Living with MTAS

This week's BMJ Careers provides a collection of articles focusing on the issue of the current job situation as a result of MMC and MTAS.


The Editor's choice : "living with MTAS" suggests junior doctors should be flexible and consider options and alternative careers.

This week and the next two, the BMJ Careers will feature articles about careers outside the NHS with the hope that junior doctors will be inspired and informed to consider alternative careers. There are some interesting articles :

• Working for the pharmaceutical industry


• Voluntary work is a good idea


• Pastures green - working abroad


• Having the best of both worlds - locuming


• Banking on it - a medical student's experience of working in the City finance sector
• Career decision making in an age of uncertainty

Impact of MTAS on junior doctors' mental health

In a BMJ letter "Mental health of applicants seems to be deteriorating", BMJ 2007;334:1335 (30 June 2007), The Royal College of Psychiatrists reported the preliminary findings of an online survey about the imapct of MMC and MTAS on junior doctors' mental health.

The results showed that there were 790 anonymous responses that indicated increased level of stress and disturbances, most attributing it to MMC/MTAS. The authors said that this requires an urgent response.

A SHO said he doubted the validity of the survey and that doctors and other professionals need resilience and MTAS has reflected that.

Extra posts for junior doctors

The Health Secretary promised extra posts for junior doctors to ease the crisis over MTAS.

She told MPs there would be 200 additional "run-through programmes" for doctors who are already in training for their chosen specialities. These 200 extra training posts will be at the ST3 entry level and made available in the second round of the application process. Further additional temporary posts - fixed-term specialist training appointments - also will be made available, but it is unclear how many.

The BMA estimates that 12,000 doctors will not get a post as a result of the system.

MTAS in The Lancet Comment

A Comment, published in The Lancet this week, 19 -25 May 2007, p.1673 - 75, expressed doctors' concerns and disillusionment about MTAS.

Various polls were published online with the Comment.
3/4 of the respondents rejected the proposal of the single interview.
80% wanted the August changeover date postponed.
85% called for consultants to withdraw from the interview process.

The Comment says both MMC and MTAS are unnecessary and disastrous and calls on the MMC chairman, MTAS and PMETB to "stop this madness".

Junior doctors lost high court battle over MTAS

Junior doctors have lost their High Court battle to invalidate MTAS interviews.

Remedy UK had argued for the system to be scrapped and all the interviews carried out again because the whole process was unfair and unlawful ( see previous postings). The judge ruled against invalidating the interviews already done but said the doctors' grievance was entirely justified. He said it was a flawed system with disastrous consequences, individual junior doctors could still have good grounds to appeal regarding the jobs allocated to them - or to take their cases before a tribunal.

Remedy UK said that "This is a sad day for doctors and the NHS", but the group would not be appealing the decision.

Last week, ministers were forced to abandon MTAS. The Health Secretary said that after the first round of recruitment, MTAS would not be used again this year. The recruitment process will be handled at a local level by medical deaneries. Junior doctors will be asked to apply directly to hospitals for jobs.

Some leading consultants said the recruitment process is deeply flawed and the continuous crisis could put patients at risk. An online survey of doctors organised by some specialists drew 3,500 responses. 85% of consultants who took part backed a boycott of recruitment interviews, 90% expressed no confidence in the health secretary and chief medical officer.

Chennel 4 News uncovered that every candidate in England was offered a one-off rescue interview, but these interviews need up to 9 consultants to sit on the panel. Patient operations are being cancelled and rescheduled as some consultants struggle to fit their work around interviews.

A group of leading consultants claimed in their letter to The Times that the MTAS has "so far failed at every task" and questioned a decision taken to allow experienced doctors just one interview to determine their future career.

MTAS update

In the controversy over MTAS ( See posting on 28 March 2007), Channel 4 News reported on 20 April that a leaked document showed that the Government was considering offering voluntary work overseas for unsuccessful doctors. VSO had given information on its placements to the DoH. The document also revealed that about 10,000 doctors may be at risk. Read more...

Channel 4 News also reported on 24 April the security breach, alerted by a doctor, after an error at the MTAS website where highly personal details of thousands of junior doctors could be seen. The DoH was informed by Channel 4 News and the website was temporarily suspended amid concerns of security lapses.

The latest error of MTAS was the rejection of the application of a UK born doctor, Dr Luk who went to Cambridge University, because he did not have the "correct immigration status". Although the London Deanery has apologised for the error, he still has not had any interviews.

Doctors groups reacted with dismay and had little faith left with what they described a "shambolic" system. At the doctors conference in London last Saturday, delegates passed a motion calling for the Health Secretary Hewitt and Health Minister Hunt to resign, for NAO to investigate how much public money had been spent on the computer system and for the system to be scrapped.

The data watchdog, ICO, is to investigate the security breach that led to personal details made available online. Read more ...


Using iPods to teach doctors to recognise heartbeats
Research studies show that the average doctor identifies 40% of heart sounds correctly.

Dr Michael Barrett, associate professor and cardiologist at Temple University studied 149 doctors who listened 400 times to five common heart murmurs for 90 minutes on iPods. After the listening session, they got 80% right.
Dr Barrett believes that the key to learning heart murmurs is repetition but 400 heartbeats were too much to ask of a live patient, so he uses computer-generated simulations of "heart songs" and convert them into MP3 files that can be downloaded to iPods. His medical students listen to the recordings whenever they have the time, this will help improve their stethoscope skills.

Last month at the annual conference of the American College of Cardiology (ACC), Dr Barrett presented the findings of his study and said "cardiology can be taught by iPod …. older physicians can also benefit from adding the MP3s to their music libraries".