President's Message 23 March 2007
From Mmc
MTAS
There have been problems with the Medical Training Appointment Scheme (MTAS) for the appointment of the first specialist trainees under Modernising Medical Careers. I led the debate on this in the Academy of Medical Royal Colleges, participated in the emergency meeting with the Secretary of State for Health on Monday March 5th and was “rewarded” by being appointed chairman of the review process. Our principle concern has been to be fair to all applicants. We are also very aware that Fellows, Members and other NHS staff have put a huge amount of work into this process. In addition many excellent trainees have been interviewed and could be offered training posts, thus we needed robust evidence of irreparable defects before halting a process which seems to have worked in some areas and some specialties – especially general practice.
The review process is on-going and the most recent decisions of the group can be read here on the College website and here on the MMC website. I strongly believe that the proposed plan can be the kernel of a fair system of ensuring the right trainees get into the right jobs. I am very happy to receive feedback from Members, Fellows and Associates about the proposals.
I am grateful to all who have previously provided me with so much useful information to help recognise the deficiencies in MTAS, I am sorry that I have been unable to respond personally to all you but many thanks indeed.
I am acutely aware that my involvement and that of the Colleges is high risk, as if we approve a defective system the Colleges may take the blame, rather than those who caused the problem in the first place. I am also personally very annoyed that there has been negative spin blaming the Colleges for being party to designing the MTAS process. The advice I gave to MMC and the Deans on how to design a selection process at a meeting on 8th June 2005 is still on the MMC website but in case they now remove it the key slides are now on the College website. I also said that if the Colleges’ advice was not followed the consequence would be similar to that of many other NHS reforms and unfortunately this has come to pass to the understandable distress of a generation of trainees. The profession must unite and ensure the trainees are treated fairly and that the profession’s standing is significantly improved as a result. We are in the driving seat and it would be disastrous to lose that position. College Priorities
We are at a stage of marked change in medicine with enormous turbulence in post graduate medical education and the introduction of re-certification for specialists in the UK. The College has to evolve to meet these developing needs of Fellows and Members. Changes to the way doctors in the UK are trained and assessed requires a new approach and Council is considering the balance of our services to ensure we provide the best possible support to physicians throughout their careers.
The College is investing, in collaboration with the other Royal Colleges of Physicians and specialist societies, in developing a series of new knowledge-based assessments for specialist trainees. This comes at a time when changes in training and in immigration rules have resulted in decreased income from MRCP(UK) and the introduction of PMETB may result in reduced funding to our training body for physicians, previously called JCHMT but now extended and relaunched as JRCPTB (www.jrcptb.org.uk) - the Joint Royal Colleges of Physicians Training Board.
The UK government has now published its proposals for the future regulation of doctors. All doctors working in the UK will be required to participate in what is being called relicensure and in addition consultants will be required to recertify in their specialty every 5 years. The College has a key role in supporting Fellows and Members to demonstrate their ongoing fitness to practice and this will build on our current support for CPD. We are working with our colleagues in the other Royal Colleges of Physicians to define the standards and develop appropriate tools.
All this requires a careful approach to budgeting and a continual review of our priorities.
The last decade has seen enormous changes in the way physicians access recent literature with most doing this exclusively on line now. Thus we need to re-focus our Library services to decrease the emphasis on the modern library while preserving and keeping accessible our unique historic library. We have created a Library Trust to encourage Fellows and others to consider leaving legacies to the College to maintain and develop this internationally renowned collection for future generations. The Treasurer would be pleased to hear from any Fellows and Members who feel able to contribute.
Equally we have to consider the most effective ways of working to ensure that Fellows and Members wherever they live and work continue to benefit from belonging to the College. Council is taking steps to ensure that the College is financially prudent as we adapt to supporting physicians in the 21st century. We will be undertaking some restructuring of the College departments – in short we will divide the College into 4 main sections, 3 departments delivering services through Fellowship and Membership services, Education, Training and Standards and Examinations with all 3 supported by Finance and Facilities Management. This will allow re-deployment of managerial costs into services which directly benefit Fellows and Members.
Other improvements in the pipeline include more sophisticated password protection for the secure area of the website which will allow us to distribute more information and services exclusively for Fellows and Members quickly and efficiently. Web streamed lectures and on line CME with self assessment questions will be easily accessible to all Fellows and Members, most of it will be eligible for CPD credits. We will introduce a new directory of Fellows and Members to foster international collegiality and, to help us understand your needs better, you will be able to update your own records on-line with changes of personal details including specialist interests.
2007 will be a busy year as the College adapts to what will be the most significant changes in UK based training for over 30 years. Therefore I would also like to add a regular “Council News” bulletin to the new secure section of the website. This will summarise the strategic discussions and decisions taken at our Council meetings and encourage wider debate on the important challenges facing the College. I would be pleased to hear from any Fellows or Members about how we should adapt to meet these new challenges. Iraq
I was delighted to be able to speak at a meeting organised by the Dean of the medical school in Basra and held in Kuwait on Saturday March 4th. I spoke on the training of doctors and outlined the UK’s plans for more focused and potentially shorter training under MMC. I also discussed the proposed scheme for Iraqi medical teams coming for update courses in the UK; a scheme for which the Academy of Medical Royal Colleges is a lead member. Both these areas received considerable interest and I look forward to trying to help our Fellows and Members in Iraq more in the future.
Neil Douglas President
