Fiasco over doctors’ jobs forces head of training to resign
From Mmc
Fiasco over doctors’ jobs forces head of training to resign
Nigel Hawkes, Health Editor
The head of a controversial scheme for training doctors was ejected from office yesterday by the sheer weight of medical opinion.
Professor Alan Crockard resigned as national director of Modernising Medical Careers (MMC) over the failure of the system for selecting junior doctors for training jobs.
Critics say that the system is so unreliable that excellent doctors will be rejected and poor doctors appointed, damaging the quality of care and risking patients’ lives.
Junior doctors and consultants have condemned the Medical Training and Application Service (MTAS) as unfair and incompetent. The recommendations of a review panel set up to rescue the process were rejected by junior doctors.
Professor Crockard has resigned with immediate effect. Lord Hunt of Kings Heath, the Health Minister, said: “I would like to thank Alan for his enormous contribution to Modernising Medical Careers.
“Alan’s work led to the successful establishment of the Foundation Programme for the early years of postgraduate medical training, which has been widely acknowledged to be a success. I appreciate that it has been a difficult time for junior doctors and would like to reassure them that we are listening to their concerns and working with their representatives to find a fair solution to this complex issue.
“I would like to reconfirm our commitment to MMC which aims to recruit and train the best doctors to provide the best possible patient care.”
Professor Crockard, a neuro-surgeon, was recruited in 2004 to run MMC, a system for revamping medical training. This turned the old system upside down, replacing what amounted to an apprenticeship with a scheme designed to teach and measure competencies in all branches of medicine.
While many doctors have doubts about MMC, believing that it is narrower and less flexible than the old scheme, it was the failures of the computer-based MTAS — a small part of the system — that brought Professor Crockard down.
Last year, when the first doctors to be trained under MMC graduated, there was a huge row about the failures of the computer system to place them reliably into junior doctor posts, known in the MMC jargon as F1 and F2 posts.
But the problems were as nothing compared with those that occurred this year, when the task was to place junior doctors in training posts that would lead eventually to consultant positions. More than 30,000 were competing for 22,000 places. Success would put them on course to become consultants, failure could mean a blighted career.
The computer could not cope with the volume of applications, limited the applications the junior doctors could make and failed to produce adequate shortlists for interviews.
Many outstanding candidates failed to get any interviews in the first round because the application forms failed to recognise academic excellence adequately. Others were shortlisted despite not being qualified for the jobs.
The Department of Health appointed a panel to try to rescue the process, but its recommendations have not found favour with junior doctors.
Dr Matthew Jamieson-Evans of Remedy UK, the body that organised mass medical protests in London and Glasgow over MTAS, said: “Resigning is the honorable thing for Professor Crockard to do. We bear no personal ill-will to him, but it is right that somebody should take responsibility.
“This is only the first chapter. Very very few doctors are happy with the recommendations of the review panel.”
Missing out
–– Professor Alan Crockard, above, was appointed national director of Modernising Medical Careers (MMC) in 2004
–– Under the old system, doctors graduated from medical school after four to six years, spent a year working in a hospital as a preregistration house officer (PHRO), then took a series of “rotations” lasting six months each as senior house officers (SHOs) for three years or more
–– After an unspecified time, and after passing Royal College exams, they could apply for specialist training, leading to the possibility of a consultant post
–– Under MMC, undergraduate education still takes four to six years. The doctors apply for a two-year Foundation Programme (F1 and F2)
–– The next stage is to apply for “run-through” specialist training, to take them all the way to becoming consultants. The post of SHO is abolished this year, so SHOs are also applying for the available posts
–– Those who do not get run-through posts can apply for one-year posts
–– The fear is that if they miss the boat this time they may never catch up and will have no chance of becoming consultants. The selection process for GPs has worked much better
