Remedy Scotland

What is MMC?

Modernising Medical Careers (MMC) is a government initiative to revamp and modernise current training of doctors within the UK.

Why was MMC implemented?

The reasons for MMC are not fully apparent. There were certainly some problems with the old system but MMC is a complete overhaul of a reasonably successful training method.

The overall outcome of MMC is skimpier, inflexible, fast-track and narrowly specialised training programme. It will eventually lead to more junior, less qualified and less condifident consultants then the older training programme. Only the government knows the reason to want increase the numbers of inexperienced junior consultants.

Who does it affect?

MMC affects the vast majority of junior doctors who are currently many years into training to be leading specialists in their fields in the NHS

How many doctors will be unemployed as a result of MMC?

8000 doctors throughout the UK from in August 2007. There may also be further unemployment or lack of training opportunites in August 2008, precipitating further exodus.

How much does it cost to train a doctor?

£250,000 per doctor - paid for by the UK tax payer. This means a total £2 billion worth of trained doctors being unemployed.

Where will our trained doctors go?

Many doctors are migrating abroad with a view to a permanent emigration. not because of a lack of dedication and passion for the NHS but because of of the inflexibility of the new system and lack of training.

Others will change career entirely.

What is MTAS?

MTAS stands for the Medical Training Application Service - an online application system designed to allow juniors to apply centrally for training rotations. However, it has been prone to crashing, as it was clearly incapable of dealing with the volume of traffic attempting to access the site.

It restricts the applications of juniors to only 4 areas of the country, which may be extremely large - for instance Scotland is one Unit of Application, as are London, Kent, Surrey and Sussex together. Previously juniors could apply to any hospital they wanted, anywhere in the country.

Deadlines for MTAS were extended due to the inability of the website to cope, and changes made to the application process during the two weeks in which it was running. Shortlisting was not completed in time, and there are concerns that it was never completed in some areas.

How is the new system choosing our future doctors?

It requires juniors to submit an online application form, much of which involves 150 word vignettes about clinical cases or ethical issues. 75% of the marks available are awarded for these vignettes, only 25% for actual clinical and academic qualifications.

The evidence for this recruiting system is untried and unproven. From initial feedback, it has become clear the system in no way descriminates between highly suitable and highly unsuitable candidates

How did the old system choose doctors?

Although there were flaws in the old system, it was analysed applicants based on the follwoing:

1. Academic achievements - Passing post graduate exams were an essential selection criteria for many jobs. This insured applicants were knowledgable and well versed in the speciality they chose to pursue. It meant your doctor would have proven record of being a specialist in the field.

These exams are world recognised and respected exams.

2. Research - Involvement in research and having publications in world recognised journals ensured candidates to jobs were recognised for helping to advance medical research and ensure the UK remained at the forefront of medical science.

3. Extra curricular activities - Doctors with a wide range of exceptional activites outside of medicine were recruited as all round, well balanced individuals. Such activities are no longer essential to be a trainee.

4. References - a reference from a supervisor, one of the most valuable tools used in any job application for any industry largely sidelined and confined to a tick-box form.

Were junior doctors consulted in MMC?

The British Medical Association and Royal Colleges of the UK have been in the process and informed of the events. Evidence suggests these organisations warned the government of serious reservations about MMC and especially the timescale the government planned to implement it.

Hasn’t it always been competitive?

Yes, Medicine has always been competitive from originally applying to medical school to applying for consultant posts. Doctors accept it is competitive but also require a system that is meritocratic and fair. This is why many doctors continually move to different parts of the country, sacrificing other commitments in order to be as competitive as possible for the career they desire.

Doctors however also expect to have certain rights when applying to jobs like any other worker in the country. These do not appear to have been the case here - for example, having almost no idea to which part of the country they may get posted to or knowing the job description/salary of the job they are applying for.

Why are doctors opposed to reform?

They aren’t!

They do recognise the importance of modernisation of training. Despite the enormity and perceived slowness of the NHS as a machine, we are keen to produce as modern, educated and holistic doctors as possible. We desire to serve the public as well as we possibly can. This, however, must involve a validated system ensuring training needs are met and the appropriate individuals are employed for the job.