without a paddle

MMC steering committee holds urgent meeting to modify the online application process (Prof Alan Crockard, far right)

and so the crisis goes on

this week the department of health announced that the process by which 30000 junior doctors are applying for 22000 jobs is to be urgently reviewed.

the reason for this was that several groups of consultants on interview panels refused to participate in the process on the basis that the entire selection system was moronic.

i have mixed feelings about the actions of these consultants. on the one hand i am glad they spoke out and got a review to take place. on the other hand i pose the question:

where the fuck were you guys nine months ago?

this disheartened doctor has been wingeing about MMC since last year. everybody in the medical profession knew this was going to happen and knew that the implementation was going to be a joke. we knew this from the way the newly graduated doctors had been treated by a similar system. yet the warnings were not heeded. our union, our royal colleges and our bosses sold us down the river with a group shrug of the shoulders and an indifferent "well who knows what's going to happen" whilst all along we were screaming "it's a shit idea, it's going to be shit and it'll fuck up our lives, your lives and those of our patients."

so this review: i'm not convinced. not convinced at all and sadly don't hold the views of my fellow learned bloggers (here and here for example) though i wish i did.

the first round of selections is nearly over. there is talk of the second round being modified to be "fairer."

what this actually means, and we can debate for days about what modifications should be made, is that MMC will continue, we WILL do exactly what we are told to do and we WILL BLOODY WELL LIKE IT. it is marxism at its most literal. you will be allocated and perform the task that we deem you appropriate for.

patricia hewitt and the department of health: why can you not see that our NHS is held together by the altruism of its nurses and doctors. you've already slain the nurses (below inflation pay rise this year most recently) and through MMC you've killed the morale of already demoralised doctors. the boat carrying our altruism is sinking because you've punctured so many holes in the fucking hull. time is running out patricia. how can you not see this?

HOW CAN YOU NOT SEE THIS?

there is a protest march on saturday. i shall certainly be attending. so shall many of the british medical bloggers. will it make a difference? i doubt it. optimistically it may burgeon public support. realistically the public will probably wonder what all these rich doctors are bitching about, the power-obsessed bastards. pessimistically i think 10% of the doctors who say they are going to attend will actually show up.

for we are the most ineffectual group of lobbyists ever. oh for being a bit more militant and bit less self-serving (like the new zealand junior docs who took strike action last year).

i've been eyeing up the canadian medical board exams. even if i get a job for august, what precedent does the behaviour of the DoH set for working in the NHS in years to come. i personally can't wait for the next set of "reforms" circa 2008. surely better to go somewhere or do something where you are valued as a person with skills to offer society.

i'll report back after the march. i really hope that there will be a sea of angry doctors there, like Sauron's army of orcs and that the british public will be thrusting their fists into the air and willing us to go and give the DoH hell.

but i worry that it will make no difference. i worry it's too late. i worry that come august this will all be done and the protests of the future physicians, surgeons and professors of this country on saturday will become but a whisper in the tragic history of the NHS.

[i am listening to the new Shins album]

ps. this is fucking psychedelic genius:

the slimiest of slime - something reptile

the HAL9000-esque automated medical job allocation process robot (MTAS) sent me to an interview last week. let me tell you about the moronic sequence of events running up to this interview.

regular readers will know that the Lost Doctor filled in his online application whilst snowboarding in Whistler at the end of january. by doing this i achieved 2 objectives:

1) i managed to avoid everyone at home stressing out immensely about the idiotic questions that needed to be answered
2) being on holiday was a great panacea in reducing my outrage at the idiotic questions

the system crashed due to the sheer number of applicants several times. little space was given for detailing achievements in medicine to date. the details of jobs available were sparse and uninformative. after finally submitting my responses, i was inundated with daily emails informing me how there would be more delays as the system was not getting people's references and that the shortlisting process was taking too long. i overheard one of my consultants two weeks ago saying how she had been couriered hundreds of applications and asked to score them all in a day. she also said how she didn't feel the application form was a particularly good discriminator of good from bad doctors at all and that is was all a "fucking painful joke."

friday (23/2/7) came and i began a weekend of nights. it was a lot of fun because i had the company of the venial sinner (MIA in the blogosphere but very much about in reality) who was also doing nights. at the same time MTAS emailed to say that the shortlist which was supposed to come out that day would only be revealed the following monday. the venial sinner and i decided that after finishing our night shift on monday morning we would go out on a bender to recreate the halcyon student days.

10am monday morning (26/2/7) and tvs and i headed into town for the obligatory caner. at about midday i received a call from vegas who informed me that MTAS had crashed and died again. no-one knew about whether they had been shortlisted for possible employment in medicine in this country for august. tvs and i continued to drink and drink. 2 tycoons (triple sec, apricot schnapps, gin, cointreau, lemonade) and 2 long island ice teas later the eyes were drooping, the gait was ataxic and home and bed beckoned, oblivious to the fact that MTAS was secretly sabotaging the airlock doors.

i woke on tuesday (27/2/7) and went to my outpatient clinic where i checked the website. MTAS said that i had 2 out of 4 interviews. i quickly booked interview times online (gone are the days of someone phoning you) and continued on with a busy clinic.

while awaiting MsD&C's return from work that evening i decided to consult MTAS again (who had by now killed the astronauts in hypersleep) to double check when my interviews were, as in the rush of the clinic i had neglected to note this important detail down. upon accessing his mainframe i found out i had a third interview. attending this interview would require a day off work and a not insignificant train ride. oh yes and it was the following day.

thanks for the notice.

i hurriedly scrabbled together a portfolio with the ridiculous number of things that i had to take there. i also printed out my answers to the questions i had completed one month earlier in canada so i could review them before the interview.

i felt sick.

i read back some of my answers. they were PAINFUL.

when you're writing the twentieth draft of something you become quite dissociated from the content. you're concentrating on grammar and flow.

i was ashamed i could come out with such drivel.

i attended said interview the following day. it was quite funny actually because, finding dry shirts difficult to iron, i said out loud in my flat "fuck this, i'm going to wear the clothes i had on yesterday" and went to the interview smelling of urine and C.difficile.

i hate waiting for anything. being an hour early, i quietly sat in the waiting room drinking water and listening to the five other candidates chat to each other (Dr D&C was ignored probably because he isn't posh enough).

sometimes when you walk into a pub or a bar you can sense an atmosphere of foreboding. in these cases the correct action is to finish your drink and leave quickly without drawing too much attention to yourself. sometimes when you meet someone for the first time you can tell that they are complete utter wankers. in these cases the correct action is to bite your lip and pray they move on to bother someone else.

well these five people were amongst the biggest fucks i've ever met in my entire life.

oh the pain! the continuous, self-serving, droning conversation. the false smiles, the belly laughing, the lack of grounding in any plane of reality. i wished the aliens from war of the worlds would appear and disintegrate them all. i prayed for their unnecessary fountain pens to fly out of their pockets and impale them in their foreheads. everything they talked about was prime, chargrilled bullshit and they were loving it.

and then i realised what it was. i realised what it was about these people that made them all so similarly disgusting examples of our species, and why i was so unfortunate to be breathing the same air as them.

they had all been summoned to this place on the basis of their answers to the stupid questions on the application form, answers that encapsulate their inflated egos and sense of self-importance. i felt like bruce willis at the end of the sixth sense when it dawned on me that i too was one of them. cheapened.

the interview was fine in itself. one of the panels didn't have my application form and so knew nothing about me. the interviewers seemed fair and normal people trying to make the best of a ridiculous situation. at the end of the day it wasn't too dissimilar to any normal job interview. just the getting there, which was marxist to say the least.

and all the way home i couldn't stop thinking about the cunts in that waiting room. this new medical system will roll on because people like them will secure their jobs and then they won't care about their colleagues (if such care ever existed.) there is a protest march on the 17th of this month. do you think any of them will go? course not. they have their interviews. fuck the rest of you.

be warned the UK public. from august your hospitals will have greatly reduced numbers of doctors working at night in an effort to make the NHS balance its books. when you finally do get to see a doctor it won't be someone experienced able to deal with most of your problems. MTAS has ejected these doctors from the cargo hold.

no, what you'll be left with is these five penises, appointed because they are adept in using buzz words such as "motivated" and "empathy" and "nonce." these are the sort of people the NHS of 2007 want to employ. i hope to god i'm not one of them.

people of britain - do not got to hospital after august lest you come across such people in a dimly lit examination cubicle. it is time to stockpile the ibuprofen, turn your kitchen into a operating theatre and find a good VET to look after you when you get ill. medicine in this country has been sold down the river by the government, the royal colleges, our "union" the BMA and our bosses because, as jarvis cocker recently said, cunts are still running the world.

[i am listening to willie nelson]

culling

this week has seen the biggest culling of junior doctors' career aspirations by a computer system and an ill thought out application form (MMC and MTAS respectively - i've talked about this before). this is probably the biggest change to medical training in the past forty years and within days hundreds of doctors have had their dreams of pursuing a medical specialty shot down. it's like the beginning scenes of saving private ryan. i, unlike many, have survived the initial onslaught of career killing fire and shrapnel. i am currently lying on the normandy beach of possible interviews, unsure of my future. i know a LOT of doctors who've been *BANG* taken out just like that and will have no job to go to in august. some of them (the ones with slightly more experience) will probably never work again as a result. absolutely gutting. absolutely fucking gutting.

the most eloquent explanation of what's been happening is quoted below and taken from the doctors.net.uk forum. i'll let it speak for itself:

"I feel like crying.

All my life there has been only one thing that I have wanted to do. I worked hard at school to get to medical school, I then worked hard at medical school to give myself the best shot at the jobs I wanted later on. I passed all my exams, won a few prizes along the way and was generally a good all rounder.

I was warned off medicine by my family and friends, they said it was too stressful and the NHS was in trouble; but I found the subject fascinating and it was not a matter of choice for me.

I have worked hard since I qualified and have had good references from all my employers. I have not taken a single day off ill in my first few years of work, and there are days when I have not felt well enough to come into work. I have passed several postgraduate examinations and attended all the relevant courses, as well as having several articles published in scientific journals.

There are many others just like me. Each of us has made numerous sacrifices because we love what we do. Our study budgets and study leave quotas have been cut, meaning we have had to pay for our own training and attend courses in our annual leave. The trust has also stopped properly reimbursing us for our travel expenses and removal costs. However we carried on because we thought that it would all be worth it, if we could have a job at the end of it doing what we loved.

These last few weeks have been the final straw for many of us. We have been subjected to the most unfair and least meritocratic selection process ever seen, MTAS (medical training application service) via MMC (modernizing medical careers). We have had to sum up our years of work and experience in several politically correct short answer questions, on which we are then judged. Examinations, experience and references are all but ignored in the pursuit of vague waffle.

The computer system crashes time and time again, confusion reigns supreme and hundreds of consultants are appalled by the process. Yet it is allowed to proceed. The short listing results are released in dribs and drabs and thousands of juniors tap away on their keyboards in a state of sheer panic, realizing that their future is being decided by the MTAS tombola.

Some of us have been lucky enough to get short listed for the jobs we want, but we shouldn’t have had to be lucky. The process should have been meritocratic, well organized and fair. It was most definitely none of these.

Young doctors such as myself are appalled by what we have had to endure this year. No one should have to go through such a process again. We all know people who are going to have their hopes and dreams crushed by this cruel joke of a system.

Shame on those who are behind this scheme. Many a tear will be shed this week by many brilliant young doctors who have had their hopes and dreams crushed in a quite barbaric fashion. Many of us will emigrate and many of us will leave the profession; I hope those behind the scheme are proud of these achievements.

Of course we do not all expect to be handed our perfect jobs on a plate. However we deserve not be lied to, we deserve not to be treated unfairly and we deserve to be treated with a little more dignity, respect and humanity than we have in 2007."

(Dr Ben Dean)

our union, the grossly ineffectual bunch of sycophants the BMA, have done precisely fuck all about it. i think they may have indulged the architects of MMC in fellatio at some point. they yesterday announced a press release saying that the system was failing.

erm STABLE DOOR CLOSING, HORSE, FUCKING BOLTED.

[i am listening to Johnny Cash]