new doctors and jobs

The medical student's (monthly newspaper) take on the multi-deanery appliation process, with a very Independant style review of the facts and figures.

Editorial in the Lancet on the drama that is newly qualified doctors and jobs. Only 8 of the 48 points in the job application for new doctors is for academic achievement. Something is not quite right there. The last sentence says quite a bit... (though I do recommend you read the whole thing).

The Lancet 2006; 367:1029
UK medical schools: undervalued and undermined
Last weekend, 400 medical students travelled from around the UK to take part in Medsin's global health conference, held at Guy's, King's and St Thomas' Medical School in London. Medsin is a network of medical students which raises awareness about global health issues. The vigour of its annual conference illustrated not only the commitment of medical students to global humanitarian concerns, but also the altruistic values and incredible motivation instilled in them by their medical schools.
Yet the achievements of these medical schools are now being undermined in a disgraceful and incompetent manner. The Department of Health, which has neither experience nor understanding of medical education, training, or careers is eroding the central responsibility of medical schools—namely, to deliver qualified and capable doctors into the NHS and to strengthen the research base of medicine.
Medical students and newly qualified doctors already feel insecure about their prospects. With headlines appearing weekly suggesting that thousands of jobs may have to be stripped out of the NHS because of budget deficits, the acute instability of the health service is bound to raise anxieties among those about to join its ranks.
This crisis has been boiling for some months. But it came to a head with a letter published in The Times on March 4 by 86 senior figures from UK medical schools. Charles McCollum, professor of surgery at the University of Manchester, and his colleagues drew attention to the way in which the Department of Health was ignoring requests by leading medical professors to review urgently its programme for Modernising Medical Careers (MMC). At the time, 660 qualified doctors had not yet been awarded an F1 place (the first of two foundation years), leaving many excellent students devastated by this apparent rejection of the skills they would bring to patient care. Astonishingly, a new untested standard of competence was proposed for those who had low scores in the new F1 application procedure. This idea has now, fortunately, been abandoned. But students will still be prioritised on the basis of a completely untested scoring system.
The F1 application process consists of 48 points, only 8 of which relate to academic achievement. The rest are self-assessments and are open to manipulation. The responsibility for granting full qualification after the F1 year rests with medical schools. It has nothing to do with postgraduate deans. Medical schools have a statutory responsibility for the primary medical qualification (medical degree), the pre-registration training year (F1), and full and final registration at the end of F1. By not discharging those responsibilities—eg, by ceding control of the fate of F1 trainees to postgraduate deans—medical schools will be in breach of their legal duties, putting themselves at risk of legal challenge from students who feel that their expectations are not being met.
Respected academic clinicians who have dedicated themselves to teaching medical students and preparing them for practice quite reasonably ask why politicians are now involving themselves in procedures for selecting and training doctors. It is the universities and Royal Colleges that have responsibility for setting and delivering professional standards of practice, not civil servants and ministers. By shifting responsibility for newly qualified doctors in this way, the government is creating a cohort of disenfranchised and demoralised young clinicians who feel hampered in pursuing career paths that best suit their talents and patient needs. This state of affairs is utterly crazy.
In response, medical students are organising a nationwide petition to oppose these ill-thought-out “reforms” (over 1000 signatures have been collected so far). Royal Colleges are being encouraged to take up the issue with ministers on the grounds that MMC has been imposed with little consultation, is damaging training, and is likely to be difficult to reverse if action is not taken soon. The Council of Heads of Medical Schools is continuing to campaign for a selection process for F1 trainees that is truly in the best interests of patients and will establish a real educational continuum as students move into clinical practice.
In 2005, the Royal College of Physicians published its final report on the future of medical professionalism, Doctors in Society. The report emphasised that “Professionalism cannot be imposed by governments or by a regulatory culture. It must emerge from and be sustained by doctors themselves”. The Department of Health's unprecedented and mistaken incursion into medical education, together with its covert attack on medical schools, are yet further examples of a thinly veiled political desire to deprofessionalise medicine.