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An open letter to the medical profession

4 June 2007<br>
Dear colleague

I am writing to you at a time of real crisis for the training of the UK’s doctors. I have spent my life training students and doctors and am most distressed by the recent problems. Due to recent changes in the training application process, thousands of our doctors have not got training posts. I would like to tell you what the British Medical Association (BMA) has done but, more importantly, what we intend to do, working with others, to resolve this sorry state of affairs. 

The BMA has been raising major concerns about the training of our junior doctors since March 2004.

We were the first to point out the huge risks of launching a new training programme with an over-ambitious big bang approach, based on an untried computer system. We called in the summer of 2006 for a delay in its implementation but this was ignored by the people responsible for the introduction of the new system.

When the training application system (known as MTAS) failed, the ensuing chaos caused extreme anxiety and turmoil for all those involved – junior doctors, staff and associate specialists and also the consultants and academics who were involved in assessing junior doctors. Thousands of these juniors had no idea – and still have no idea – whether they can continue their professional training after 1st August 2007. We hear every day about highly talented junior doctors who may seek their futures abroad now that their careers appear blighted by this crisis. What a waste of talent and what a
loss to the Health Service and to the future care of our patients. 

After the collapse of MTAS, the BMA again called for the process to be halted before further interviews took place. It was only after thousands of interviews had been held, requiring exceptional effort from trainees and consultants, that the Government started to admit the seriousness of the problem and set up a Review Group . 

At this stage we took the clear and united view that the right way forward, while continuing to express the outrage and anger felt by all doctors, was to work constructively for a solution that did not just throw away the thousands of interviews already held and worsen the present chaotic situation even further. We recognised the political risks of this strategy but felt that our overwhelming duty was to try to do everything we could to support our junior doctors.

Ideally all candidates should have had all of the interviews to which they were entitled. The BMA and others have worked hard to get this proper solution in all four devolved nations. Due to the smaller numbers involved, a workable solution was achieved in Wales, Scotland and Northern Ireland. Because of the numbers involved, the same outcome proved impossible in England. We have, therefore, continued to press for the best solution possible for junior doctors, working often with great difficulty inside the Review Group and through all other channels available. 

In view of the recent High Court action, and some limited movement by the Government, the BMA continues to work for the best outcome possible for all the doctors affected by this shambles. It has pressed the Secretary of State not to claim costs against Legal Remedy UK, the junior doctors’ pressure group who brought the High Court action. 

Over the coming weeks we will promote even more forcefully, the key principles that we believe are essential for the training of our junior doctors. We do not underestimate the enormous difficulties. However, there is a great danger that the profession ends up fighting amongst itself rather than doing everything we can, collectively, to find the best solution to a bad situation. Now is the time for unity – to ensure doctors get the best possible training available, and patients get treated safely. 

We are consulting our members through an online survey of juniors and consultants to help us shape the way forward. I urge all those affected to complete the survey. We will be working with all those who are interested in a constructive approach to this problem – to make sure this fiasco is resolved, and that it doesn’t happen again. We will shortly be giving evidence to the Tooke Inquiry to ensure that a proper, thought-out system is put in place for 2008 – designed by and for doctors. 

We owe our young doctors good training to provide excellent care to our patients in the future.

''Professor Parveen Kumar President, British Medical Association.''