Saturday, 28 April 2007

Surgeons have bigger balls?

The president of the Royal College of Surgeons has written to his members:

"To Members and Fellows of The Royal College of Surgeons of England

The review Group met again on Wednesday 25th April and I am writing to give you an update on the present position.

You will recall that I put to an earlier meeting, a proposed scheme to enable those who are able, but are not successful in securing a ST3 post this time around, to continue their training in what I called ‘transitional training posts’. During the opposition Day Debate on the 24th April the Secretary of State for Health, Rt. Hon Patricia Hewitt MP, agreed the need for additional training posts.

“As part of the review, we are working urgently with the royal medical colleges and the NHS to establish the need for additional training posts—which will of course have to be approved by PMETB—including one-year placements and more senior posts. We are also considering how we can provide more effective training support for doctors in service posts—that is, non-training posts—to maximise their development opportunities. That is the issue on which Professor Douglas’s review group is now focusing, having dealt with earlier problems involving the application process, and it will make a full statement—as will I, to the House—on the support that will be available very shortly.”

Since I last wrote to you, I have discussed my plans with the Senate (with representatives of all the surgical colleges and specialist associations), ASGBI and ASIT. In the light of all of this feedback, I have refined the plans for additional training posts, in England, which have the support of all of these bodies and which I think will offer the best career prospects for as many of our able trainees as possible.

The plans are currently with a working party of the Review Group to consider the detail.

In essence, selection for specialty training should be at the ST3 level for the next three years and the number of run-through training posts at ST3 level should be expanded. There should be a concomitant decrease in the number of training posts available at ST1 in 2008 and in both ST1 and ST2 in 2009. The numbers at ST1 and ST2, for this year however, will remain unchanged.

All ST1 posts should be FTSTA’s. There are c.760 ST1 posts for surgery in England (910 for the UK)
All ST2 posts should be FTSTA’s. There are c.808 posts in England (1043 for the UK)
There should be an expansion in ST3 numbers over a transitional period of three years from 2007 to 2009.

The case for expansion at ST3 is to meet the College’s stated policy in relation to the future workforce required to provide an acceptable quality of service and to continue to ensure patient safety.

You may be aware of the Independent Review into MMC, announced earlier this week by the Health Secretary to be chaired by Professor Sir John Tooke. I am attaching the terms of reference for information. He telephoned me several days ago and I had the opportunity to discuss the review with him. I have written to him today, expressing my concern that there is no specific mention of the role of PMETB in the terms of reference. I have asked him to confirm that PMETB’s involvement to date and its future is addressed in this review. I will expect changes to be made before we can offer our support.

Terms of Reference for Independent Review
(full terms of reference then follow)"

It seems that the goalposts have been shifted yet again, how on earth are candidates meant to keep up with these almost weekly changes and how stressful is this never ending mess? The proposed amendments essentially mean that the President has no faith in MTAS to select the right candidates as there will be no run through training posts at the lower levels of ST1 and ST2. These proposals are an improvement however it is yet another example of how unfair the process has become. Clearly there are some candidates who would have applied for ST3 rather than ST2, if they had been aware of these conditions.

It is excellent that he has asked for a definitive answer as to PMETB's role and future, an eye must be kept on this area; PMETB are now in the spotlight and will not be allowed to creep in via the back door.

In my opinion balls of steel would be demonstrated by the President if he were advising a scrapping of MTAS, walking from the review group and proposing an immediate return to local applications. He may have demonstrated tougher balls than the RCP President, but that doesn't say much does it?


Anonymous said...

What level did the ferret fancier apply at?

Anonymous said...

If all ST1/2 will be FTSTAs, what will happen to those ST1/2 who did not tick the FTSTA box because they wanted a run through post?!!!!!

Anonymous said...

Surely the ftsta box is now obselete.

Garth Marenghi said...

The ferret fancier applied for the P45 slot.

Anonymous said...

The only way forward now is, ALL doctors should leave medicine!

I bet they'll find a way to mess this up too if they tried! What a stew of blunder after blunder after blunder! :-)

“Oh wad some power the giftie gie us To see oursel's as others see us! It wad frae monie a blunder free us, And foolish notion”
;-)) Hehehe

Garth Marenghi said...

an interesting idea,
in theory if you could get everyone on board it would give doctors amazing power,
unfortunately there are always going to be that sizeable selfish bunch,
I like the idea though!

34500 doctors relocating! said...

(ALL doctors should leave medicine!)

Let's all go to Australia <@_@>


Anonymous said...

I'm guessing surgery at ST2

Anonymous said...

I think this is the best MMC blog on the net. But I'd like to hear more about the ferret fancier's personal experience as well as just the latest MMC news and gossip.

mens sana said...

I did hear a rumour from a "usually reliable source" that the RCS council had more or less agreed to pull out of the whole MTAS process but that this decision has subsequently been softened, presumably due to pressure from on high

Garth Marenghi said...

mens sana,
very interesting indeed, sounds likely doesn't it?

Anonymous said...

IMO the Royal Colleges of Surgeons should have applied for exemption from EWTD back in 2002.

Then at least they might have been able to offer proper surgical training posts.

They should also have never given up training responsibilities without a fight, but that's an obvious statement to anyone who's not on a Royal College Council and hoping for a gong, innit?

Anonymous said...

Last year, I was asked to apply for a seat on the Royal College of Surgeons Trainees SAC.

Basically I was asked (by College staff) because I've had a huge amount of involvement in training issues and Royal College events, and hence I was the obvious choice.

So I put in my application, and it was rejected. Why? Apparently because there were 'a large number of high quality applicants and I didn't make the cut.'

Bullshit. If the otehr applicants were such high quality, why had they never been involved in training and educational issues before? Why hadn't they given up their free time to help out and get involved with Royal College activities? How had such 'high quality applicants' appeared out of thin air?

I had no trouble finding out. The SAC seat was allocated by reading the list of applicants' names to the current committee, and letting them pick who they wanted. The guys they picked are brown-nosing slimy sleazy types who've never demonstrated an interest in training. Their only interest is in sitting on a committee. Sadly the current committee is made up of the same types, and they simply voted on their cronies.

And we wonder why these idiots are letting us down? They were never properly elected to represent us in the first place. They're there for the glory.

Garth Marenghi said...

sounds shocking but unsurprising,
seems like that has happened in all the Colleges and certain Unions,
there is nothing worse than these committee types,
the cronies then breed more cronies and on and on...

what's the fix?

Anonymous said...

Agree, it's the same in the BMA. Any old idiot can get themself 'elected' onto a committee by simply turning up.

That's the reason I stopped having anything to do with the JDC. They have 6 people in a room, they elect each other, then they claim to be representing the profession.

I was once asked to go along to one of the craft committees, and was told all I needed was one signature from a BMA member to get myself officially 'elected' onto that committee. What a load of bullshit. Not to mention that only 9 months ago, the head of the BMA's attitude was 'MMC is going ahead, there's nothing we can do about it. What's next on the agenda?'

What we need in both cases is transparency. This should be easy in the internet age.

I propose that for future appointments to SAC and JDC seats (anyhting where the elected member is representing the profession) they provide a CV and application letter which is visible to the entire profession they are claiming to represent. All members of the BMA / Royal COllege should be able to log in and cast their vote in an informed manner.

What do you think?

Garth Marenghi said...

I am in total agreement.

I think the more open and transparent an institution can become the better it will function.

As you say, in this day and age the internet has made it much easier to survey people's opinion and do things more democratically.

There is no reason why the BMA could not do this. They are of course reasons why they don't- the committee nerds would never get elected in a more democratic system.

I think there is room to explore this, there are some BMA JDC who have good intentions, a minority admittedly.