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British government targets U.K. medical training program for improvement
Some junior doctors who did not obtain training posts are in temporary positions until October.
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The Aug. 1 start date for junior doctors in the United Kingdom passed without the forecasted catastrophes, but as predicted, a large number of junior doctors did not obtain training posts.
This year, the number of specialty applicants was overwhelmingly larger than the number of available positions, as previously reported by Orthopaedics Today International [“Changes to British junior doctor program lead to protest among trainee applicants,” May/June issue]. This swell in applicants, coupled with the introduction of the Modernizing Medical Careers (MMC) program and the failing Medical Training Application Service (MTAS), led to outrage and protests among junior doctors.
Now, the National Health Service is taking steps to improve MMC and MTAS for next year.
“As would be expected, there is a huge amount of resentment and anger about the fact that MMC and MTAS were railroaded through in such a hurried fashion without any proper assessment of whether they would work logistically,” Sebastian J. Dawson-Bowling, MRCS, vice president of the British Orthopaedic Training Association (BOTA), told Orthopaedics Today International.
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“The whole MTAS system … was completely unable to cope with the volume of work generated. … Had a pilot run been attempted in one or two regions, this would have been immediately apparent.”
Some in temporary positions
Dawson-Bowling said that many junior doctors are facing unemployment, or have been forced to move across the country for positions under the MMC system.
Clare Marx, CBE, FRCS, chair of the Specialist Advisory Committee (SAC) in trauma and orthopaedics [training] and vice president-elect of the British Orthopaedic Association (BOA), believes that most junior doctors got jobs. “We’re going to find out over the next 3 to 6 months exactly how many people haven’t got jobs, but I would say the vast majority are in employed. Unfortunately, many will not be in training posts,” she told Orthopaedics Today International.
The MTAS Review Group, which was established in March, instituted a rescue plan for some junior doctors who did not receive training posts, according to David L. Hamblen, PhD, FRCS, consulting editor for Orthopaedics Today International. This plan places junior doctors in temporary positions until October, but these positions are often unrelated to their desired medical careers.
“One of the next crises that’s on the horizon is what happens in October when … a considerable number of people in these holding posts lose them,” Hamblen told Orthopaedics Today International.
Road to improvement
The National Health Service and other government entities are taking steps to improve MMC next year.
According to Hamblen, the MTAS Review Group suggested that additional training posts be created in specialties with high competition ratios or those specialties identified as “projected workforce growth areas.”
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In addition to an enquiry, headed by Prof. Sir John Tooke, into the MMC program and MTAs, the Health Committee of the British Parliament has also launched an inquiry, headed by Prof. Sir John Tooke, into the MMC program and MTAS. “In other words, the government has taken this quite seriously,” Marx said.
The committee is accepting written evidence from organizations and individuals, and will focus primarily on whether MMC principles are sound, the strengths and weaknesses of MTAS, and the number of international medical graduates eligible for training in the United Kingdom.
The BOA, SAC and BOTA have each submitted evidence and recommendations to the Tooke enquiry, according to Marx and Dawson Bowling, and intend to do the same for the Select Committee. Among their recommendations, the BOA and SAC again asked for a further transition period.
“We’ve always said that … we wanted a 2-year transitional period at minimum to help people to get into the correct post,” Marx said.
For more information:
- Sebastian J. Dawson-Bowling, MRCS, a specialist registrar in the Southeast Thames orthopaedic rotation and vice president of the British Orthopaedic Training Association, can be reached at +44-127-320-5613; e-mail: sebd_b@hotmail.com. He has no financial conflicts to disclose.
- David L. Hamblen, PhD, FRCS, professor emeritus at the University of Glasgow and consulting editor for Orthopaedics Today International, can be reached at 3 Russell Drive, Bearsden, Glasgow, G61 3BB, Scotland; +44-141-943-1797; e-mail: dlhortho@doctors.org.uk. He has no financial conflicts to disclose.
- Clare Marx, CBE, FRCS, chair of the Specialist Advisory Committee (SAC) in trauma and orthopaedics [training] and vice president-elect of the British Orthopaedic Association, can be reached at Ipswich Hospital, Heath Road, Ipswich, Suffolk IP4 5PD, England; +44-1473-702-030; e-mail: clare.marx@ipswichhospital.nhs.uk. She has no financial conflicts to disclose.