Royal College of Physicians of Edinburgh

From Mmc

Dear Dr...

MMC/MTAS

I have been inundated with emails indicating major problems with the shortlisting process for MMC. Despite the enormous effort and commitment put into the shortlisting process by many Fellows and Members - for which profuse thanks - there are numerous examples of applicants with outstanding CVs who have not even got a single interview. Lord Warner promised UK graduates that they would be able to train and that promise needs to be delivered. We must not lose good trainees overseas. The trainees also need as much information as possible as soon as possible.

As the UK Academy of Medical Royal Colleges lead on Training, I led the discussion between the Colleges and with the Chair of the PG Deans on Monday 5th March. There was unanimous agreement among the Colleges that the MTAS system needs urgent improvement. A letter was written to Patricia Hewitt with a proposed plan of action (see below). A meeting was hastily arranged with Patricia Hewitt and Lord Hunt that night in which I participated. The Secretary of State has agreed to announce on Tuesday 6th an immediate review of the Medical Training Application Service. The Academy will lead this review and I will be deeply involved. I welcome comments from Fellows and Members on the proposed actions.

The Colleges have agreed that the round 1 appointments process should proceed, as many excellent doctors have been shortlisted and their career advancement should not be delayed. We are assured that there will be a large number of posts available for appointment in round 2.

Neil Douglas, President. Royal College of Physicians

LETTER

5 March 2007

The Rt Hon. Patricia Hewitt Secretary of State for Health Department of Health Richmond House 79 Whitehall London SW1A 2NS

Led by the Government (through MMC and the Deaneries) the profession has worked intensely since 2003 to ensure effective implementation of Modernising Medical Careers.

Doctors in training are our seed corn, a mainstay of service in the future. From graduation onwards their training now covers every facet of what is needed to be a good, safe doctor, working for the benefit of the people of the UK, their own professional and personal fulfilment, and their continued commitment to the NHS.

Therefore we learn, with dismay, of the exposure of serious weaknesses in the Medical Training Application Service (MTAS). We see a crisis of confidence in this critical element of the new system.

The trainee doctors who are directly affected feel this most keenly and distressingly. Many who had been led to understand (for example by Lord Warner’s statement last summer) that there would be jobs for all doctors trained in the UK, find that they have not even been short-listed for interview. By consistent report they include people who are among the brightest and most able of their generation.

Of course there has always been competition for posts in the NHS, though not as open and transparent as it must be today. But a system that fails to deliver what is necessary, and has been promised, is unacceptable to the public and profession alike.

In addition to technical problems, there are concerns about the questions asked; concerns that qualifications and achievements have not been taken sufficiently into account; about the adequacy of training for assessors; about the time available for interview; about reports of inconsistent ratings of individuals; and delays in conveying the outcome to applicants and guidance on subsequent arrangements. We do not have full data on these events but the frequency and consistency of reports leaves little doubt that things have gone badly wrong.

In the face of these concerns we are grateful for the resilient commitment of so many senior doctors in this complex and time-consuming short-listing and interview process.

To restore confidence this state of affairs must be put right without delay, ready for the second round of applications. The Academy and its constituent Colleges and Faculties are requesting an urgent review of the process of selection.

At its meeting this morning, the Academy agreed the following list of action points that it believes need urgent attention.

I am copying this letter to Lord Hunt, David Nicholson, Clare Chapman, and the Chief Medical Officers.

Professor Dame Carol Black Chairman

PLAN OF ACTION

Action now

  • Communication now key including personal responses to non-short-listed
  • Inform candidates not long-listed + publish specialty by specialty competition ratios ASAP.
  • Plagiarism software to be upgraded + used
  • Not necessary to fill all posts in round 1 if criteria not met
  • Ability to probe applicants in depth at interview in round 1 with full cv always available
  • Initiate review
  • Appeals for non-short listed now

For round 2

  • Plagiarism software to be replaced + used
  • More points for cv
  • Scoring system to be reviewed
  • Short-listing system needs to be less consultant intensive and less time pressured
  • Consider specialty exams

For future years

  • CV - counts more
  • Knowledge – national generic MCQ run by AoMRC for short listing and ranking
  • Clinical abilities – from F2 Summative workplace assessment
  • Attitudes – MultiSource Feedback in F2
  • Must remember Foundation selection
  • Review of MTAS software functionality and ensure tamper-proof
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