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UK Medical Profession Dips Into Chaos

Aaronsingh272x721_2Aaron Singh -- This past two weeks, the UK medical profession has been in turmoil. Senior doctors have been outraged, junior doctors have been driven to tears, and medical students (including yours truly) have been filled with fear for their futures. All this because a storm months in the brewing has finally hit us. It goes by the benign-sounding name Modernising Medical Careers (MMC).

MMC is the brainchild of the Department of Health, and was proposed to reform the training of junior doctors in the UK. It culminated in the Medical Training Applications Service (MTAS), which required all junior doctors, regardless of the jobs they currently held, to fill out an application form more akin to a Communications Skills exam. They weren’t even allowed to submit their CVs or portfolios. The method has since come under heavy fire for its many flaws, chief among them allocating a tiny percentage of marks to applicants’ academic grades and experience, and mainly being a test of creative writing. I provide a sample question for your amusement:

Describe a recent example from your surgical experience of a time when you found it difficult to make an effective judgment in a challenging situation. How did you overcome this difficulty, and how has this experience informed your subsequent practice?

Based on your answers to questions like the one above, you are then offered interviews by the four deaneries of your preference. But the total number of jobs available through this system means that, come August, 8000 junior doctors will find themselves without jobs.

On results day, the MTAS computer system crashed multiple times. Junior doctors in hospitals throughout the country found themselves without answers and had their suspense prolonged. Doctors found themselves with interviews for jobs they didn’t apply for. Some application forms went missing. All in all, the system was a huge letdown; as the British Medical Association put it, “a shambles”.

Entire careers. Jobs. Families. Dreams. Ambitions. All dependent on whether you can write waffle well enough in answer to those questions to get the job you want, where you want it. Since then MTAS has come under heavy fire from the medical profession. Newspaper headlines have highlighted it. Members of Parliament and prominent politicians have spoken out against it. Most of the medical Royal Colleges have criticised it. Indeed, several deaneries involved in MTAS itself have withdrawn in protest. And some of the countries’ best doctors and researchers, including a few of my lecturers here in Cambridge, have signed a letter to the Department of Health expressing their disgust with the seemingly carefree way MTAS is messing with doctors’ careers.

This Friday, a white coat ‘March in March’ has been planned, where doctors from all over the country will march from the Royal College of Physicians to the Royal College of Surgeons in London to protest this treatment. Over a thousand doctors are expected to attend.

As a medical student, most of this is still over my head. But it makes me fearful. Very fearful. Imagine all that work, all those years of slogging through med school, all those years on the wards, all going down the drain. Reports of junior doctors bursting into tears on the job this week have been all over the news. Fortunately it seems that the government is starting to back down after all the uproar.

There might be a light at the end of the tunnel after all, but for now it seems quite dim.

March 13, 2007 | Permalink


Even as medical students MMC and MTAS are very imortant developments. Although it can seem long way off for us, the system is likely to be based around the same kind of thing when we apply (unless doctors and students continue to keep up the pressure on the government). In fact, in less than a year, I will begin an MTAS journey for my foundation application and although that seemed to work better than for the ST applications, it is still basically just an application form.

I would really like to be a part of the protest this weekend but unfortunately neither time, nor money permit me to attend. I'll be there in spirit though. I just hope the goverment take notice and cease to ignore what has been going on around them for a while now.

Posted by: imamedicalstudentgetmeoutofhere | Mar 14, 2007 1:34:46 AM

MTAS is a blip. Bullying is worse.

Posted by: | Mar 14, 2007 3:06:40 AM

Having just completed my MTAS form - answering questions on how i maintained the patient as central focus of care and yet not being able to tell interested consultants that I do enjoy outdoor sports, have a paper submitted for publishing or that I go to trauma conferences in my spare time - I am also disillusioned. It is not just our poor slightly senior collegues who are suffering.
There are members of my year who, dare I say it, are more academic, with PHds etc , than myself. However some of these people ended up in the second round of jobs.

I will be at the march on saturday - to show my support for my peers, the doctors who are already caught up in this fiasco - as well as for myself as my chosen career path is already in jeopardy due to early calls to specialise early.

If you can come - please do - the support will be invaluable. Our Jobs, Your Health, Their Mistake.

Many Thanks for listening


Posted by: Rhiannon Talbot | Mar 14, 2007 8:37:23 AM


I applied through MTAS for the foundation programmes. I havn't experienced any problems so far.

I'm not sure how its like for ST.
I personally believe MTAS must continue although there needs to be some reforms in the system.
It will take time...

Posted by: Dr Deeb | Mar 14, 2007 9:15:45 AM

Problems will always arise when intelligent people are forced to compete and realise that .. yes, there are people out there smarter than me.

But when an application system designed to determine one's future is created in a matter of months and based on replies to a few mundane questions it will inevitably be flawed.

I personally believe that anyone who has a strong interest in a particular area of medicine should have an opportunity to pursue that career, simply because a career satisfaction will help ensure that clinician performs to the best of his or her ability. If you cant pass the exams.. then that should be a hint to maybe try something easier..

Most entered medical school as the top whatever percentage at high school. And if not, time had to be spent in adult life proving we had the ability to gain the knowledge a doctor needs. At the end of that we all gain a medical degree.. (honours and distinctions dont matter in the real world. myocardial infarctions kill so they are on the exams, and once u know to order an ECHO for heart problems you probably wont miss the one atrial myxoma you will see in your life)There is very little there to separate us.

However the one thing which we all lacked when entering medical school was the attitudes necessary to be a doctor. Some of us may have been caring and compassionate enough to go help out at our local charity shop. Some of us may have had a competitive streak and enjoyed running marathons. Some of us may have actually known what probity meant!

If MTAS is successful at determining whether we have achieved the main objective of medical school... which is recognising and developing the attitudes of a safe doctor... then it is a success.

Honestly... the questions were quite simple. One simply had to choose an example and write about it. We were all itching in our socks to write about the 20 bits of research we did.. .the lectures we attended.. all the charity work we did.. all the committees we were on and events we organised.


A few years ago globalisation was the buzz word. This system is just racist.

Posted by: B. Walker | Mar 15, 2007 4:34:35 AM

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