MMC head resigns
30 Mar, 07 | by BMJ Group
The national director of Modernising Medical Careers, Professor Alan Crockard, has resigned over the MTAS debacle.
He sent a letter last night to the Chief Medical Officer, Professor Sir Liam Donaldson, saying he did not feel he could stay and watch what was happening to junior doctors, who seem to have been forgotten in the whole process.
A spokesperson from MMC said Professor Crockard was very sorry that it had come to this. “He stongly believes in medical education and the future of junior doctors. He felt they were going to be potentially disadvantaged.
“He just became despondent that his principles were not being adhered to,” said the spokesperson. “He just didn’t feel it was going the right way.”
In a formal statement issued late on Friday Professor Crockard said:
“I can confirm that I have resigned from my position as National Director for Modernising Medical Careers with immediate effect.
“I care passionately about medical education and training. In 2003, I moved from my position as Director of Education at the Royal College of Surgeons to join the MMC team. At the college, we developed a competency based curriculum. When I joined MMC, we used the same principles to develop a curriculum for a new two-year training programme called the Foundation Programme which was launched in 2005.
“It is now widely considered successful and fit for purpose. In addition the doctors completing the Foundation Programme this year seem as if they will match well into the new specialty training programmes.
“The principles of MMC are laudable and I stand by them. More patients should be treated by trained doctors, rather than doctors in training. We should ensure our doctors are trained to explicit standards of competence and that they have a clear, transparent career structure to follow.
“The recruitment of doctors into these new training programmes is separate to the development of the educational standards that MMC has been working to deliver. This recruitment process, through the MTAS system, undeniably needs to be reviewed. This process was developed outside my influence.
“Moving to the last few weeks, I have become increasingly concerned about the well intentioned attempts to keep the recruitment and selection process running. I accept that in many areas and in many specialties, this round of recruitment and selection has been acceptable. But the overriding message coming back from the profession is that it has lost confidence in the current recruitment system.
“In the interest of the most important people in the whole process, the junior doctors, this must urgently be addressed.
Modernising Medical Careers is a Department of Health agency charged with improving medical education for the benefit of patients and doctors alike. Its brief was to reform postgraduate medical training.
But MTAS, the computerised application system which has caused all the problems for junior doctors applying for posts starting this August, was not in the hands of the MMC. Instead the project was run by a separate Department of Health agency. Professor Crockard had no control over it.
The MTAS review group, chaired by Professor Neil Douglas, and which met this morning, expressed its regret at Professor Crockard’s decision, said the spokesperson.
As yet it is unclear what the ramifications of Professor Crockard’s resignation will be. Statements are due this afternoon from the Chief Medical Officer in Wales and the Director of NHS Education for Scotland. If his decision triggers other academics to pull out of MTAS, the system could collapse, though it seems unlikely the government would let that happen at this stage. BMJ will bring the latest news as soon as we get it.
Meanwhile, there was an ironic twist for review group chair Professor Douglas, who is president of the Royal College of Physicians of Edinburgh.
The council of his Royal College has said it believes MTAS has failed doctors and wants candidates appointed on the basis of interviews supported by CVs. It encouraged consultants to continue with the interview process but wants to see a review of the new system.
The statement went out in the name of the council’s vice president, Professor Peter Brunt, rather than that of Professor Douglas.
Dr Mike Jones, Dean of the College, would not comment on Professor Crockard’s resignation. He would only say that the College intended to continue with the appointment process.
“We have to make sure junior doctors are appointed,” he said. “We are being guided by the review group.”
It is sad that Prof.Crockard has resigned & his statement has put further questions on this whole process.It really seems that junior doctors have been forgotten.As a junior doctor I personally feel distressed as I am unsure about what future holds for me.Not only that my exams & my work are suffering.My exams & interviews were around the same time which resulted in me paying less attention to my exams & now it seems that all the previous interviews are scrapped.My work is suffering as it is becoming more & more difficult to concentrate with all this tension going around.
I hope something concrete comes out soon to give us some relief.
Aadil Jan Shah
March 30th, 2007 at 3:05 pm
“More patients should be treated by trained doctors, rather than doctors in training.”
Forgive me, my great and wise Lord Professor. I cannnot see just how we are supposed to GET more trained doctors, other than letting doctors in training treat patients. Then again, I’m not the head of MMC, a position which surely requires extra creative ability and an abundance of brain cells.
“But the overriding message coming back from the profession is that it has lost confidence in the current recruitment system.
In the interest of the most important people in the whole process, the junior doctors, this must urgently be addressed.”
At least Prof Crockard had the decency to acknowledge that the profession didn’t like MMC, unlike the DH’s no-apology-ignore-doctors-lalala-I-can’t-hear-youuuu stand so far. He may just have redeemed himself in the eyes of his detractors through this move. I certainly think better of him for this.
The Angry Medic
March 30th, 2007 at 6:25 pm
Why are we being guided by the review group on this issue? The JDC, who represent junior doctors, walked out of the review because they disagreed so strongly with it’s conclusions. The whole point of the review was to address junior doctor’s concerns over the MTAS process. If the JDC walked out, then it must be pretty clear that the review group has entirely failed in that aim.
Louise Hyde
March 30th, 2007 at 10:28 pm
Too little too late….I’m not sure how his resignation will influence recruitment as “apparantly” he had nothing to do with MTAS, but I can’t help thinking that the whole process is getting from bad to worse by the minute!
E Touma
March 31st, 2007 at 3:24 am
Thank you Professor Crockard! I am glad that you have had the courage to speak out against the abysmal treatment of us junior doctors. I am so glad that not ALL of my letters to those guiding the MMC debacle have been ignored.
Now, when will the rest of you admit that this process is not fit for purpose?
Simon Bonell
March 31st, 2007 at 11:48 am
I don’t see why our profession has to be controlled by the government. Imagine if they told lawyers how to run their training and told them they could only have one interview!
We should tell them to get stuffed and see how they run their hospitals without us!
Strike! we would have for a lot less a few years ago when they tried to scrap the ADHs.
had enough
March 31st, 2007 at 4:28 pm
Prof Alan Crockard has nothing to do with the current crisis. The MMC was not perfect but was reasonably running smoothly, with aim to restructure postgraduate medical training and reduce the chaos in the previous system where one post attracted on average 500 applications, one will be appointed and the rest 499 or more will have to apply for other jobs with average SHO have to apply for more than 500 post every 6 months ( 20 applications every week) and to stop doctors spending unlimited time in the SHO level ( some of them spent more than 10 years as SHO.
But the whole crisis came from the significant shrink in the number of available posts. MTAS identified 32.200 junior doctors working currently in the NHS and applied for ST1, ST2 and ST3. Only 18.500 posts are available for these 32.200 doctors ( 7577 ST1 , 6140 ST2 , 4016 ST3 and 777 ST4. these figures including non training posts).
The figures appeared in this article, which is similar to the figures circulated on the media during last few weeks (30 thousands doctors competing for 22 thousands jobs) is simply wrong and misleading.
In summary, 14 thousands doctors will be unemployed in August. Everyone of them cost 250000 pounds in undergraduate training and another 200.000 pounds in postgraduate training. The actual financial loss may be up to 7 billion bounds. The NHS will lose 12% of its overall medical workforce and about 40% of its junior doctors.
S.A.M , Junior Doctor , South West Wales
Sam
March 31st, 2007 at 5:50 pm
Mums4medics reported Prof Alan Crockard to the GMC. Shortly after, he resigned. Coincidence? Maybe. Now it is time for a few more who have been complicit in this betrayal of Junior Doctors to do the decent thing and follow suit. A legal challenge has been launched by RemedyUK. They are calling for more written evidence. Junior Doctors out there get in touch with them at legal@remedyuk.org and that way you can hurry to scrapping of the whole system and not just the fatally flawed shortlisting system.
B Green
March 31st, 2007 at 6:45 pm
His resignation doesn’t inspire confidence in the ‘review’ of MTAS. Perhaps he already knows the conclusion and has jumped before it is published.
The Angry Surgeon
March 31st, 2007 at 8:56 pm
A shame to lose one of the people who would known most about what is good and bad about the system and could have made appropriate corrections. I had 2 interviews which went well as I took leave, atttended courses, and prepared my portfolio well. Unfortunately to be told that these apparently have no value. This process has wasted complete 2 months of my time which would have been better utilised in my surgical training.
Archita Gulati
April 1st, 2007 at 6:42 am
It is unfortunate that MMC has landed it such a shamble.But i think the only way forward is to acknowledge the faults and come up with solutions ASAP in the first round rather than making it worse with new regulations every few days delaying the process and increasing the pressure. Uncertainity and lack of clear strategy is the biggest flaw. Of course they can learn from the mistakes and make it more effective for the second round and for the future.
Karthik Thangavelu
April 1st, 2007 at 9:46 am
It is a shame Prof Crockard who was renowned for his skills in transoral approach in C-spine surgery (atlanto-axial) will NOW be in the BRITISH MEDICAL HISTORY books for the fiasco of our medical training!
He should have resigned long ago; as it was clear the system was not working for some: mainly because there aren’t enough training posts for all junior doctors.
Now that Round 1 has come to an end; speaking to various Consultant Ophthalmic Surgeons; they strongly feel the candidates who have been selected & come through to the interviews were all exceptional & out-standing!! They have been happy & had put in the hours to change & adapt to the interview process, now only to be told the candidates they have interviewed can ONLY HAVE ONE CHOICE!!!
WHY IS IT MTAS in England remains isolated in its decision to offer applicants just one interview for a post?
Wales and Scotland have decided they will each stick to their original plan and continue to offer more than one interview to candidates who are appropriately qualified.
I feel after being around the country to 4 deaneries & region, living out of a backpack and spending hundreds of pounds travelling, completely furious how this Governement has little regard for the dedicated & conscientious junior doctors.
I feel that REMEDY UK should be fully supported in mounting a legal challenge against the MMC & DOH (which it has a strong case) for the recent change in goalpost when it has been Black & White that in Round 1 we are allowed 4 choices now to only be told we can choose 1 !!!
Nick Ophthalmologist
April 1st, 2007 at 12:27 pm
I’d like to know when the BMA are going to stand up for us? Crockard quitting hasn’t even been covered by the BBC as yet even. Neither MMC, MTAS, the BMA or PMETB care about junior doctors at all. We are merely government commodities.
Sonali Dutta
April 1st, 2007 at 1:58 pm
Another revelation.. how can MTAS NOT be in the hands of the MMC? I was strongly under the impression that this new nationalised form of application WAS the MMC Scheme. Now knowing that the head of the MMC had ‘No control over it’ does not exactly instill my greatest confidence in the system.
As a current Foundation Year 1 this is the second year I have observed the ‘teething problems’ to put it mildly, that MMC has caused and I am seriously considering, alike my counterparts, to either move abroad to continue my medical career or quit medicine and make a career change. One of the reasons I chose medicine was simply because it almost provided a job guarantee for life; this doesn’t seem to be the case now… I mean, look at Prof Crockard…
Abeyna Jones
April 1st, 2007 at 4:09 pm
It’s about time that someone involved in this situation admitted that it had been damaging in many ways and that junior doctors have been abandoned. So far the only people who have admitted “their mistakes” have been the junior doctors filling in their computerised application forms in which they had to describe their mistakes and what they have learned from them. Come on, you elders, do the same.
Dr J H Burton
April 1st, 2007 at 4:57 pm
Medical human resource planning has long been unscientific and it is a tragedy for many junior doctors that more rigour has not yet been applied…
Dr. M. Donnelly
April 1st, 2007 at 7:23 pm
hiya..
good move by the prof…
when will the others make the move and i think patircia hewitt should resign taking the responsibilty as well for causing such a tension in many doctor’s career and davastating instabilty in the NHS which was running smoothly uptil now.
may god bless NHS and the patients .
ucannotignoreit
April 1st, 2007 at 9:22 pm
Professor Crockard you should feel thoroughly ashamed of yourself, throwing in the towel instead of sticking at it and helping to sort this fiasco out. It is the sort of behaviour one expects of a politician.
DA
April 1st, 2007 at 10:40 pm
In the days to come we should be concentrating on the wise word of Prof Crockard:
“I know little of the law, but it seems to me basically unfair to advertise the possibility of four interviews and then suggest that these might not be honoured.
Equally devastating would be the suggestion of some stakeholders, that the completed interviews be discarded and the process be rerun.”
idoc
April 2nd, 2007 at 12:11 am
I haven’t been shortlisted for ST1 in ACCS despite of 1 year training in relevant field; whereas couple of my freinds had been shortlisted who are not even registered with GMC yet or just got on February 2007. If MMC wants patients to be treated by trained doctor, rather than trainee, I just wonder whats wrong with me.
MDG
April 2nd, 2007 at 4:42 am
I pity the doctors who are still hoping to get any straight answer from Department of Health. Unfortunately Prof Crockard is one of its famous victims.
Resigning is a a coward’s act. He should have stayied and fought with us against the system. Junior doctors have long been bullied by their peers who’s interest is only to collect medals and prizes for the work put in by us !.
Down with the Colleges, and all the so call ‘training’ that we are receiving. There is no support from these guys as they are only subservents of a controlling DOH.
Let’s unite and prove we are a force they must take into account !!
dracula the romanian
April 2nd, 2007 at 8:53 am
MMC Meltdown continues. If Crockard knew all this (see his resignation letter) about lack of top leadership, why wasn’t he screaming it from the rooftops before he quit? Junior doctors were pointing all this out over a year ago and more … and nobody listened. How much more important a responsibiility can there be than to get the training and development of senior medics right? He should be in the Tower, together with Hewitt and Donaldson.
If Crockard wants to redeme his reputation he must offer some leadership to the junior doctors. Better than anyone, he knows where the bodies are buried in this dreadful shambles. But first, and unlike his letter, he must acknowledge that the whole scheme was utterly flawed - not just in its implementation (no surprise surely?), but in its core concepts.
Why are the media (papers, TV) largely silent about this resignation? Only the Torygraph seems to have mentioned it in print. It is impossible to exaggerate the problems the NHS will face in August. There will either be a lot of empty posts - and all that that entails - or a lot of square pegs in rounds holes (the most generous way of describing that the best medics will not be in post). There will also be thousands of unemployed, UK-trained medics in despair at the waste of 8, 9, 10 years or more of their lives and the untold expense (in human emotion, sheer effort and cash) that is to be rubbished.
If there is a profession where morale is fundamental it has to be hospital doctoring. What is this cohort of junior docs - even those ‘lucky’ enough to manage to stay in it - to think of a career in a system that is riven with problems, ‘challenges’ of a negative corrosive kind, desertion at the moment of crisis by those supposed to provide leadership? And yet, through it all, they do their nightshifts and look after us all. Or the Goverment must hope they do ….
Doctors Dad
April 2nd, 2007 at 9:53 am
At least Prof Crockard admitted the failure of MTAS. We as junior doctors need to know sooner rather than later the outcome of the interviews that we have been through. I find it completely unacceptable to scrap the interviews that have already been conducted. These shortlistings and interviews must be honoured with new strategies for those who are not shortlisted, being fair with everyone.
anees sharif
April 2nd, 2007 at 10:28 am
I am afraid that the MTAS/MMC is just the tip of the iceberg when it comes to the disregard and incompetence the Labour Party have demonstrated in their dealings with the medical profession. In their obsessed bid to win the spin-war they insist on raming through the most ill-considered and poorly conceived “reforms” that have not in the slightest way been validated or audited and without any proper consultation. It is so thinly disguised that the purpose of MTAS and MMC is to exert government control over the number of doctors being employed (hence, the reduced training positions and the creation of the a sub-consultant grade) - in order to address looming NHS deficeits. Shame on our Royal College and PGMDE “representatives” for not standing up for the junior members of the profession. I think this resignation is appropriate.
I would suggest that the expedient course of action for the BMA, Remedy UK is to seek Conservative Party support to draw attention to Labour’s denigration of the medical profession and the general hash that the government backed MTAS has mad eof our training. After all David did turn up for our rally and has said that doctors should have more ability to regulate their own profession - hear, hear.
Modocs
April 2nd, 2007 at 11:15 am
The whole MTAS process is a debacle. The major problem is that this Labour government does NOT listen to opinions. Opinions from consultants, and in particular, doctors in training (saying there should be less ‘doctors in training’ but more ‘trained doctors’ is just a fudge and a play of words by Prof Crockard) have all been ignored because a non-medic like Patricia Hewitt who completely does not and refuses to understand the training system required to produce ‘competent’ doctors says she has got it right.
In addition, there appears to be widespread abuse of the MTAS with many doctors openly admitting to lying on the application forms about the number of audits and research projects they have been involved in, and these are the ones who often end up with the 4 interviews, whereas the honest ones are being played out by an incompetent system and an even more incompetent Patricia Hewitt!
Sivakumar Sathasivam
April 2nd, 2007 at 3:11 pm
Training in medicine has become an endless exercise log-book filling and 360 degree reviews, rather than seeing patients and doing procedures. Juniors are now subject to scrutiny from consultants, managers, nurses and just about everyone who has an opinion.
However, the so-called respected members of our profession seem to have escaped such mechanisms of accountability and have presided over the biggest debacle (MTAS/MMC) in the living history of our profession. Therefore to the underperforming MTAS and MMC committee members, I suggest a 360 degree review for you.
For :
1. Condoning a unvalidated and unaudited system of medical training to proceed
2. Going back on promises for those granted >1 interviews (but good on you MMC Scotland and Wales for maintaining some integrity)
3. Being Labour governments lap-dogs and allowing them to cut our jobs (to balance the NHS books)and create a sub-consultant grade
4. Selling out the junior members of your own profession whom you have been entrusted to represent
5. Allowing an unprecedented loss of confidence and morale in the medical profession
You are FIRED! Crockard - good riddance. Hope there will be more to follow suit.
Dan Corbett
April 2nd, 2007 at 5:01 pm
There should be no pity for Professor Crockard, who has been complicit in this MMC/MTAS fiasco from the very beginning. He has held on until the very last minute, and jumped like a coward before he was pushed.
Professor Crockard has given us a system with leaked marking schemes, creative writing exercises, minimal scoring for genuine academic achivement, botched shortlistings, ghost directives from the DoH, goal-posts changing at the last minute.
I am sure that junior doctors with be touched by Lord Hunt of Kings Heath, the health minister words in The Time on Saturday
“I appreciate that it has been a difficult time for junior doctors and would like to reassure them that we are listening to their concerns and working with their representatives to find a fair solution to this complex issue.”
I am sure that Blair’s crony has lost enormous amounts of sleep worrying about those poor junior doctors. So the goverment and Patricia Hewitt push on with the system regardless, even after the BMA JDC walked out of talks with the review panel.
They refused to listen to us last year so why should they listen now? Where were they to answer questions on 17th March? They are not alone though, the BMA, PMETB, and the Colleges are all acountable. Weak leadership across the board. I just hope that their knighthoods were worth selling the hopes and careers of thousands of doctors.This fiasco is just another catastrophe from this arrogant, unaccountable government.
So after having spent the past 2 very uncertain and anxious months desperately filling in on-line forms, waiting to hear if they have or have not been deemed competent by a computer, travelling around the country to attend interviews, doctors have now been told that all these will be scrapped, and only 1 choice will be counted. Futhermore consultants now have to interview everyone for their 1st choice. How can that be fair, and how can bias be eliminated? Is this the way to treat some of the the best minds in our country?
This system patronises and belittles those public sector workers, whose good will for years has held the NHS together. I fear now that the damage may be irrevocable, and this lost generation will either leave the country (after >£200,000 spent on education), or leave the profession
Disillusioned and Disappointed
April 2nd, 2007 at 6:32 pm
I believe that MTAS was formed in good faith in order to bring accountability and fairness to the process of recruitment of trainees.MTAS may have its problems of not identifying the best trainees but I think the problem lies in the posts that are available.I do not think that if we use the CV and interview method we will overcome the latter problem. The fact of the matter is no matter which method is used there will be a sizeable number of junior doctors who will be unemployed in August.I think that is where we should focus our efforts.we should try and create more training jobs to accommodate the majority of the junior doctors.One way is to reduce the wages so that the budget can be stretched to pay more doctors or reduce the number of hours each doctor works so that the remaining hours can be worked by another junior doctor.just a few ideas.
fred chikwanda
April 2nd, 2007 at 10:36 pm
It is just me but do others think that the MMC and MTAS committees have done a terrible job. Without question, this episode has been a spectacular disaster. Good riddance to Cockard. Why don’t our senior colleagues responsible for this debacle, show some dignity and own up?
Rebecca C
April 2nd, 2007 at 11:56 pm
What a bloody mess. How the hell can we all compete with each other in this one chance saloon that is MTAS 2007. There are good SHO’s post MRCP with 2 years at this level competeing with those with PhD’s etc, etc and LATS etc., etc.
Are the more experienced going to be discarded due to apparent lack of career progression and apparently pointless research or are the less experienced going to be discarded as victims of their year of qualification and lack of LATS etc who would otherwise have been “perfect for this new system”
I really do think this whole situation highlights a lack of respect for junior doctors which is increasingly evident throughout the NHS.
We all need to withdraw our applications on mass. Its not about who got more interviews, who did or didnt get shortlisted, its about ensuring that we are never treated this badly again.
The problem is we are all a bunch of selfish muppets who only care about our own interests!
SHO london
April 3rd, 2007 at 2:24 am
Professor Crockard’s departure will be mourned by few who are involved in practical attempts to train doctors within the idiocy of MMC. He accepts some of his failings but not the major problem, that being the whole MMC agenda. Simply to dumb down the requirements to be a “specialist” to the level that would have been expected of a competent second registrar 10 years ago achieves nothing. The products of MMC will not be properly trained. At best they will be, upon completion, middle grade registrars. They will then require a period of “fellowship” to turn them into anything resembling consultants. Thus, effectively reinventing the senior registrar. The MTAS fiasco is not an endpoint of its self and is really only a symptom of the terminal decline of medical training in this country.
A properly trained doctor
April 3rd, 2007 at 1:09 pm
Good riddance to Crockard and shame on the established consultant grade for refusing to stand up for our brutalised junior doctors.
Changing the current system is desirable - i am currently working in Canada and have gained an insight finally of what it is to be “trained ” properly. This is achievable by having a consultant based system of healthcare where junior doctors are there primarily to be trained. This does not exist within the NHS and in this enviroment the changes in training have always be doomed to fail. We are putting the cart before the horse. MMC will let down patients as surely as it has let down doctors.
And to all those established consultants who refused to stand up to the changes, no doubt believeing that a subconsultant grade was in their interests- guess what -you’re next. Now that we have established that the government can do what it likes and now that there is medical unemployment your positions will be undermined - serves you right.
Ravi
April 11th, 2007 at 1:30 am