Royal College of Surgeons (Eng)

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College statement on MTAS

ou will be aware of the ongoing discussions within the Academy’s Review Group about MTAS. Over the last 2 weeks the Royal College of Surgeons has continued to gather evidence from surgeons and trainees across the country who are caught up in the MTAS application process for surgical training posts. I am conscious of the strength of feeling of Fellows and Members revealed by our on-line survey and the constant flow of correspondence I have received. It is very clear to me that there has been a fundamental failure to deliver a system which is fair to all and is efficient in delivering the best surgical trainees for the NHS.

I am pleased that the Department of Health have again confirmed that they will abort the MTAS short-listing process for all trainees except GPs for 2007; the statement of the Review Group (22 March 2007) gives further clarification of the process of selection now being followed for this year which will employ full CVs, portfolios and probing interviews. The new process will not utilise the discredited application form used by MTAS for short-listing. Doctors and surgeons have demonstrated that structured interviews are the only valid method for selection.

I am particularly pleased that the Review Group has accepted my view that the operational details of the rescue package must vary from specialty to specialty, thereby taking particular account of the specific requirements of surgery as a craft specialty.

For eligible trainees applying for ST1, ST2 or ST3, the new procedure means they are guaranteed an interview for their 1st choice, and they now have the opportunity to reassess and change that first choice in the light of the geographical and specialty specific competition ratios published on the MTAS website (www.mtas.nhs.uk)

The new procedure also allows anyone whose application form did not gain entry to the MTAS system to apply directly to their 1st choice. If they are eligible for training, they will also be guaranteed an interview for their first choice posting.

It is now up to us as a College to support surgeons in each individual Deanery to make sure that they see all of the candidates at ST1, ST2 and ST3 who have put that Deanery as their first choice in their original MTAS form, or who would now like to put the Deanery as first choice in light of this re run.

Those Deaneries that have been waiting for a decision from the Review Group can now confidently proceed with interviews that ask probing questions using CVs and portfolios.

Those Deaneries that have already started their interviews will have to make an assessment about those interviews that have already taken place. In some cases Deaneries will be confident that they have carried out probing interviews with CVs and portfolios and can carry on; other Deaneries may not be confident that their interviews are consistent with the new guidance from the Review Group and may need to start again.

I understand the anguish that this may cause those candidates who have already been interviewed, but I have worked closely with our trainee organisations and feel that it is the fairest way to treat all candidates.

I recognise the special problems still facing academic medicine and steps are being taken to ensure adequate arrangements for dealing with applications for academic posts

The College will not be held to the original timetable if we cannot guarantee fairness to all of our candidates and to deliver the best possible trainees for the NHS.

Council is increasingly concerned that patient care may suffer if consultants are asked to give up time in clinics and operating theatres to interview the thousands of candidates let down by MTAS.

We must now have assurance from employers that consultants will be released to undertake the necessary interviewing and the Department of Health must acknowledge that this will mean cancelling clinics and other non-urgent duties at short notice. Chief Executives must be made aware that our consultants will need support to see this new appointment process through.

There must be an independent review at the end of this selection process which examines the role of PMETB, the Deans, MMC, MTAS and the Royal Colleges.

MTAS must not be run again until all of the Colleges are satisfied that it has a role to play in selection of our trainees. Any future selection process must take account of the lessons learnt from this shambolic exercise.

Bernard Ribeiro CBE

President

22 March 07

I am very grateful indeed to all of you who responded so quickly to the survey. I thought it important to seek your views and equally important to let you all see the results.

5900 Fellows and Members in the UK were surveyed (that equates to total number of Fellows and Members for whom we have email addresses) and there were 2386 responses, a response rate of 40.4%.

The results are:

Option A……..80…..….3.3%

Option B……414…….17.4%

Option C…..1892…….79.3%

I am still involved in discussions with the Review group and will update all of you as we progress.

Mr Bernard Ribeiro CBE

President

20 March 07

Dear Fellow / Member

You will be aware from recent emails, the MMC and MTAS websites and reports in the media, of the concerns that have been raised and discussions that have been taking place about MTAS. It is important that the College now has an indication of the views of Fellows and Members on this matter. I should be grateful if you would respond to the question below, by return email, indicating your overall view as A, B or C. I hope to be able to collate a significant number of responses by noon tomorrow.

On the basis of any personal experience you have had as an applicant / trainer / advisor / assessor / interviewer, do you consider that MTAS:

A is working well generally and should be continued, subject to any necessary modifications; or

B has worked less than adequately but is capable of continuation, subject to significant modifications as currently proposed; or

C has such fundamental flaws that it is incapable of continued operation and should be abandoned for the 2007 round with a return to the deanery appointment processes that were in place last year.

Thank you in anticipation of your assistance

Bernard Ribeiro CBE

President

The Royal College of Surgeons of England

09 March 07

To all Members and Fellows of The Royal College of Surgeons of England resident in the UK

MTAS

I have just returned from an all day meeting of the review group at the Department of Health that included representatives from The Academy of Medical Royal Colleges and the British Medical Association. I thought you should see immediately a press release that we are issuing tonight from the College summarising the real progress I think we have made today.

Surgeons agree rescue measures for failing MTAS system

The Royal College of Surgeons has successfully negotiated a rescue package for trainee surgeons. The Department of Health has agreed to re-run the first round of the Medical Training and Application Service (MTAS) to make sure that all worthy candidates will be shortlisted.

Surgeons will now use full CVs and the customary structured interview to select candidates for jobs rather than relying on a computerised selection process which has clearly failed and has caused deep distress to both trainees and those who were tasked with selection.

All candidates who have been previously selected for interview will still be interviewed, but trained medical advisors will now go back and examine in detail the candidates who were left out first time around. Those candidates who are worthy of training posts will now re-enter the process and go forward to interview at no disadvantage.

The President of the Royal College of Surgeons, Mr Ribeiro said,

“Over the last few weeks I have gathered evidence from surgeons, trainees and their families around the country and I understand the distress that the MTAS process has caused.

It is clear that there is a large group of highly skilled trainees who have not been short listed for interview due to faults in the application process.

I am pleased to say that the Secretary of State for Health has listened to our advice and acted quickly to set up this review which has hopefully reassured both patients and trainees. We can only be part of an application process that provides the NHS with first class trainee surgeons – this is vital for the safety of patients. The College has consistently given advice to the MMC team on a process for selection of surgeons by surgeons. I will continue to pressurise the Department to act on our advice to introduce a selection process for next year which is fair to all and effectively selects the highest quality surgical trainees for our NHS, our patients deserve no less.’’

Those consultants that will be involved in further round one interviews over coming weeks should note carefully the requirements we have insisted upon with regard to structured, in-depth interviews and the availability of application forms and full CVs for all applicants.

This email is being sent now to bring you up to date on discussions today. I shall write to you again next week as discussions unfold.

Bernard Ribeiro CBE President The Royal College of Surgeons of England

07 March 07

There have been several important meetings over the last few days at which the current situation with regard to MTAS has been discussed. I shall be writing to you again in the next day or so with detailed information about these discussions and I will be issuing a press release.

In the meantime can I inform those of you who will be involved in interviews at ST1, ST2 or ST3 level that it has been agreed by Council that these should be conducted only with CVs available for all candidates and the opportunity to probe trainees fully with regard to the range of their abilities, to ensure that the best candidates are selected.

Bernard Ribeiro CBE