Association of British Neurologists (ABN) Position Statement

From Mmc

Association of British Neurologists (ABN) Position Statement

There are 141 1st choice and 432 total applications for Neurology at ST3 with 30 available posts as per the recent documentation on MTAS: 49 of those putting Neurology as first choice (35%) and 121 (28%) of all applications for Neurology were short-listed. A limited ABN(T) survey of research fellows showed that 15/32 responding obtained no interviews and 10/32 only one. Of these 25, 20 had a BSc, all had registrar experience (9 in formal LAS/LAT posts), 20 had distinctions/prizes, 17 peer reviewed publications and 20 any publication. Although this is partial data from larger group of about 90 or so neurology research fellows it probably confirms what many have already said i.e. that the short-listing process is not reliably selecting many who have been previously thought to be excellent candidates for Neurology higher specialty training. Other anomalies have included “essential” criteria in the person specification which were not specified (and did not formally exist) at the time the application process closed – most notable is “evidence of achievement of ST1 competencies in medicine….and ST2 competencies in medicine by August 2007”, the lack of CVs and the lack of transparency (to most short-listers and applicants) about how short-listing marks generated an order of applicants.

The ABN via its Council, Officers, Academic and Training Committees and its SAC members has repeatedly raised the issue of the high number of “specialty ready trainees” currently in research posts, their limited options to obtain a post in the current round and the consequences for those who are unsuccessful. Because the vast majority were well post-MRCP, application at ST1/2 was not an option. Our understanding is that, on current plans, those who obtain an ST2 run-through post in Core Medical Training this year will be guaranteed an ST3 post in one of the medical specialties next year subject to a satisfactory assessment and performance profile: that is the “promise” of the new MMC “run-through” process. The implication of this is that non-ST2 applicants can only be offered unfilled posts after this process is complete. Thus, unless there is a substantial shift in position as a result of the Douglas Review Panel, those trainees in research but not in run-through programmes (and without a current NTN) will be at a major disadvantage and less well qualified trainees in ST2 may obtain ST3 posts over them. In addition they may be potentially disadvantaged by the requirement to demonstrate core ST1/2 medical competencies using new (but still not finalised, piloted or validated) assessment protocols.

Therefore, we very strongly believe that significant numbers of excellent applicants are not being given a fair chance to gain entry to their chosen specialty using the current criteria despite the extra years of training that such applicants have invested over and above the required minimum and, often, after the guidance of their deaneries and specialty advisors. In the current framework of employment law this would seem, at the very least, to be of questionable legality. Whilst no one would pretend that doing clinical research and having publications and/or a higher degree are automatic guarantors of clinical excellence and competence we believe there is a strong positive correlation. It is shocking that trainees with self-evident commitment and longer experience through exposure to neurology in a research environment will potentially be denied a fair opportunity to compete for their specialty of choice.

Through clinical research such trainees will have gained valuable neurological knowledge and skills relating to clinical practice and these will often be evident by a fair interview process especially in the multi-station interview format. There is no need to treat such research trainees as “special cases”: reasonable credit for higher degrees, publications and presentations should inform the short-listing: their acquired skills should be evaluated at the interview process in open competition with others.

We are therefore insistent that:

• all those eligible for ST3 Neurology entry in the current process should be interviewed and not excluded on the basis of a flawed short-listing process

• those who are unsuccessful in obtaining an ST3 post this year should have the opportunity to apply in open and equal competition for ST3 Neurology in 2008 and 2009 at least (and not simply for places in ST3 Neurology unfilled by ST2 entrants) as part of the process of transition

• the fairest distribution of trainees will be most likely to be achieved by a supra-regional or national competition for places rather than a within-deanery system given the relatively low number of ST3 places likely to be available in 2008/9

Mark Wiles (TEC, ABN)

Geraint Fuller (SAC Neurology, RCP)

Graham Venables (President Elect, ABN)

David Chadwick (President, ABN)

Distribution:

All members of ABN

Prof Neil Douglas, Prof Ian Gilmore

Dr C Clough (Medical Director, JRCPTB)

Prof W Burr (Lead Dean for Neurology)

Postgraduate Deans

MMC (Prof Shelley Heard)

PMETB (Prof Peter Rubin)