As senior clinicians with responsibility for the safe and effective training of junior doctors in Scotland, we recognise and acknowledge the valuable contribution of all doctors who work in NHS Scotland.
Consequently, the concerns expressed about the implementation of Modernising Medical Careers and the new Medical Training Application Service are being taken very seriously by us all.
We welcome the recently announced review of MMC selection and recruitment. We look forward to contributing fully to the review, working in partnership with the UK Academy of Medical Royal Colleges and UK Health Departments in order to ensure that we identify and implement best practice in the future, helping to ensure that its recommendations are fair to all doctors involved.
Throughout the development of MMC, Scotland has maintained a flexible approach to implementation. This flexibility has allowed the delivery of MMC in Scotland to remain largely on track, thanks to the hard work and commitment of all those involved, and the pragmatic working relationships that have developed between medical royal colleges and faculties in Scotland, BMA Scotland, NHS Education Scotland, NHS boards and the Health Department in order to manage the process.
NHS Scotland is clear about its responsibility to support its doctors, and the career advice and help that NHS Education Scotland is offering to junior doctors not shortlisted for round one is an example of this commitment. BMA Scotland believes that the fairest way to deal with concerns about shortlisting is to interview all those who applied to Scotland in the first round but were not shortlisted. This solution is being considered most seriously; however, we await the recommendation of the review group on shortlisting candidates. If those recommendations do not meet Scotland's needs we will have no hesitation in proceeding to implement such a solution if it proves to be the fairest outcome for all junior doctors who have applied to Scotland.
In advance of tomorrow's planned march in Glasgow, we would like to reassure junior doctors in Scotland that many of the concerns being raised by them have already been dealt with and, as new issues surface, we will continue to work to ensure that solutions are found. The previous appointments process for junior doctors was far from perfect and MMC presents us with an opportunity to improve training, make the appointments process fairer and provide a better standard of care for patients in Scotland.
John Orr, President, Royal College of Surgeons of Edinburgh; Professor Neil Douglas, President, Royal College of Physicians of Edinburgh; Dr Brian Williams, President, Royal College of Physicians and Surgeons of Glasgow; Dr Mairi Scott, Chairman, RCGP Scotland; Dr Peter Terry, Chairman, BMA Scotland; Dr Harry Burns, Chief Medical Officer for Scotland
Junior doctors let down by selection shambles
THE Scottish Parliament's approved selection process which decides which junior doctors will be interviewed for the first round of training posts is in a shambles. Fatal flaws in the computerised selection criteria drawn up by the Postgraduate Medical Education and Training Board, the government's committee of postgraduate deans, has resulted in up to 50% of appropriately qualified junior doctors in some hospital specialities not receiving an interview for higher training posts.
They have been promised a second chance at the next round of interviews but by then most of the posts, especially the prime appointments, will have been filled. This means effectively that the equal opportunities legislation, human rights and countless other Acts passed by parliament and Strasbourg have been violated, but the powers-that-be say tough.
So who's to blame? One would have supposed that the BMA would have been proactive in effectively defending the trainees - you can bet your bottom dollar that's just what it hasn't been doing. Yes, it has written the odd article in the medical journals, managed a few footnotes in the odd newspaper and even lobbied the odd Labour official. But speak to any junior doctor and ask what they think of the BMA and they will tell you in more than a few expletives how useless it has been.
While one might expect PMETB and the government to be less than truthful about how the shortlisting process is so disastrously failing the junior doctors, the lack of any real appropriate public statement from any of the royal colleges is, however, lamentable. Their remit is to ensure that junior-doctor training is of an appropriate standard, yet they have failed to ensure that the very process used to select the best doctors actually works. Oh, they, too, have sent the odd letter to some faceless committee and government body and, as you would expect, it has been blandly ignored. The royal colleges surely have a responsibility to the public at large and to patients in particular to shout loudly when things are patently wrong.
Ask any consultant working in our hospitals what they think of the junior doctors' dilemma and they overwhelmingly will tell you the same story: "It's simply dreadful."
Yet we, too, are in no small part to blame for the shambles. Just as with the royal colleges, we have been unbelievably passive and only now are beginning to feel a little guilty and, hopefully, will do something - but don't hold your breath.
So what's to be done? Thankfully, the junior doctors have taken it upon themselves to protest tomorrow in a last-ditch attempt to bring their plight to public attention. Was it organised by one of our esteemed bodies (BMA or royal colleges)? Don't be silly - "honours" are at stake. You can buy a title in more ways than one from this Labour government.
Dr John D Mackenzie, NHS Consultant, 43 Hazledene Road, Aberdeen
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