Junior Doctors Committee newsletter and update on MTAS


15 June 2007
Advice to applicants to England - latest
The first stage of Round 1 offers for speciality training and FTSTA posts is now closed. Posts that have been declined by applicants during this process are now being re-offered to eligible and competent applicants. You will have 48 hours to decide whether to accept or decline any offers made to you, with the post being re-offered to the next applicant if you decline it. This will continue until Wednesday 20 June with the final deadline for all offers at 23.59 on Friday 22 June. Round 1 will then have closed.

Round 2 is only open to those applicants who enrolled in the first round of recruitment with MTAS and who have not been offered a specialty training post. If you have been offered an FTSTA post in Round 1 in England, you are still able to compete for specialty training posts in Round 2.

Those eligible to apply in Round 2 will be able to make an unlimited number of applications, regardless of deanery or specialty. You will not be required to give information about your preferences between Units of Application. Previous applications submitted through MTAS will not be used during Round 2. Recruitment in Round 2 will be locally managed, but deaneries will be using MTAS to check applicants’ eligibility.

For full details about these arrangements, please visit:
- www.mmc.nhs.uk/pages/news/article?A6DEEFB8-79EE-4B43-98AA-964BE4E71306
- www.mmc.nhs.uk/pages/review

There are still many doctors confused and worried about their situation, and conflicting information about the recruitment process is circulating. If you have been advised that:
  • you would not be offered a specialty training post if you had declined an FTSTA post
  • you were not able to apply for a specialty training posts in Round 2 having been offered an FTSTA post in England (please see advice below),
  • you have not applied in round 1 but have registered with MTAS, and have now been told you cannot apply in round 2,
  • it was not possible for the deanery to tell you your ranking information, or
  • that you are likely to be unemployed on 1 August,
then please contact the JDC at info.jdc@bma.org.uk, as this advice is incorrect. It may also have been given to other candidates. We will take such false advice up with those promulgating it, and the Department of Health, on your behalf.

Department of Health guidance
The Department of Health (England) has stated the following–

"The Secretary of State has given a commitment that all MTAS applicants in substantive NHS employment on 31st July, will continue to have employment while they progress through Round 2. In addition, SHAs, Trusts and Deaneries are asked to take all reasonable steps to provide support to doctors who they currently employ who are not successful in obtaining a training place.

All Trusts should have a named Board level contact for applicant support with the support of clinical tutor networks."

We will push to ensure that this is the case. If there is any doctor, currently in training in England, who is unemployed on or after 1 August, but before the end of Round 2, please contact askBMA who will record this information on behalf of the JDC. It is important we know if this promise is broken because this will enable us to do something about it.

Job adverts
It has come to our attention that Deaneries are advertising posts in advance of Round 2. If you have not yet secured a Run-through training post please keep checking BMJ Careers (www.bmjcareers.com/tpl/jobsCurrent.php) and NHS Jobs (www.jobs.nhs.uk/) for the latest information. We are appalled that applicants have not been made aware of this in advance and will be taking this further with the Review Group and the Department of Health.
As per the guidance released by the MMC Team, you are only eligible to apply in Round 2 if you are already registered with MTAS and have –
  • not gained a post at all, or
  • accepted an FTSTA post only or
  • rejected any offers of run-through programmes that were made to you in round 1.
Further detailed information is available here - www.mmc.nhs.uk/pages/news/article?A6DEEFB8-79EE-4B43-98AA-964BE4E71306

Please ensure that you find out as much as possible before accepting a post. Read examples of the information you should request here. It is vital that you determine whether it is a FTSTA, Run-through Programme or Trust Grade post and whether or not it is approved for training by PMETB and whether it is going to lead to a CCT or CESR. A definition of CESR can be found on the PMETB website here www.pmetb.org.uk/index.php?id=article14

Applicants declining an FTSTA – ability to take up StR posts
The guidance previously issued to deaneries did not specifically cover the scenario where an applicant declines an FTSTA and then subsequently is considered for a run-through programme in the same deanery. However, the MMC team have said that the guidance clearly states the next highest scoring applicant who has not already accepted an allocation to a run-through programme (ST or ACF) should be offered a place if one becomes available due to other applicants declining offers, even if they have previously declined a FTSTA in the same deanery.

Meetings with Remedy UK and the Department of Health and with Professor Brown and colleagues
BMA officers, including the acting Chairman of Council and officers of JDC had a very constructive meeting with Remedy UK last week. The next day, both the BMA and Remedy UK met with senior officials from the Department of Health and junior doctors’ views and continuing anxieties were presented strongly to the Department’s officials

Remedy UK then gave a presentation to the Junior Doctors Committee meeting on 8 June and answered questions from committee members.

The acting chairman of Council, chairmen of GPC, CCSC and SASC met with Professor Brown and some co-signatories of his letters to the Times newspaper on 13 June.

Junior Doctors Committee – 8 June 2007
The committee met all day on Friday, and naturally MMC and MTAS were the main topics discussed.

In wide ranging debates about the detail of the submission to the Tooke enquiry (which will be submitted by the Association later this month and will be available on the BMA website), the following resolutions were carried by the committee:

“This committee believes that:
The current 2007 implementation of entry into specialty training is not fit for purpose as it directly contravenes PMETB’s stated requirement that processes for recruitment, selection and appointment into specialist run-through training programmes should be open, fair and effective.
There are grave concerns regarding the lack of flexibility and future limited opportunities to enter into Specialty Training and therefore declare that the current model of specialty training should be abandoned in future recruitment rounds in favour of a system that is truly open, fair and effective.
A ‘one size fits all’ approach does not suit every specialty and that separate basic and higher specialist training will be of practical benefit for junior doctors and the profession as a whole.
and we call upon the JDC Officers to support and work with the RCP, RCSEng, RCoA and any other supporting Royal College, in developing this and in providing supporting evidence reflecting this to the Tooke Inquiry.”

“This committee mandates JDC to ballot its membership on its support for the recommendations of the Tooke Inquiry.”

“That JDC believes that progression in specialist training (as opposed to pay in specialist training) should be on the basis of competency rather than to time in training, and therefore award of a CCT should be on the basis of completion of the competencies of specialist training as opposed to completion of time in specialist training. We note with dismay that some regional specialty committees have talked of ‘dumbing down’ competencies to ensure annual progression but this should not shorten the minimum time in a given specialty or subspecialty.”

“That this committee believes that passing exams should remain an essential part of assessment.”

There was also consideration of the judicial review and the witness statements of the BMA from the chairmen of JDC and CCSC. The decision to enter detailed witness statements (available in full on the BMA website), having been cited as an interested party without prior notification, was a decision taken at the highest level within the Association by senior officers of the BMA. This decision was made because of a need to defend the Association, which had been cited because of its involvement in a group alleged to be illegal, and because the proposed solutions offered to the courts were not believed to be in the interest of junior doctors. Statements very critical of the BMA were included in the submission to the court.

The BMA witness statements were produced within a very short timeframe. There was no time to call an emergency meeting of the JDC or its executive prior to submission of the evidence, which would have been needed to allow the committee to vote on the contents of the submission, or even to allow the JDC or its executive time to comment. It would have taken much longer than the court deadline allowed to canvass wider opinions and agree a consensus position, as the Association was not aware that it would called as an interested party until 25 April. The policy made at the junior doctors conference, however, guided the Association’s submissions.

The witness statements were in no way a defence of MTAS. Nor did they express opposition to Remedy UK themselves, rather that the solutions they proposed would not be welcomed by the profession as a whole as a way of dealing with the many problems of MTAS this year.

We have consistently expressed our anger at the Department of Health’s appalling handling of these reforms, which is clearly apparent from our submissions to the Court, and the High Court’s judgement on the case (www.bailii.org/ew/cases/EWHC/Admin/2007/1252.html). Our submissions made it clear that our preferred options were interviews for all applicants for all of their applications as guided by the emergency motion from the junior doctors’ conference.

Our position throughout this mess has been to fight for both our members’ interests and patient safety. We believe it would have been unfair on the thousands of junior doctors who had already been interviewed and the consultants who had interviewed them to have wasted their time and energy preparing for and going through the interview process, by discarding the tens of thousands of interviews which had already taken place. Offering interviews to applicants who had not yet been shortlisted in their applications would be a more equitable solution and this is what we pressed the DH to do. If posts cannot be filled by August, NHS trusts have made it clear that they will seriously consider filling them with non-training grade doctors and we have started to see examples of these posts being advertised in bmjCareers recently. This would not be in the interests of our members and we therefore believed at the time, and still do, that the process for appointing doctors to run-through posts should continue, with all interviews that have taken place left to stand.

This was supported by the BMA’s Council at the meeting last week, and a separate statement will be released soon.

Tooke Review - surveys
If you have not already done so, please fill in the surveys on the BMA website:

and on the MMC inquiry’s website:

www.e-consultation.net/MMCInquiry/index_https.asp

to directly feed in your views on MTAS and MMC

Annual leave
As a result of uncertainty over the timing of interviews and the extended selection timetable, some junior doctors may find themselves without enough time to take their full complement of annual leave this year. The JDC has developed some advice for doctors in this situation which can be accessed online.

Legal advice – available next week
The JDC has been working hard to clarify the legal situation for MTAS applicants who are unsuccessful this year. We have taken legal advice from our solicitors and from a leading QC in employment law and have been exploring a number of possible avenues with them.

However, we would not wish to raise junior doctors’ expectations unrealistically. Our legal advice so far is that the majority of MTAS applicants will be unlikely to have grounds to challenge their individual treatment during the recruitment process, but there may be a small number of applicants who have legitimate claims. We are currently confirming with our solicitors some advice for members and will issue more details on this early next week. In the meantime we would urge all BMA members who feel they may have a case to contact askBMA on 0870 60 60 828 urgently as a grievance needs to be registered as early as possible in any case.

Sci 59
The psychometric test ‘Sci59’, which is designed to generate a list of medical career choices that reasonably match your personality profile, is currently available to all members online.

www.bma.org.uk/ap.nsf/Content/HubBMAcareersservice?OpenDocument&Login

Please contact cbanton@bma.org.uk if you have any access problems.

BMA Counselling Service and Doctors for Doctors
We recognise that this is an extremely stressful time for junior doctors. If getting through the recruitment process is causing you distress and upset and if you would like to talk to someone about this, please use the BMA Counselling Service and the Doctors for Doctors Unit.

For help, counselling and personal support just call 08459 200 169, and you will be given the choice of speaking to a counsellor or a doctor-adviser whom you can call directly.

The service is confidential, and when making contact you can choose to remain anonymous. It is available to you and members of your family who normally live with you.

www.bma.org.uk/ap.nsf/Content/Hubhealthandwellbeing.

This website includes a link on the left hand side ('Where to go for help') which lists dozens of organisations set up to support doctors, and we urge juniors experiencing distress or anxiety to contact these organisations for help if need be, as coping alone can be extremely daunting and difficult.

Petition for SAS doctors
Because of continuing delays to the progress of the staff and associate specialist doctors’ contract negotiations, the BMA has set up a petition through the BMA website. All members are encouraged to fill in this petition, which can be found here:

https://www.bma.org.uk/Survey.nsf/DoQuest?OpenForm&q=SMAY-743FEL&mode=a&pre=y

Finally….
Let us know about the problems you are facing. If you get in touch with askBMA we can flag up your grievances at the highest possible level of the organisation you are having trouble with. We continue to press for all the problems stemming from the MMC / MTAS crisis to be resolved in your interests

Note: For more information on MTAS go to : http://www.bma.org.uk/ap.nsf/content/HubMTAS.

© British Medical Association 2008

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