St Georges Consultants

From Mmc

--Admin 18:10, 12 March 2007 (EST)

Dear Mrs. Hewitt,

I am writing on behalf of the consultants at St. George's Hospital, London, to express our views about the MTAS process.

We feel that the process is so fundamentally flawed as to be incapable of delivering its aim of selecting trainee doctors for appropriate training posts. The reasons for this are many, but amongst them are:

The IT software has not worked well - some posts have not appeared on the list of available jobs, some applicants have been unable to submit their forms, doctors have been given interviews in different locations at the same time, some doctors ineligible to be short-listed have been.

The short-listing process has not given adequate time for those short-listing to scrutinise the forms they have been sent (for example, some consultants have received 2-300 applications on Thursday evening to be completed and returned by Monday). Where this has not proved possible, short-listing has gone ahead with less than 50% of the scorers responding.

Many applicants had not appreciated that their forms would be marked in sections, by different consultants. They have therefore not repeated relevant items of information in each section in which it could be scored. Those scoring part of a form cannot award marks for information which is contained elsewhere in that form.

There have been examples of fraud, with applicants utilising fabricated examples sometimes derived from the internet, to support their application.

Insufficient weighting has been given to past experience, academic achievements etc. which should be powerful discriminant of suitability for further training.

There is no evidence that we are aware of to validate the capability of the scoring system to predict successful completion of training for the individual being scored.

There are too many other concerns to list them all here.

We have considered three courses of action:

1) Allow the process to continue as it stands,

2) Accept that the system will be modified after round 1, and therefore continue to interview for that round,

3) Withdraw from interviewing and ask for a complete overhaul of the selection process.

With the exception of two individuals, the consultant body supports complete withdrawal from the process, and request that it is halted immediately.

The only fair course of action is to re-run the short-listing process, having corrected the deficiencies above, and others not listed. Then, and only then, would we be prepared to participate in the interviews.

We acknowledge that this will disadvantage those who have already been placed by the scheme, but the risk of proceeding with such a flawed process we believe outweighs this concern. I have spoken to some trainees who are in that position, and they recognise the validity of this argument.

If re-short-listing is not an option, we propose that selection for training posts for August 2007 is undertaken by the pre-existing mechanism, whilst MTAS is redesigned. There are many lessons that can be learnt from the attempted implementation which could help develop a system in which the profession had confidence.

We would further propose that rather than attempt to introduce the redesigned system countrywide simultaneously, it is piloted in several sites in parallel with the existing system in order to identify any problems with the software and to provide objective evidence of its ability to select the best candidates for each training post.

The argument that MTAS has been used successfully in some areas (e.g., South West England) is invalid, as it only considers those who were interviewed, and does not assess whether the right doctors were selected for interview in the first place.

We have grave concerns that the future careers of many excellent doctors will be blighted by this process if it is not stopped, and even greater concerns that the whole delivery of medical care in the UK will suffer because the best suited doctors for individual training schemes may have been overlooked. The consultant workforce of the future will therefore not be of the standard our population deserves.

The decision announced this weekend following consultations between the profession and the DoH that the process is to be extensively reviewed prior to progressing to round 2 reinforces our concern. To accept that a system is so flawed as to be unfit for purpose, but to still to accept the outcome of its first round is neither logically consistent nor morally defensible.

Michael Bailey, Medical Director, on behalf of the consultants of St George's Hospital