RCP Presidential e-bulletin: 15 March 2007

From Mmc

From: The President [1]

Sent: 15 March 2007 15:33

Subject: RCP Presidential e-bulletin: 15 March 2007

MODERNISING MEDICAL CAREERS

I am not given to hyperbole, but it is difficult to overstate the effect of the last fortnight on British medicine. Those of you working in the UK will have been immersed in it and receiving e-mails from me; those working abroad may be puzzled, so read on. I am devoting the whole of this bulletin to Modernising Medical Careers (MMC) and its selection process, the Medical Training Application Service (MTAS).

We have seen hospital doctors, both trainees and consultants, focus their dissatisfactions and frustrations of the last few years on the fraught and failing appointments system (MTAS) to the new training programmes of MMC. Hindsight is always powerful and few people anticipated quite the anger and frustration that have welled up as a result of the inevitable inequities from 33,000 plus doctors applying for 18,000 plus training posts.

On one level, there have always been disappointed junior doctors who have failed to make progress in their chosen but popular specialty (but the failure has never looked so transparent or irrevocable). On another level, the process has brought to the surface the huge anxieties that Fellows and Members have had about the Postgraduate Medical Education and Training Board (PMETB) requirements for competency-based assessments. While there may be some sound educational principles behind this form of assessment, there is a widespread feeling amongst clinicians, shared by me, that this cannot yet be translated into fair and equitable selection processes. It is the concern that the tools in place have not allowed us to select the best specialists for the future that has brought the system to the point of breaking down.

And so what of the accusations laid at the door of the Colleges that they should have prevented this? Of course the Royal Colleges have been undermined on training issues since the government set up PMETB with the explicit role of taking over our statutory responsibilities for training. We have worked with PMETB, with MMC and with MTAS to make the best of a system about which we have had reservations. We have achieved real improvements in many areas, but in others have expressed serious concerns that have been ignored. Consequently, we reject the government’s attempt to deflect blame by implicating us, reported in the media recently.

We have to move on now, and injustices will be compounded if we walk away from the selection process. We have achieved real short-term improvements to the first and second rounds, but must now use the hard-learned lessons to bring some common sense back into selecting and training the specialists of tomorrow. This is the only way to achieve the standards of care that patients deserve.

Professor Ian Gilmore President, Royal College of Physicians