27 April 07 Email To Members and Fellows
From Mmc
To Members and Fellows of The Royal College of Surgeons of England
The review Group met again on Wednesday 25th April and I am writing to give you an update on the present position.
You will recall that I put to an earlier meeting, a proposed scheme to enable those who are able, but are not successful in securing a ST3 post this time around, to continue their training in what I called ‘transitional training posts’. During the opposition Day Debate on the 24th April the Secretary of State for Health, Rt. Hon Patricia Hewitt MP, agreed the need for additional training posts.
“As part of the review, we are working urgently with the royal medical colleges and the NHS to establish the need for additional training posts—which will of course have to be approved by PMETB—including one-year placements and more senior posts. We are also considering how we can provide more effective training support for doctors in service posts—that is, non-training posts—to maximise their development opportunities. That is the issue on which Professor Douglas’s review group is now focusing, having dealt with earlier problems involving the application process, and it will make a full statement—as will I, to the House—on the support that will be available very shortly.”
Since I last wrote to you, I have discussed my plans with the Senate (with representatives of all the surgical colleges and specialist associations), ASGBI and ASIT. In the light of all of this feedback, I have refined the plans for additional training posts, in England, which have the support of all of these bodies and which I think will offer the best career prospects for as many of our able trainees as possible.
The plans are currently with a working party of the Review Group to consider the detail.
In essence, selection for specialty training should be at the ST3 level for the next three years and the number of run-through training posts at ST3 level should be expanded. There should be a concomitant decrease in the number of training posts available at ST1 in 2008 and in both ST1 and ST2 in 2009. The numbers at ST1 and ST2, for this year however, will remain unchanged.
All ST1 posts should be FTSTA’s. There are c.760 ST1 posts for surgery in England (910 for the UK)
All ST2 posts should be FTSTA’s. There are c.808 posts in England (1043 for the UK)
There should be an expansion in ST3 numbers over a transitional period of three years from 2007 to 2009.
The case for expansion at ST3 is to meet the College’s stated policy in relation to the future workforce required to provide an acceptable quality of service and to continue to ensure patient safety.
You may be aware of the Independent Review into MMC, announced earlier this week by the Health Secretary to be chaired by Professor Sir John Tooke. I am attaching the terms of reference for information. He telephoned me several days ago and I had the opportunity to discuss the review with him. I have written to him today, expressing my concern that there is no specific mention of the role of PMETB in the terms of reference. I have asked him to confirm that PMETB’s involvement to date and its future is addressed in this review. I will expect changes to be made before we can offer our support.
Terms of Reference for Independent Review
The review will examine:
- the extent to which MMC has engaged the medical profession and to make recommendations to ensure that it has the support of the profession in the future
- the extent to which implementation to date has met the needs of doctors in training, patients, the service and employers
- the governance structures across the UK that underpin MMC and the inter-governmental working arrangements of the four home countries
- the implementation processes underlying MMC and the methods used in selection and recruitment
- factors relating to the wider professional, regulatory, workforce and service environment which may have impacted on the programme.
It will also consider specific issues that have been the subject of stakeholder concern, including:
- the extent and quality of stakeholder engagement with the programme
- the effective engagement of doctors in training and the profession as a whole in MMC and the development of a proper understanding of its aims and benefits
- the appropriate relationship between the acquisition of competence and the pursuit of excellence
- the assessment methodologies used in the selection process including the relative merits of competency-based and more traditional methods of selection and recruitment
- the use of assessment centres in selection and recruitment
- the level of choice on offer at application
- the lack of flexibility available to trainees on run-through programmes
- the role of fixed-term training posts alongside run-through posts
- the relative roles of the Deaneries and the Medical Royal Colleges in delivering components of the programme
- the need for flexibility in implementation across the UK.
Bernard Ribeiro CBE
President
27 April 2007
