Dedicated is the word most often used to describe doctors. So, when they look out their white coats and theatre scrubs to take to the streets instead of the hospitals and health centres in protest about their jobs, it is a symptom of a very serious problem that requires urgent action. In this case, the Department of Health must admit that its new computer-based system for allocating specialist training posts to allow junior doctors to progress in their chosen specialism is causing chaos. It must change it before it results in serious long-term damage. This is not scaremongering: there is evidence of doctors changing career despite long years of studying for a medical degree followed by hospital training. A country that allows such desperately-needed professionals to jump ship at that point because they cannot progress to a senior position is one which has sold out its proud medical heritage.
With 30,000 juniors competing for 22,000 available specialist places, there will be considerable movement and not everyone will find the place they want. The question of whether there are enough places has still to be addressed, but that major policy issue has been unnecessarily confused by changing the system of allocating places. The new online applications have been criticised not just by the juniors looking for a training place, but also by the senior consultants who have to sift the applications and carry out interviews. Both are complaining that the system does not allow a proper statement of individuals' qualifications and experience. In a scientific discipline, above all, it is reasonable to expect decisions to be made on sound evidence so that a specialist training post is allocated to a candidate who has acquired some experience of the type of skill required and shows some aptitude for it.
Instead, frustrated young doctors are complaining of having to write "psychobabble" on their applications. The government, belatedly acknowledging the severity of the crisis the new system has provoked, announced over the weekend that applicants can submit supporting material, and that previously rejected candidates can now be considered. That is a step forward, but it does not overcome the problem of junior doctors being able to apply for specific training places. This is a serious difficulty because, despite their junior title, these are people in their late twenties who are likely to have commitments, whether a joint mortgage with a partner tied to an equally hard-won job or a young family. They cannot always move easily from one end of the country to another. Applying for posts without knowing where they are is a recipe for chaos.
The new system was brought in under the grandiose title of Modernising Medical Careers. On examination by senior practitioners who want to match the best young talent to the most appropriate training, it has been diagnosed, in the phrase a previous Health Secretary has applied infamously elsewhere, as not fit for purpose. In this case, the remedy is simple: the doctors know best.
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