andy Garnham, a surgeon in Wolverhampton and a member of the panel, told the Times (6 March) that the consultants were unhappy about the way that a shortlist had been prepared from the original 650 applicants.

    “The whole system had serious flaws,” he was quoted as saying. “No long list had been done and there were people on the shortlist who were ineligible, whose qualifications had not been checked or whose immigration status was in doubt. This is …

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