Monday, 12 March 2007

MMC shambles

This piece, signed by some of the most senior and distinguished doctors in the country, appeared in the British Medical Journal. Please read it:

The last two weeks has seen the Medical Profession in the UK torn apart by an Exocet we should have seen coming. That Exocet is called MMC and in particular its job application arm, MTAS. The howls of anguish from the juniors have been silenced only by …. well, the silence of the seniors. The Colleges have offered extreme sympathy. We, the undersigned, are roused, belatedly, to express incandescent outrage at the apparent vandalism taking place before our eyes. Although it might ease our conscience to shelter behind our Colleges and Presidents, they in turn pick the mood of their electorate, and silence shifts perception of the line to be drawn between collaboration and appeasement. In negotiations with MMC over a process which rides roughshod over the Colleges’ Royal Charters to protect education and training, the Presidents must have felt between the proverbial rock and hardplace – marginalised in opposition, complicit in submission. This is not the time for recrimination, but for a united and rockhard opposition to MTAS, offering whatever help is necessary to find a workable and worthwhile version of MMC.

The speed and scale with which the Exocet has struck is truly awful. Stories from top juniors flung on scrap heaps after a decade of training, from seniors marking applications who had to look up Medical Schools to see if they existed, and interviewers too embarrassed to look candidates in the eye, and with no CV’s or references to guide – oh so elitist and incorrect when choosing a safe doctor. Stories all so bizarre and spontaneous they have to be true, and yet the process proceeds apace while proper documentation of problems is awaited… And all the while the Deans, and the myriads of helping Consultants distracted from their day-job of patient-care, are congratulated for their superhuman efforts – for their efficiency and ingenuity – some tossing coins to choose among applicants, some threatening to leave applications unread by the deadline, collecting dust while the applicant learns from the internet that he is no longer fit for purpose. Doctors intelligent? What other group in society would be such hand-maidens to their own apocalypse.

The fault? Teething problems blamed on computer glitches and thousands of non-UK European doctors swamping the UK applicants with their numbers; and on wide-scale plagiarism and on answers available for sale to the ridiculous questions designed by civil servants to root out any doctor looking in vain for a box to register a first class degree. Consolation? Yes, it could have been worse if the Highly Skilled Migrants had not been sacrificed during the selection process; with any luck, we have been told with a straight face, many of them have still been given posts and will therefore leave large gaps in the second round if the Appeal Court comes to the rescue.

Do you want to laugh or cry? A few seniors, signing this letter, want to shed tears of contrition and anger. We wish this nightmare to stop now. The juniors can’t stop it. Our leaders’ hands are more tied than ours by diplomatic niceties. We still wish them luck because only they are likely in the long run to succeed in bringing about the improvements required. Meanwhile there is an onus on us, and us has to mean very urgently the vast, silent majority of UK Consultants. Two things must happen. We need to register unmistakably that Consultants can be as roused and exercised by the standards of care of future patients and fate of our juniors, and therefore the NHS, as we were about our contracts, and leave our leaders and MMC in no doubt about our views. And we need possibly to stop the current interviews or, at the least, make sure that only truly excellent candidates are appointed in the first round until sense prevails and a meaningful process installed for a delayed second round.

Neither will happen unless our letter strikes a chord. Our leaders have pressed the MMC and ministers hard for changes before the second round of appointments. We worry whether deckchair movement is enough. And we do not know for certain whether there will be movement, after the news story has moved on, or whether indeed any good posts will be left by then. We fear that something Titanic will hit the profession if chairs labelled MTAS are not removed or re-invented altogether. 35000 applicants – and the new UK medical schools have yet to produce a doctor! Some interview panels have already packed their bags. If isolated reports of the interview process are correct, we hope this knowledge may stiffen the resolve of others confronted with inadequate candidates or paperwork, with snowballing resignations bringing a flawed process to a halt.

How can you register your views? The juniors have set up websites ( and and this (BMJ) website will itself take comments. By the end of this week, or earlier, we will have a single- purpose website with short list of questions at , which will enable us to petition the Presidents and MMC with exact numbers. And you can decide whether we petition for a temporary halt, a back-to-the-drawing-board halt, the resignation of the architects of MMC. Try to have your GMC number available so that we can prove real and unique people sign the electronic petition. Meanwhile, support the juniors’ websites, and post your responses and experiences here.

We will march with the juniors on March 17th. If you join us now, we may be able to smile that day, not cry.

Morris Brown, Consultant Physician and Professor of Clinical Pharmacology, University of Cambridge
Nick Boon, Consultant Physician and President-Elect, British Cardiovascular Society
Nick Brooks, Consultant Physician and President, British Cardiovascular Society
John Camm, Consultant Physician and Professor of Clinical Cardiology, St. George's Hospital Medical School
Edwin Chilvers, Consultant Physician and Professor of Respiratory Medicine, University of Cambridge
Paul Corris, Consultant Physician and Professor of Thoracic Medicine, University of Newcastle
Paul Durrington, Consultant Physician and Professor of Medicine, University of Manchester
Paul Emery, Consultant Physician and Professor of Rheumatology, University of Leeds
George Griffin, Consultant Physician and Professor of Cellular & Molecular Medicine, St. George's Hospital Medical School
George Hamilton, Consultant Surgeon and Professor of Vascular Surgery, Royal Free Hospital
Alistair Hall, Consultant Cardiologist and Professor of Clinical Cardiology, University of Leeds
Tony Heagerty, Consultant Physician and Professor of Medicine, University of Manchester
Humphrey Hodgson, Consultant Physician and Vice-Dean, Professor of Medicine, Royal Free & University College School of Medicine
Richard Hughes, Consultant Physician and Professor of Neurology, Kings College London
Kay-Tee Khaw, Consultant Physician and Professor of Clinical Gerontology, University of Cambridge
John Lazarus, Consultant Physician and Professor of Clinical Endocrinology, University of Cardiff
David Luesley, Consultant Oncologist and Professor of Gynaecological Oncology, University of Birmingham
John Monson, Consultant Surgeon and Professor of Surgery, University of Hull
Philip Poole-Wilson, Consultant Physician and Professor of Cardiology, NHLI, Imperial College, London
Timothy Rockall, Consultant Surgeon and Professor of Surgery, University of Surrey
Robert Sutton, Consultant Surgeon and Professsor of Surgery, University of Liverpool
Deborah Symons, Consultant Physician and Professor of Rheumatology, University of Manchester
Roy Taylor, Consultant Physician and Professsor of Medicine & Metabolism, University of Newcastle
Doug Turnbull, Consultant Physician and Professor of Neurology, University of Newcastle
Hugh Watkins, Consultant Physician and Professor of Cardiology, University of Oxford
Robert Wilcox, Consultant Physician and Professor of Cardiovascular Medicine, University of Nottingham
Nick Wright, Warden, Queen Mary College, London


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