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Physician trainees raise concerns about modified recruitment process

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2038 (Published 20 May 2020) Cite this as: BMJ 2020;369:m2038

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  1. Abi Rimmer
  1. The BMJ

Changes to the physician specialty training recruitment process have caused distress and led to many high achieving candidates going without posts, juniors say.

The covid-19 pandemic has meant that face-to-face interviews for physician training posts were cancelled and that trainees’ self-assessment scores were used instead to assess their suitability to enter a training programme.

However, although there were 10 domains for self-assessment, the physician specialty recruitment office decided that only five would be used to assess trainees applying for physician specialties: quality improvement, teaching experience, MRCP(UK) results, training in teaching, and presentations.

An analysis of the self-assessment scores of 117 trainees, conducted by the British Junior Cardiologists’ Association’s starter committee, found that these changes may have led to many trainees who would otherwise have been successful missing out on a training post.

Jack Samways, committee member and core medical trainee, explained, “In contrast to the normal distributions of the shortlisting scores and interview based final assessment scores, the model has resulted in a significant negative skew.

“The revised physician specialty recruitment office model has not managed to mimic the previous interview based process and appears to have reduced the ability to discriminate between candidates. Given the uncertainty around speciality recruitment with the implementation of internal medical training, this process has been a cause of distress to many physician trainees.”

Double disadvantage

William Walshe, a second year core medical trainee, told The BMJ that anyone disadvantaged by the new system would be doubly disadvantaged because of the introduction of three year internal medical training (IMT), which replaces the two year core medical training (CMT).1

These changes mean that, from next year, core medical trainees will have to complete a third year before applying for specialty training.

Walshe said, “Due to the IMT changes, they will be unable to apply next year for ST3 posts to their chosen specialties, and have to wait two years because of the decisions made over the last few weeks.”

Simon Gregory, deputy medical director for primary and integrated care at Health Education England, said that the decision to change the recruitment process had been made by a group comprising representatives from the four UK nations, specialty recruitment leads, the Academy of Medical Royal Colleges’ trainee committee, and the BMA’s Junior Doctors Committee.

He said, “The model agreed for the physician specialty recruitment office specialties was based on data from previous recruitment which sought to maximise the likelihood that appointed candidates would have performed satisfactorily at interview. Recruitment is still ongoing, with offers outstanding, so we are unable to provide fill rate data at this stage.

“The medical and dental recruitment and recruitment selection team plan to publish data regarding this once recruitment is completed. Discussions are taking place nationally on what information will be published and when, across all specialties affected, including those coordinated by the physician specialty recruitment office.”

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