What’s Up (Junior) Doc?

What’s Up (Junior) Doc?
London, May 22 2007

With in excess of 34,000 doctors chasing 18,500 training posts due to start in August, one might expect that a slick system would be employed to ensure that the best candidates were matched with the most appropriate jobs. And maybe that’s what the MTAS (the Medical Training Application Service - an online application system designed to allow juniors to apply centrally for training rotations) was meant to achieve. However, it had been prone to crashing, and many junior doctors claimed that it was clearly incapable of dealing with the volume of traffic attempting to access the site.

Also, MTAS restricted the applications of juniors to only 4 areas of the country, which could 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.

Needless to say, junior doctors are not happy, and their frustrations were compounded in April when site security (or lack of) became the next issue to cause concern – with claims that doctors were able to read each other's messages, and that applicants' personal information could be freely accessed. The Department of Health took action at the end of April by suspending the site, and commencing an investigation into the junior doctors concerns.

Dr Andrew Rowland vice chairman of the British Medical Association (BMA) Junior Doctors Committee commented at the time: “The Department of Health has at last seen sense and effectively abandoned the unfair, discredited, and shambolic MTAS system”.

But the BMA itself has not escaped unscathed. The BMA chairman, James Johnson, has now announced his resignation. BMA treasurer Dr David Pickersgill said colleagues had lost confidence in James Johnson, and that he had failed to convey the anger felt over the system for matching junior doctors to specialist posts. This relates to a letter the James Johnson wrote with Dame Carol Black, chairman of the Academy of Medical Royal Colleges, to the Times newspaper on 17 May. In it they rejected a suggestion favoured by junior doctors at that time that a first round of interviews under the MTAS be scrapped. "We agree that a better system is needed, but believe that it should be achieved through argument and negotiation, not action that could risk harming patients, the NHS or our colleagues,” they said. But this is becoming an increasingly fierce and political battleground, and Mr Johnson seems to have underestimated the negative reaction his comments were likely to receive. Ironically, the letter stated “The mood of our institutions is not one of resignation”.

Still, with no ideal solution yet in sight, the debate rumbles on, in the traditional media and online. One interesting feature of this story is the way online media are being used for anything from spreading the word and venting spleen, through to organising action groups, such as Remedy UK. This makes for a fascinating way to view the evolution of this issue, with at least four perspectives available – Department of Health press releases, professional medical body press releases (such as the BMA), traditional media, and doctors blogs and action group websites.

You can compare and contrast, with the links below as a starting point:

What the BMA has to say:
http://www.bma.org.uk/ap.nsf/Content/BMAChairmanResigns  
Reaction from Remedy UK (a doctors’ action group):
http://www.remedyuk.net/index.php?option=com_content&task=view&id=191&Itemid=125  
A doctors’ blog:
http://nhsblogdoc.blogspot.com/  

The latest from the Department of Health:
http://www.mmc.nhs.uk/pages/news/article?FE8CEF61-B7DF-45BC-A54D-B3D4E3B23E35  

Paul Hartigan, PharmiWeb.com