Letter from Guy's and St Thomas' Trust
From Mmc
Senior Clinical Staff Committee
Guy’s & St Thomas’ Hospitals
London SE1 7EH
23rd March 2007
PRIVATE & CONFIDENTIAL
Prof Neil Douglas
Royal College of Physicians
9 Queen Street
Edinburgh
EH1 1JQ
Dear Professor Douglas,
Guy’s and St Thomas’ Foundation Trust is one of the flagship hospitals of the NHS with a strong reputation for clinical excellence, effectiveness and modernisation. As consultants working at GSTT we are only too aware that the clinical effectiveness of the hospitals depends upon the quality and dedication of our junior doctors from whom we demand and receive high levels of performance.
We are therefore deeply concerned to learn that approximately 40% of our juniors have not been short-listed for a single interview in Round 1 of the Medical Training Application Service (MTAS) process adopted by Modernising Medical Careers. We find ourselves, not surprisingly, having to support a group of distressed, angry and, because of a lack of helpful feedback from MTAS, disillusioned junior doctors, many of whom we know are outstanding trainees. We appreciate that medicine has always been a competitive career but this treatment of our junior doctors has been uniquely appalling.
The position of doctors who have already trained for several years and who are applying for ST3 positions is particularly difficult as they may have limited career options if they are not appointed. The recent recommendation of the review to ensure that all of these candidates receive at least one interview is to be welcomed but this will only cover up on this occasion a major failing of workforce planning by MMC which needs to be addressed systematically. MTAS has been understandably derided for rejecting the well tested methods for selection and ranking of doctors used throughout their previous education and for imposing an unproven and untested system that, when used in isolation, has no clear validity and which is evidently unsuited to the vital task of selecting the next generation of consultants. The only fair alternative is to return to the use of the curriculum vitae and other indicators of ability and achievement both for short-listing and at interview.
In addition we are very concerned that the rigidity inherent in the MMC process not only reduces flexibility in training and devalues career broadening experience such as work abroad or full time research, but is also extremely family unfriendly and will consequently downgrade the quality of the consultant workforce on which the future of the NHS depends.
So concerned are some colleagues here at Guy’s & St Thomas’ that a significant proportion of consultants would propose complete withdrawal from MMC/MTAS.
We urge you to:
1. Incorporate the curriculum vitae back into all stages of the selection process 2. Not to allocate any posts until all suitable candidates have been interviewed 3. Interview all applicants who meet specifications once and use this information for all their applications 4. Ensure that there are alternative career pathways both for candidates who are not appointed in the current round and for those who want to take a more flexible route 5. Make sure that for next year this current system is dismantled and replaced by a system that has the confidence of consultants and trainees
Yours sincerely,
Dr David Treacher Dr John Rees Dr Nicholas Hart Chair SCSC Deputy Chair SCSC for recently appointed Consultants
Cc: Prof E Paice Dean Director, London Deanery, Stewart House, 32 Russell Square, London WC1B 5DN Cc: Right Honourable Patricia Hewitt MP, Secretary of State for Health, Richmond House, Whitehall, London SW1A 2NS
This letter was drafted following a recent meeting of senior clinical staff and was then E-mailed to all consultants for their comment. They were asked whether they supported this letter and to reply within 48hours particularly if they felt unable to give their support. The overwhelming rejection of the MTAS process at Guy’s & St Thomas’ is reflected in the results of this survey:
Of 125 respondents, 97.6% supported the letter and 30% of this group favoured complete withdrawal from the MTAS process if fundamental changes were not made. Of the 3 consultants (2.4%) who neither supported the letter nor wished to withdraw, one was involved in MTAS and the other two felt MTAS should be persisted with but did acknowledge that there were problems in the system, particularly with implementation locally.
