Description

It has been a busy year for doctors in the UK.
The changes in training including Modernising Medical
Careers (MMC) and Medical Training Application
System (MTAS) are affecting junior doctors and
consultants alike. The systems have been forced onto
a medical community still trying to catch up with the
changes.

We have already seen changes in the UK in recent
years including the effects of the European Working
Time Directive, but nothing like the changes this year:
Electronic application not allowing for submission of a
CV and the implementation of run-through training
with change from time-based to competency-based
training requires a lot of f lexibility from everybody
involved. It is far too early to say whether these changes
will lead to an improvement in training. However, it is
already clear that the changes were not very well managed.
Or not managed at all? Nobody took responsibility.
Whole teams were being put together by a computer
algorithm, they met for the first time in the beginning
of August looking after patients most had never seen
before, sometimes in a hospital they had never worked in
before. Numerous doctors were and still are left without
job security, some had to take up jobs they otherwise
would not have taken up and some left the NHS to
pursue a career abroad. MTAS also had noticeable effects
even outside the NHS: Removal companies struggled to
meet the demands of thousands of doctors moving house
during the same weekend. If somebody had designed the
modernisation as a scientific experiment it probably
would not have stood up to the scrutiny of peer review,
since too many variables that could not be controlled for
had been changed at the same time.

Thus, if there really is an improvement in training
we will never find out why. With the run-through
training it will become more difficult to stand out from
the crowd. This and other CME journals give trainees
the opportunity to get published allowing them to
improve the increasingly important training portfolio.

Mathis Heydtmann

Gartnavel General Hospital

Glasgow