BMA raises specialty recruitment concerns

by Tim Tonkin

The BMA has criticised plans that could see junior doctors forced to sit unexpected exams or complete unverified self-assessments in order to access specialty training posts for 2021.

Location: UK
Published: Wednesday 21 October 2020
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The association has criticised plans by HEE (Health Education England) for an increased reliance on the MSRA (Multi-specialty Recruitment Assessment) during recruitment for 2021, with some specialties using it for the first time, and others using it as the sole method of selection.

Warning that there is no evidence of the MSRA’s effectiveness in the majority of specialties it is being proposed for, the BMA has also issued concerns that imposing an unexpected exam on doctors exhausted from the pressures of COVID-19, is unfair.

The association has warned that the plans to use unverified self-assessments for some specialties in 2021 was concerning, since the equality impacts assessment on this methodology from the 2020 process has yet to be published.

Unexpected exam

BMA junior doctors committee deputy chair Lucie Cocker (pictured) warned that, in requiring trainees to sit an exam they had not expected, HEE had not adequately considered the mental and physical toll that the pandemic has taken on junior doctors.

She added that with exams having to be conducted remotely online due to social distancing requirements, many doctors might struggle to get the time off to take the assessment due to rising rota commitments.

She said: ‘Delivering quality medical recruitment in a newly virtual environment, with the NHS under the strain of a pandemic, was always going to present a challenge. However, it is essential that any solutions found should be equitable and validated, and that junior doctors are given the certainty and time they need to prepare properly.

‘Extra exams and changes in selection procedures and requirements, without truly knowing their impact on selection in specialties or the individuals taking those assessments, will damage junior doctor wellbeing, in a profession that is already approaching breaking point as a result of COVID-19 and historical NHS pressures.

‘The BMA has been clear throughout deliberations – extra exams and assessments, short single-panel interviews, and unverified self-scoring are inappropriate for recruitment and selection in 2021, when comprehensive virtual interviews and alternative models of delivery are feasible and deliverable.

‘We are disappointed that our concerns regarding the MSRA have not been acted on, and further issues remain in the proposed processes. Throughout discussions, we have been driven by the need for equality in recruitment and allowing participation from all doctors from all backgrounds, be they domestic or international. We still await public release of the Equalities Impact Assessment for the 2020 recruitment proposals that was completed in August.’


The BMA had already received concerns from doctors about the recruitment methodology used in 2020 recruitment process, which faced significant disruption in March this year owing to the onset of the pandemic.

When meetings to determine a Covid-resilient approach for 2021 recruitment began during the summer, the BMA emphasised doctors’ dissatisfaction with aspects of the 2020 recruitment methodology, such as the increased focus on exams, unverified self-scoring and lack of interviews.

Working in conjunction with other trainee organisations such as the Academy of Medical Royal Colleges Trainee Doctor Group, the BMA was able to submit clear proposals for an approach that would better suit doctors.

These included using the MSRA as just one part of a number of recruitment method, ensuring that interviews were conducted by a minimum of two panel members including a consultant, and that evidence from self-assessments be verified.

In its previous discussions with HEE and the Medical and Dental Recruitment and Selection, the BMA had supposedly obtained an agreement that MSRA exams would be used as part of a variety of recruitment tools rather than in isolation.

The association has warned that the assessment, which has only been validated for usage with recruitment to general practice, could also unfairly impact international medical graduates looking to work in the UK, due to a lack of familiarity with the NHS and not have English as a first language.

Justify proposals

Specialties scheduled to use the MSRA as part of the recruitment process for 2021 include:

  • ACCS Emergency Medicine
  • (CT1) Anaesthetics
  • Clinical Radiology
  • Community Sexual and Reproductive Medicine
  • Core Psychiatry Training
  • General Practice
  • Neurosurgery
  • Nuclear Medicine
  • Obstetrics and Gynaecology
  • Ophthalmology
  • Paediatrics

The BMA is calling for the publication of the Equalities Impact Assessment from the 2020 recruitment process in order to explain or justify the current proposed changes for next year.

The association has also insisted that doctors required to undergo self-assessment as part of their recruitment application be given adequate time to prepare, and that interview panels must consist of a minimum of two panel members, including a consultant.

If you are concerned about the effect of the proposals as they have currently been proposed, then make sure to raise them with your regional JDC rep, or email [email protected]