The MMC story
BMJ 2007; 334 doi: https://doi.org/10.1136/sbmj.070270 (Published 01 February 2007) Cite this as: BMJ 2007;334:070270
- John Bonner, medical journalist1
- 1London
Modernising Medical Careers (MMC) was set up to build the pathway that would lead the Lost Tribe home. That was the term coined in the early 1990s to highlight the neglect felt by junior doctors in the senior house officer (SHO) grade—a group whose working conditions were seen to be poorly regulated with too great an emphasis on the needs of the service instead of training.
Proposed change
Throughout the latter half of that decade, a number of organisations issued reports proposing changes to the SHO system. But these were largely concerned with looking at ways of improving the existing training structures, and it was August 2002 before plans were put forward for radical reform.
In his strategy document “Unfinished Business,” the chief medical officer for England and Wales, Sir Liam Donaldson, advocated replacing the traditional medical postgraduate education system with a two year foundation programme. The first year would replace the preregistration house officer grade and the second year would incorporate a generic first year of SHO training. The foundation programme would then lead on to the new specialist or general practice training phase.
Remedy for various problems
Donaldson's proposals were intended to remedy the problems within the SHO system-that is, that many of those in the post were in short term or non-training posts, or endured poorly planned training with no clearly defined end points. There were also deficiencies in the selection and appointment procedures, together with inadequate supervision, assessment, and career advice. Additionally, there was concern over the implications of the European Working Time Directive in 2009, and the new arrangements were designed to curb the growing reliance on SHOs as NHS workhorses.
MMC was the four UK health ministers' response to the Donaldson report in …
Log in
Log in using your username and password
Log in through your institution
Subscribe from £184 *
Subscribe and get access to all BMJ articles, and much more.
* For online subscription
Access this article for 1 day for:
£50 / $60/ €56 (excludes VAT)
You can download a PDF version for your personal record.