The Royal College of Surgeons has withdrawn from the MTAS review group, chaired by Professor Neil Douglas.
Bernard Ribeiro, the college’s president, announced his decision in an open letter to Professor Douglas in which he said that the DH had failed to make adequate transitional arrangements for “a large number of well-trained, experienced and committed senior house officers who are in danger of being lost to the NHS”.   
Mr Ribeiro had asked for 240 extra senior training posts for surgeons over the next three years.
He said a fundamental concern was that trainees for specialist surgery were being selected too early in their career, before they have had a chance to prove their dexterity in the operating theatre.
“Almost two years after first raising my concerns, there is still no recognition whatsoever by the Department of Health of the scale of this problem or its profound implications, far less the prospect of an acceptable solution in terms of a temporary expansion of national training numbers.

“I am also concerned about the arrangements for selection of junior doctors into run-through surgical training programmes. Surgery has unique requirements in terms of recruitment – the criteria for selection include diagnostic skills, clinical judgment and manual dexterity. It is neither practical, nor indeed safe, to select junior doctors with a view to a career in surgery without the opportunity for assessing whether they have the full mix of professional skills required.
He said it was “with the greatest reluctance” that he was pulling out of the group.

Yesterday health secretary Patricia Hewitt announced that an extra 200 specialist training posts would be made available for those unable to secure training posts. A further number of non-training posts would be available she said.The BMA said this did not go far enough, with 12,000 applicants under MTAS unlikely to secure training posts.

“Creating more temporary posts on its own is not an adequate solution” said Jo Hilborne, chair of the Junior Doctors Committee. “We need to know that there will be more opportunities to get into long-term training in years to come, and increased flexibility to move between specialties and regions.”

All applicants are due to be told the outcome of their first round interviews by 7 June. They will be offered posts on the basis of their ranking, irrespective of the candidate’s order of preference. They will have until 23.59 on 10 June to accept or decline any initial offers. Candidates have been advised to make their decision straight away to give them ‘the maximum possible time to finalise your personal arrangements’ or ‘so that the training opportunity can be passed on to one of your colleagues’.

Any remaining unfilled posts will be offered between 11 and 22 June, with applicants given only 48 hours to respond.

Round One will close on Friday 22 June, at 23.59.