Intended for healthcare professionals


Has Modernising Medical Careers lost its way?

BMJ 2007; 335 doi: (Published 30 August 2007) Cite this as: BMJ 2007;335:426
  1. George B P Madden, final year medical student1,
  2. Anthony P Madden, consultant anaesthetist2
  1. 1University of Birmingham, Edgbaston, Birmingham
  2. 2Department of Anaesthesia, Southmead Hospital, Bristol BS10 5NB
  1. Correspondence to: A P Madden Anthony.Madden{at}

    Originally intended to address problems with the senior house officer grade, Modernising Medical Careers has since expanded in scope and radically altered its plans for specialist training. George and Anthony Madden question whether it is still fit for purpose

    Summary points

    • Modernising Medical Careers began as an attempt to address longstanding problems with the senior house officer grade

    • It has since expanded in scope to reform all levels of postgraduate medical training and bears little resemblance to the proposals that were approved during consultations

    • There is now a real danger that it will deliver a generation of highly specialised doctors who lack the breadth of experience and flexibility that will enable them to manage unusual clinical problems or change as medicine advances

    • This cannot be good for patients, NHS employers or the government, indicating that MMC may not be fit for purpose

    The Medical Training Applications Service (MTAS) has caused huge upset within the medical profession. Not only has it failed to allocate trainees in a fair and transparent way, but it has failed to ensure all allocations have been completed in time for 1 August 2007.

    In recent months, the distinction between MTAS, the selection process, and Modernising Medical Careers (MMC), the actual reforms, has often been overlooked. This year MMC will implement the specialist training programme, the most ambitious and radical overhaul of medical training in living memory. If it fails, there will be no easy way to repair the damage. In light of the failure of MTAS, one must ask if MMC can succeed.

    What is Modernising Medical Careers?

    MMC is a system designed to produce consultants in seven to nine years after graduation, and general practitioners in five. It begins with the foundation programme, a two year introduction to the core skills of medicine. It then goes on to the new specialist training …

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