Association of Anaesthetists of Great Britain and Ireland
From Mmc
March 2007
Modernising Medical Careers and the Medical Training Application Service
A statement from the Association of Anaesthetists of Great Britain and Ireland
The Association of Anaesthetists of Great Britain & Ireland (AAGBI) represents more than 90% of practising anaesthetists in the UK and Ireland. One third of its members are trainees and, through their representative section (the Group of Anaesthetists in Training รข GAT), the AAGBI is the main national body representing the views of trainees in anaesthesia and its associated subspecialties. In the light of events surrounding the short-listing and interview process for Modernising Medical Careers (MMC) operated by the Medical Training Application Service (MTAS), we wish to voice our serious concerns about a number of important issues.
From the start, the entire process has been fraught with difficulties, most of which were both predicable and predicted. Experience with the Foundation Year process raised many concerns upon which we commented, but our warnings appear to have gone unheeded.The current process for recruitment into run-through training has thrown up a number of other worrying issues. Problems so far identified by our members include:
- The computerised application process appears to have been blighted by technical problems that resulted in the deadline for applications being extended in February.
- Once the applications had been received, MTAS was meant to assess the eligibility of the applicants so that only the names of those eligible for posts were forwarded to the Deaneries. This process failed. Many ineligible candidates were short-listed, thereby denying eligible candidates an interview. We are aware that the initial round of applications was processed before the appeal judgement on the status of International Medical Graduates (IMGs) was announced. In light of that judgement, we hope that the situation regarding IMGs has now been clarified, and we insist that matters of ineligibility are now resolved before the second round starts.
- The short-listing process at Deanery level was meant to be a computerised process. This too failed in some regions, and applications had to be marked by hand. The deadline for this process was so tight that those given the job of short-listing were overwhelmed with applications. This was particularly true for anaesthesia.
- We have received reliable reports that short-listing through MTAS was not blinded in some Deaneries. This meant that those doing the short-listing could not only see the marks given by others but could also, in theory at least, change these marks.
- These and other problems meant that many requests for references were sent out at the last minute. Although this process was intended to be electronic, no allowance was made for the lack of an electronic response from a referee and, as a result of this and other failures, paper-based systems had to be resorted to. Ultimately, some candidates were obliged to track down a signed, written reference at almost no notice. This is unacceptable.
Our modern, safety-orientated NHS culture is meant to eliminate errors by careful system design, rigorous process testing and thorough piloting before implementation. It is appalling that the consultants of the future have had their careers put at stake by a system that was not designed well, did not undergo adequate testing or piloting, and was not checked thoroughly before its abrupt implementation. Given that this process is recruiting doctors across the UK into a scheme that offers little scope for a change in career, we wish to express our profound dissatisfaction and disappointment in the process to date. We think that an urgent review should be conducted before the second round of interviews starts.
Dr David Whitaker, President, AAGBI
Dr Sara Hunt Chairman, Group of Anaesthetists in Training (GAT)
08 March 07
Dr Judith Hulf
President
Royal College of Anaesthetists
Churchill House
35 Red Lion Square
London WC1R 4SG
Thursday 8th March 2007
Dear Dr Hulf,
We write to you in your capacity as both President of the Royal College of Anaesthetists and as a member of the MTAS Review Body appointed by the Department of Health. As you know, the Group of Anaesthetists in Training (GAT) Committee represents >95% of anaesthetic trainees in the UK. We wish to present to you the overwhelming and united opinion of the trainee anaesthetists who have been the victims of the woeful inefficiency and underperformance of the Medical Training Application Service (MTAS). We do not need to tell you about the many problems and injustices that this poorly thought-out and badly executed process has visited upon a generation of hard-working, able and enthusiastic young doctors. We have but one simple message for you from those who represent the future of our specialty: please do what you can to stop the process. Allowing the first round to continue whilst contemplating what may prove to be merely cosmetic changes for the second round does not reverse the injustices already committed; it perpetuates them and thereby risks increasing them. Even at this late stage, we believe that there is sufficient time for new applications to be submitted and short-listed on merit, and for interviews to take place in time for August appointments. There is a rising groundswell of professional and public opinion that believes that this system can be stopped, and indeed must be stopped, rebuilt and started again. We think that you will get the support of the public, the medical profession and perhaps, most importantly of all, that of the substantial majority of the trainee anaesthetists in the UK for a 'lean sheet' approach to this problem. The thinking behind the MTAS system, which was created in large part to push forward the as yet unproven Modernising Medical Careers (MMC) training scheme, was defective, the preparation was inadequate and it was, in the form it finally took, doomed to failure. Despite their suggestions for improvement being ignored, many members of the medical profession tolerated it at the time in the hope that the system, actively supported and promoted by the Government and the Department of Health, would succeed. They were wrong, and those who warned of the problems ahead, most notably GAT and the Association of Anaesthetists, were not heeded. This is in the past and now we ask you to go forward with your colleagues on the MTAS Review Body to replace a system that you did not devise, for which you are not primarily responsible, and which all admit is broken beyond repair. Failure to act decisively now will, when the smoke clears, be seen as a clear abrogation of responsibility to support the legitimate aspirations of our best young doctors and, ultimately, the welfare of the NHS patients who depend upon their services. We know that you will do what you can to return sense and order to the current chaos. We implore you to do this by halting the MTAS process and starting over again. Yours sincerely,
Sara Hunt Chairman, GAT
Chris Meadows Chairman Elect, GAT
