On the channel 4 news the other day Victoria McDonald did a piece on MMC (modernising medical careers), MMC being a scheme that is being rushed through by the current government. The news piece presented a very balanced view of the story and amply demonstrated several flaws in the policy.
In many junior doctors' opinion the new system is flawed in principle, is being rushed through in a chaotic fashion and allows no flexibility for applicants. Add to this the fact that non-EU graduates' applications are being put straight into the waste paper basket, while any EU grad can apply freely; independently of the quality of their medical education or command of the english language.
I emailed the Deputy CMO as he was interviewed on the C4 program and was pretty unfair with his comments. He stated that juniors had to accept that they couldn't become cardio-thoracic surgeons in East Anglia and would have to accept what they were given!
His comments took the whole issue completely out of perspective. No junior doctor expects their choice of career to be exactly met 100% of the time! This is what the Deputy CMO was implying!
To get things clear: MMC forces juniors into applying via the centralised system known as MTAS. You have to apply to deaneries that are absolutely huge areas and if you are offered a job, you have to accept it before you know the precise location and details of the job! If you are applying with a partner, wife +/- children then you will have to pray hard to make sure you are anyway near your partner. The new scheme does allow you to 'buddy' your application with your partner, but this drags the better applicant down to the level of the weaker applicant; what a recipe for resentment for years to come!
The old system of applications had its flaws no doubt. The new system had the potential to fix most of these, but down to a mixture of political expediency and sheer incompetence the situation is getting worse! Juniors also have to choose their specialty much earlier than in years gone by, and anyone with half a grey cell could predict that many will be seeking to change specialties within a year or so; guess what? there is no flexibility to change specialties built into the system! A consultant I've chatted to expects even with a perfect selection process (MTAS ain't that!) then you can expect at least 10% of people to change specialties, and this isn't even taken into account!
Anyway here's the Deputy CMO's response:
"Thank you for your email following the Channel 4 news interview shown on Monday evening and I'm sorry you took offence at my comments.
The point I was making in the interview was that in today's healthcare environment, doctors must be flexible and realistic about their career choices. I stand by my comment that medicine is competitive, and has always been so. Before MMC, not all junior doctors got into training programmes. That was the reality. MMC is not changing that, but it is making it explicit for the first time, which I believe is a far more honest approach than has been adopted in the past. This year, however, presents the best chance for junior doctors to get a training number as the changes brought about by MMC are being implemented. Doctors have an excellent chance of getting into training and the vast majority will do so - perhaps just not in their first choice of specialty or location.
I simply do not agree with the statement made on the programme that because medicine is a vocation that it is essential that doctors have a right to a free choice in their career. This does not reflect the reality of life, nor does it reflect our professional obligation to the public.
With best wishes"
Well that doesn't convince me at all I'm afraid. Given the predictions that some have made, it seems many thousands of juniors will be out of a job come August 2007.
'Training posts'- depends what he means by this as FTSA posts are 'training' but many consultants openly admit these are dead end jobs and have warned people not to take them under any circumstances!
I disagree with the Deputy CMO and if one counts 'training posts' as only the ST (Specialist training) posts, then there will definitely be thousands without a career path from August.
The beauty of the old system was it was far more meritocratic than the new MMC system. It gave you flexibility to have a stab at what you wanted to do for a few years, and if unsuccessful you became more experienced and at least you had been given a fair chance
Contrast this to now, where you have to choose very early indeed, and the system is overtly not meritocratic. MTAS is a big stinky politically correct sewage works of a selection system. It selects people based on their ability to bullsh*t and does not take into account or give appropriate weight to actual training and experience achieved.
So we have now torn down a system that encouraged further training and experience, and a fair competition for jobs that resulted in a relatively meritocratic process. And this has been replaced by a disorganised shambles that is not meritocratic in the slightest, and that will unfairly cast thousands of potential specialists into the bog of service providing monkeyhood. The specialists created by this system will not be as good; they will not have to graft for their place as in days of old (gaining valuable training and experience) and MTAS will select the talkers of tripe and not the good workers.
for some real information about MMC see: http://www.remedyuk.org/
and a good piece in the telegraph:
http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2007/02/12/hjunior12.xml
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