Monday, March 06, 2006

Modernising Medical Careers: An Update

the shit that is MMC has apparently hit the fan.

you all probably remember me going on about this ad nauseum in previous posts. as a quick summary, this "modernisation of medical careers" came into full effect in august last year.

the official line is that the current system of training for newly qualified doctors is convoluted, overly selective, biased and too old school. hence MMC has restructured the entire post-qualification career progression for the benefit of doctors and their patients. the new structure will speed up the training of doctors to consultant level.

before (or "in my day") doctors would secure jobs on the basis of their performance at medical school in written and clinical examinations and the strength and breadth of their CV coupled with the impression they gave at interview. this is not dissimilar to, well, ANY profession.

now however, final year medical students/newly qualified doctors do not do this. instead they have to fill in a form.

this form consists of 6 sections.

  • Academic Achievements,
  • Non-academic Achievements,
  • Reasons for applying for a post,
  • Good Medical Practice,
  • Teamwork,
  • Leadership

the applicant has to write a 75 word piece on each of these sections extolling their virtues. no more interview. also, each of these sections are equally weighted. so, academic achievements takes the same priority as non-academic and leadership.

this is a bit mad newly qualified doctors rarely need to take a leadership role, not on a regular basis anyway. and yes i would certainly prefer to work with a music afficianado but would be seriously pissed off if he/she could cite the back catalogue of Wilco but was unable to examine someone's chest.

unsurprisingly, medical students are unhappy. one of the reasons is that this application is a bullshitter's dream. you could write anything you wanted and because it is being marked without interview no one would ever know that, despite having put down that you were captain of the uni football team, you have no idea what a striker is and it doesn't matter because you will never ever be asked.

you can read more here about this mess and if so inclined sign a petition put together by disheartened medical students. i really feel for them. having worked so hard for the past five years they have been told that actually maybe they should have spent more time looking at ways to demonstrate their team work skills.

dr D&C demonstrates teamwork skills every weekend. on purchasing a round of drinks that is too numerous for my two hands i shall call on friends to carry said drinks to the table. dr D&C also demonstrates leadership skills by delegating who shall carry what.

"you take the 2 guinessess first because they're for the guys right at the end of the table by the wall. i'll bring our ones over last as we're nearest to the bar. STAT. if there's time i'll sign your appraisal at the end."

the problems are not just with selection either. during the first two years after graduation the new doctors are continually assessed. i am not knocking this for one minute. i think continual assessment is an excellent idea. the issue is WHAT they are being assessed on.

my house officers have to be assessed on taking a history from patients, their clinical examination of them andbasic skills such as taking blood/cannulation.

these are NOT skills that new doctors should need to be assessed on. by bloody finishing medical school people should be proficient in the above. hence it is a phenomenal waste of their and my time. clearly this is designed to weed out the reprobates, the utterly skill-less. i would have hoped that they would not have made it through their primary degree but obviously the department of health does not have this confidence.

lots of important sounding professors seem to agree. 80+ of them wrote this letter to the Times last weekend (accompanying article here).

and the icing is that only the first two years post graduation of the MMC scheme has been formalised. NO-ONE KNOWS what will happen afterwards. years of uncertainty await.

in my opinion this restructuring is not about doing the best for patients or ensuring clear career progression for doctors. it is about money. the NHS has no money. it needs to keep on delivering a consultant led service. the MMC will do this (in name at least) in a shorter time than the current system. the fact that the consultants produced will have several years less experience is immaterial.

[i am still listening to Clap Your Hands Say Yeah]


Anonymous said...

God, it's a farrago, isn't it? Fingers crossed that those eminent names will have some push.

The Gov. could save the NHS some money if they stopped pushing Correcting for Health / the National Pogrom for IT down everyone's throats.

Kate said...

This actually has nothing to do with this post.

Wanted to say thanks for the comments you posted on mine, and that I'm superextremelynuttily jealous about the tix.

Enjoy the evening of transcendental goodness that is Sigur Ros. =)

The Venial Sinner said...

I only just got round to reading this but strangely enough someone else was telling me about it last week as his girlfriend has just gone through the process. I presumed he was exaggerating, but it would seem not.

He also said that quite a few of the top academic performers ended up without a job because they didn't do so well at filling the form in and had put too few choices down to get any of their jobs.

Sounds all fucked usual.

Vegas said...

The NHS is doomed. In the words of Daddius, the great philosopher: "Get your exams and get the hell out of there".

In the meantime, go to and download the Rainbow clips - excellent. Bungle never had to worry about his career being modernised, and if you had asked Zippy to do a week of nights he would have told you to f@*k off.

Anonymous said...

Did you hear that it's possible to edit other people's online MMC forms?