Association of Surgeons in Training
From Mmc
21 march 07
letter from Association of Surgeons in Training to Professor Douglas
Dear Professor Douglas,
Re: ASiT Call For Immediate Halt to the MTAS Process
The Association of Surgeons in Training represents surgical trainees from all specialties and at all levels with a voluntary membership of over 1930 trainees, and networks with all of the surgical specialty trainee bodies to represent the needs of trainees to promote excellence in surgical training. We had outlined to the review group, in our letter to you on Friday 16th March, the minimum criteria that had to be achieved in order that we could continue our support of the review process.
We were disappointed to read the outcomes and proposals form the review group announced on Friday 16th March in the Department of Health press release, combined with the nature of the responses in the debate in response to the Urgent Question in the House of Commons on Monday 21st March by the Secretary of State for Health, where she was unable to satisfactorily reassure regarding the opportunities for employment, and to address the make-up of the review panel. Furthermore, we believe the reassurances by the secretary of state that the application process had undergone Quality Assurance to be incorrect and would challenge what these processes were.
These factors cause us such grave concern that we now acknowledge that our proposals cannot be met, and we have no faith in the review body, as a whole, to deliver the requirements of surgical trainees. The inability of the Department of Health to openly and honestly reassure the public and the profession these processes have been carried out in an appropriate and timely manner leads us to believe that we can no longer trust the process to deliver its promises.
ASiT call for the irreparably damaged, MTAS system to be halted, and the outstanding interviews suspended with immediate effect. We strongly believe that the only viable option now available is to return to the previous deanery based application and selection methods for selecting those people for entry into higher surgical training.
On behalf of Surgical trainees, we can no longer advocate support for a system, when the review process outcome poses even more unanswerable questions, and has the potential for even more inequality in the process, than even the original system itself. ASiT strongly believe that the review panel should be disbanded and the responsibility for further addressing the selection methods for each specialty be devolved back to the relevant Royal Colleges and Specialty Associations.
It is therefore with regret that we must also call for the abandonment of commencement of the run-through grade and specialty training, of Modernising Medical Careers, due to commence in August 2007. We believe that a return to deanery based shortlisting and selection methods may unfairly discriminate against the more junior trainees at each level of application, therefore the lack of a clear transition period with adequate opportunities for entry in 2008 and 2009 could seriously disadvantage these trainees if selection at all levels were to occur at this time.
We have fully considered the suffering and anguish that this withdrawal may cause to trainees who have been shortlisted and who have already received interviews, and it is unfortunate that this action is required at all. However, we now strongly believe that the proposals suggested may further disadvantage even these trainees due to the additional insecurities and inequalities suggested. We will provide whatever support possible to these individuals in order to aid a smooth adjustment back to the previous selection processes.
We are extremely disappointed that the level of investment of public funds in getting to this stage has resulted in such a catastrophic implementation of a process that should ultimately be of benefit to the training of surgeons, which we were attempting to resolve through communication with the review panel, however, we can no longer justify further expenditure in such an inequitable system, that will no longer provide the public with reassurances that they will be treated by the best doctors in the future.
ASiT will continue to represent the views of surgical trainees to the Surgical Royal Colleges and Specialty Associations, and are happy to work with these organisations in order that the needs of surgical trainees are adequately represented in the selection processes for the future, and to avoid the critical errors of this experience. We look forward to developing the work in order that a satisfactory implementation of MMC can occur in 2008.
We look forward to hearing a statement from the review group to acknowledge a halt to the process, and a return to a process that can restore the confidence of the public and the profession,
Yours Sincerely,
Conor Marron
President
Association of Surgeons in Training
at The Royal College of Surgeons of England
35/43 Lincoln's Inn Fields
London
WC2A 3PN
5 March 2007
LETTER FROM Association of Surgeons in Training to the Media
"Further to our telephone conversation last week you may be interested to know that a selection (interview) panel in the West Midlands deanery has just stood down and refused to carry out interviews today to appoint surgical trainees over major concerns that no long-listing of applications was performed, and that inappropriate people have been shortlisted don the basis of experience and immigration status. The panel had no-confidence in the process and have therefore refused to go through with the interviews.
As you may be aware, the West Midlands is one of the largest deaneries in the country and I strongly suspect that the decision here will have a knock-on effect and similar things replicated throughout the country.
This may well spell disaster for the MTAS system and hence cause major problems and the system to fail. This would represent a huge disaster for the public given the amount of public funds invested in the MMC and MTAS programmes, which would be rendered effectively useless at this stage. This is now a story that should be drawn to the public's attention.
I have attached a copy of a letter of invite that we had sent to the Rt Hon Patricia Hewitt last week to which a response is awaited. This is an initial approach and a more strongly worded letter will follow this week as it is now time that the Secretary of State for Health stood up publicly and stated the position of the DoH. I had alluded last week to a background document which I have also attached, but I hope you will forgive me that it is not in ideal format just at the minute but I think that given developments that this will help you get to grips with the interlinked problems facing medical training.
With regards to this process:
We communicated with members of the interview panel in the West Midlands last night to express our concern over the proposed action being considered and we felt that the interview process should continue and that if the candidates were not of the highest possible calibre that they should not be appointed. We expressed concern that some very good candidates may well have been shortlisted and appointable, and that a failure to carry out the interviews would be of detriment to these people.
Whilst we are disappointed with this outcome, we fully sympathise and understand the position of the panel in the West Midlands, and wish to support their decision fully given the fact that no long-listing had occurred. We now feel it extremely important that we now work together to find a method of selecting the best candidates for surgical training in order that we can protect the high quality of surgeons that the training process will deliver as consultants to deliver patient care in the future.
This may involve a complete abandonment of the MTAS selection process for surgery and for individual deaneries to advertise, shortlist, and recruit individuals this year using the same manner as previous years. Whilst the MTAS system has tried to move to a more robust system of selection of surgeons for the future, this has proven not to have worked due to the intense timeframes involved and the inherent complexities of the processes that were tried to be implemented. It is frustrating that a huge amount of public funds and time of individuals has been wasted through the pressure to introduce a system that is not fit for purpose within a timeframe that was pointed out, by us, in November 2005 to be too short.
Whilst we are disappointed that this process has fallen down, we feel very strongly that we now need to move forward with a process that will be fit for purpose and allow us to be able to appoint people to the grades applicable for entry to the MMC process. We support the introduction of MMC, but our concerns remain over the feasibility, reliability, and validity of the MTAS system to accurately distinguish those doctors who are suitable to progress in training. We feel at this stage that abandonment of the MTAS system and the selection of individuals by the appropriate methods used previously is now imperative to allow the process to move forward urgently within the timeframe allowed."
Regards,
Conor
Conor Marron President Association of Surgeons in Training at The Royal College of Surgeons of England 35/43 Lincoln's Inn Fields London WC2A 3PN
