TRAINING DOCTORS
Newly qualified medical students are being disadvantaged by the new training system
The Times January 15, 2008
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Sir, This year will be tough for many highly qualified medical graduates who are committed to a career in their chosen specialty. These doctors are being disadvantaged in the transition to a new training system. This highly skilled group, including many clinical researchers, will find few opportunities to access the higher specialist training they require to become consultants. We are repeatedly informed that the average competition ratio is 3:1 for all training posts. This obscures the real state of affairs for those former senior house officers (doctors less than midway through their specialist training), particularly in the competitive acute specialties, where the ratio may be as high as 20:1.
From data available to us, we believe that more than
40 per cent of UK graduate doctors seeking posts at these higher levels will be unable to access specialist training this year, because of an inadequate number of posts.
We continue to lobby health ministers to increase the number of training posts, to ensure that these good and committed doctors progress to consultant level to benefit UK patients and to reassure the public that their huge investment in these doctors has been worthwhile.
It is not too late to avert yet another debacle in the long saga of Modernising Medical Careers (MMC/MTAS), but the prospect of large numbers of UK doctors being unable to complete their training is now real.
Bernard Ribeiro
President, the Royal College of Surgeons of England
Ian Gilmore
President, Royal College of Physicians of London
Neil Douglas
President, Royal College of Physicians of Edinburgh
Judith Hulf
President, Royal College of Anaesthetists
Unless British graduates are protected and given 'priority' to 'British' speciality training, like every other country in the world, expect this saga to contune forever while doctors from the whole wide world are allowed to apply! Thus, crushing the the hopes and dreams of our young doctors as well as their continuing 'aspiration to excellence' on the way! You can also kiss Britain's position as world leader in medicine and medical innovation good bye forever! End of a golden era when British medicine was considered to be 'the best in the world !' It was British doctors that did that and they can do it again!
Time the seniors handed down the heritage as they took it; world class golden standards!
STOP MMC
Sam, London, England
The crisis in doctors' training is NOT a question of "doctors have to compete for jobs just like the rest of us" nor of "stiff competition is good for patients".
Competition for specialty training position was always stiff, but the government threw out the old, preferable competition for a disastrous untested new scheme without justification. The new scheme is plain bad - it doesn't select the best docs and HMG got their sums wrong: they didn't create enough specialty training posts and allowed too many doctors from abroad to apply.
Those who don't get a post are lost to medicine in the UK because in this country, you can only work for the NHS. Doctors can't set up shop under their own name, nor are there private hospitals to work for (BUPA only takes senior docs). So we are left with HMG spending 250k to train someone to doctor in the NHS
and then not having work for them to do. A different matter from the rest of the labour market and one that merits special consideration.
Ben Kotzee, Hitchin, Herts,
I also welcome this letter. However I believe even their concerns are an understatement of the scale of the problems. In Scotland there are, in addition to research fellows, a large number of Doctors in "Fixed Term Training Posts." These people were often ineligible, because they were overqualified, for ST2 posts last year. They are now being told they cannot compete with current ST2 trainees for entry into Specialist Training Posts. This is clearly unfair but worse, means that Specialist Training Posts will be filled with doctors who could not have been appointed if there were open competition. Much of the focus on last year's fiasco was on the mechanism of appointment (MTAS) but it is now clear that the structure of the new training scheme is wrong and the rules for implementing it are being imposed without regard to the quality of the service that junior doctors train in and for.
Dr Neal Padmanabhan, Glasgow, UK
This letter now proves what a complete and utter nonsense it was to continue with a process last year that was half baked and poorly implemented. These are the consequeces forseen last year and opposed by thousands in the junior ranks.
Too little, and for me and thousands of others, too late.
Dr Matthew Daniels, Cambridge,
I am delighted to finally see a letter like this from 3 of the Royal Colleges.
This was the statement we need a year or even two years ago from our clinical leaders - certainly we needed it by the time of the RemedyUK march on March 17th 2006 - then the interviews could have been boycotted and the profession could have brought MMC down, and retained the values of professional expert flexible training.
Now we are at grave risk that the Tooke Review recommendations will not be taken up, and those in power in the DH and MMC allowed to continue to hold power, holding to their beliefs - like the belief in the value of written answers to "White Space" questions, which still litter this year's applications forms.
Young Professionals need to be able to shape their careers and find innovative ways forward - MMC is too rigid, and is as the Presidents say cutting out a way ahead for many Juniors.
Many of our best have left, many will follow, disillusioned by the NHS as an Employer
Dr Gordon Caldwell, Worthing, West Sussex
I think the whole situation is Terrific, It has passed the point of any possible correction, The whole health system is going down hill
A MORGAN, LONDON, UK
At last some sense from senior members of the profession! Itis long overdue!
Increase in the number of junior doctors' training places is clearly needed immediately if we are not to lose many more UK educated doctors to the colonies this year.
Gordon Caldwell's excellent point, that those in power in the DoH and MMC remain in place, illustrates the further and difficult problem - how can we hope to put in sensible reform while incompetent buffoons with axes to grind about their beliefs in a clearly failed system are in position to continue to adversely affect the training system?
They need removal in order to assure the victims of MMC last year that Tooke's reforms will be adequately applied.
David L. Cox, Loggerheads,
Why didn't these luminaries not speak out about this situation several years ago.
Happy to hear them do it now, but its too little to late for thousands of us.
The colleges along with the BMA have let their profession down shamelessly.
P45 Dr, Edinburgh, Scotland
Please note - the title of your piece is incorrect - medical students are not being immediately affected by these changes. The changes affect the continued education and training of QUALIFIED doctors who are currently running the more junior end of the NHS. Medical students receive 5-6 yrs' undergraduate training, then graduate and work for another 2 yrs before having to enter the process we are all talking about. Many doctors affected have been practicing for up to 6-8 years. They are not
medical students.
A Doctor, Portsmouth, UK"
Any News?
What happened to those young doctors so far?

Thank you for reminding me David, I'm just exhausted, that's all ...