03 May 07 Modernising Medical Careers: a response from two Presidents of The Royal Colleges
From Mmc
Modernising Medical Careers: a response from two Presidents of The Royal Colleges
We do not underestimate the immense damage inflicted on British medicine by the mplementation of Modernising Medical Careers (MMC) as outlined by Morris Brown and colleagues in their Comment (March 24, p 967).1 The selection system was unpiloted and seriously flawed, and the broad generally welcomed principles of revised training for young doctors became lost in the inflexibility of the system, which was imposed with the tightest of time scales and shifting aims. We therefore welcome the announcement by Patricia Hewitt, the UK’s Secretary of State for Health, of an independent review, to be chaired by Sir John Tooke, to establish the way forward for MMC. However, the way forward will be clear only when we understand fully how the recent unhappy episode came about so that lessons learned will help to avoid future mistakes. Our Colleges welcome that close scrutiny. Although the House of Commons has been told “Modernising medical careers is the outcome of years of work by the medical royal colleges”,2 the genesis of MMC and the Medical Training Application Service (MTAS) has been complex and the final products far away from the principles of “Unfinished Business”,3 the chief Medical Officer’s proposals for reform of the Senior House Officer grade.
The terms of reference for this review are crucial so that the role of not just the Colleges but also postgraduate deans, the Department of Health, and the regulator of training, the Postgraduate Medical Education and Training Board (PMETB), can be examined. We will be seeking full input into the terms of reference so that the outcome will be a postgraduate training scheme that is professionally led, flexible, and sensitive to service requirements, but is also one that promotes the excellence in clinical and academic medicine that the UK deserves.
Ian Gilmore, Bernard Ribeiro
Linda.Cuthbertson@rcplondon.ac.uk
President’s Office, Royal College of Physicians, 11 St Andrews Place, Regent’s Park, London NW1 4LE, UK (IG);
President’s Office, The Royal College of Surgeons of England, 35–43 Lincoln’s Inn Fields, London WC2A 3PE, UK (BR)
Brown M, Boon N, Brooks N, et al. Modernising Medical Careers, Medical Training Application Service, and the Postgraduate Medical Education and Training Board: time for the emperors to don their clothes. Lancet 2007; 369: 967–68.
House of Commons Debate. Modernising Medical Careers, March 19, 2007, column 579. See http://www.publications.parliament.uk/pa/cm200607/cmhansrd/cm070319/debtext/70319-0004.htm, accessed on April 19, 2007.
Donaldson L. Unfinished Business: proposals for reform of the Senior House Officer grade—a paper for consultation. Department of Health, 2002. See http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4007842, accessed on April 19, 2007.
A letter to the lancet. Published online on www.thelancet.com on April 20, 2007 DOI:10.1016/S0140-6736(07)60637-0
