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Training: BMA expresses concern over changes to specialty recruitment

BMJ 2020; 371 doi: (Published 29 October 2020) Cite this as: BMJ 2020;371:m4230

Linked Opinion

Changes to speciality recruitment 2021—leaves trainees with more questions than answers

  1. Abi Rimmer
  1. The BMJ

Recruitment for specialty training has been substantially changed this year, with all interviews taking place online and an increased use of computer based testing. The BMA has raised concerns about the changes that affect the 2021 recruitment round for specialty training across the UK.1

In a webinar on 21 October Health Education England set out the changes that will be introduced owing to the covid-19 pandemic.2 There will be increased reliance on the computer based multispecialty recruitment assessment (MSRA). Although this test is already used by some specialties, such as general practice, applicants to acute care common stem and paediatrics will need to take this test for the first time this year.

All interviews will take place online, and there will be no interviews at all for applicants to general practice and psychiatry. Appointments to these specialties will be solely based on the MSRA. To account for the disruption to training caused by the pandemic, Health Education England said that it had amended the requirements for some applicants.

Speaking during the webinar, Claire Wright, national specialty recruitment manager at Health Education England, said, “We’ve amended scoring criteria and person specifications to make sure that people don’t miss out because of placements they haven’t had, exams they haven’t had a chance to sit, or courses they haven’t been on.”

The BMA said that it had a number of concerns about the changes to the recruitment process, such as the use of the MSRA, which it said “is not designed for, validated in, or tailored to, many specialties where its usage is now being proposed.”

The association said that it was also concerned about the use of self-assessment—whereby trainees mark themselves against certain criteria. “Some specialties continue to use unverified self-assessment scoring, and the equality impact assessment on this methodology has not yet been published from the last round,” the BMA said.

In comments posted online during the webinar, several junior doctors also expressed concerns about the changes.3 One anonymous poster said, “The way this group of doctors has been treated throughout this process is shocking. This would not happen in any other line of work and is unacceptable.”

Specialty recruitment 2021

When do applications open?

  • Adverts for posts in the first round (for those applying to CT1/ST1/run through) recruitment will go up on Monday 2 November

  • Applications will open on Thursday 5 November and close at 4 pm on Tuesday 1 December

  • Interviews will be conducted between 4 January and 16 April, and offers will be released by 19 April

  • The application window for posts in the second recruitment round (ST3+) has been brought forward

  • Adverts will go up on 23 November, and applications will open on 26 November, closing on 17 December. Interviews will take place between 4 January and 4 May, and offers will be released by 5 May

What is the multispecialty recruitment assessment (MSRA)?

  • It’s a computer based test with two components: a professional dilemmas test and clinical problem solving. It has been used by several specialties for some years. It will be used in acute care common stem emergency medicine, paediatrics at ST1 level, and anaesthetics at ST1 level for the first time this year

  • The test is administered by the GP national recruitment office, so if you are applying for a specialty that requires you to sit the assessment, this is the office that will contact you. “If you haven’t applied for general practice, don’t worry, it’s not an error,” Wright explained. “They are the people who run the test”

  • The tests are undertaken at Pearson Vue testing centres nationwide or online for those who are shielding or self-isolating

Are these changes to specialty recruitment permanent?

  • It’s unclear. Speaking on the webinar, Sheona Macleod, deputy medical director for education reform at Health Education England, said, “Recruitment is never going to be exactly the same as it was. I think we need to build on what we have learned”

  • She said that Health Education England would need to evaluate the changes and learn from what it was doing. She added, “One of the things that covid is doing is making us re-examine all of the ways that we deliver education and training, whether that’s recruitment or progression”


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