MMC and the World after
          MTAS
Ian R. Hastie
MMC and the World after
           MTAS
 Ian R. Hastie

Dean of Postgraduate
 Medicine, London
MMC and the World after
            MTAS
  Ian R. Hastie
 Dean of Postgraduate
  Medicine, London


Consultant Geriatrician
"MMC and the World after
       MTAS"
      A Personal View
Modernising Medical Careers: why?

• PRHO competences not consistent
• “Lost Tribes” of SHOs: some wasted time
• Variable ...
Time from Graduation to SpR
        (UK SpRs in London May 2006)
400
350
300
250                                     medic...
Modernising Medical Careers

 “ ……..the end product of the training
 process, whether a hospital doctor or
general practit...
Postgraduate Training Programmes in
           Medicine -August 2007
                    Full
graduation          Registra...
2007 after Rounds 1&2
Posts         All        15,684
              RT         11,880
              FTSTA      3627
      ...
2007 after Rounds 1&2
Posts         All          15,684
              RT           11,880
              FTSTA        3627
...
Success Rates after Round 1
                % Successful %Unsuccessful


All UK (and        71.9%         28.1%
Equiv)
Gra...
Decision on HSMPs
Lines of Responsibility

                               DH


                            MMC Board -
includes reps from th...
Learning from 2007 - DH
• Criticism included
   – Big Bang
   – Rushed consultation
   – IT development not sufficiently c...
“A national online application
system has considerable merit and
could potentially be more efficient
    than previous sys...
“A national online application
system has considerable merit and
could potentially be more efficient
    than previous sys...
?2008
• No National IT system
• National Person Specs.
• Local Application Form
  – Less ‘white space’ and more CV
• Local...
2008 Recruitment Process
• Most specialties will be local recruitment
• A few will be national eg GP and Histopath
• Separ...
?Clinical resource requirements in one
      deanery for 2008 recruitment
• Across all specialties with 2008 recruitment, ...
Competition in 2008
• 2007 RT trainees will progress to ST3
  – Many ST2/3 will be taken by RT
• Therefore competition mor...
What about Run-Through?

• Trainees Appointed to RT in 2007
• ST1 --> ST2
• How do we move from ST2 -->3 ?
Most Popular Medical
Specialties and would move
          location

     • Cardiology 16%
     • Respiratory 10%
     • Ga...
Leave London rather than
        accept :
•   Allergy      • Nuclear Med
•   Audiology    • Paediatric
•   Chem Path      ...
How do we move from ST2 -->3 ?

    • Which specialties?
    • Open or Closed appointment ?
    • Local or National appoin...
Proposal for ST2-->3 for
            Medicine
• Majority placed locally by closed appointment
• 10-20% of posts put forwar...
TOOKE!!
•   Split Foundation
•   3 year core training programmes
•   Uncouple Run-Through**
•   PMETB:GMC
•   Universities...
Postgraduate Training Programmes in
    Medicine - ?August 2008 and Beyond
                    Full
graduation          Re...
http://www.mmc.nhs.uk/pages/programme_board


You may find it useful to read a paper on the outcome of
 consultation and d...
Thank You for Listening
(and not throwing anything)
  ihastie@londondeanery.ac.uk
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MMC and the World after MTAS

  1. 1. MMC and the World after MTAS Ian R. Hastie
  2. 2. MMC and the World after MTAS Ian R. Hastie Dean of Postgraduate Medicine, London
  3. 3. MMC and the World after MTAS Ian R. Hastie Dean of Postgraduate Medicine, London Consultant Geriatrician
  4. 4. "MMC and the World after MTAS" A Personal View
  5. 5. Modernising Medical Careers: why? • PRHO competences not consistent • “Lost Tribes” of SHOs: some wasted time • Variable supervision at SHO level • Changing workload – EWTD • Changing disease patterns, new technologies and new drugs • Rising patient expectations • Difficulty in planning careers • Snakes and ladders of career progression
  6. 6. Time from Graduation to SpR (UK SpRs in London May 2006) 400 350 300 250 medicine paeds 200 anaesth 150 surgery 100 50 0 3 4 5 6 7 8 9 10
  7. 7. Modernising Medical Careers “ ……..the end product of the training process, whether a hospital doctor or general practitioner, should be a highly qualified, well trained and accredited doctor who can deliver the care and treatment patients need in the modern NHS.”
  8. 8. Postgraduate Training Programmes in Medicine -August 2007 Full graduation Registration CCT Appointment Allocation F1 F2 ST1 ST2 ST3 ST4 ST5 ST6 Foundation Basic Higher Specialist Programme Medical Training Program. (2 years) Training (3-6 years) (2 years) RUN-THROUGH
  9. 9. 2007 after Rounds 1&2 Posts All 15,684 RT 11,880 FTSTA 3627 Academic 177
  10. 10. 2007 after Rounds 1&2 Posts All 15,684 RT 11,880 FTSTA 3627 Academic 177 Eligible Applicants 27,849
  11. 11. Success Rates after Round 1 % Successful %Unsuccessful All UK (and 71.9% 28.1% Equiv) Graduates All 31.3% 68.7% International Graduates
  12. 12. Decision on HSMPs
  13. 13. Lines of Responsibility DH MMC Board - includes reps from the BMA, Academy of Medical Royal Colleges, NHS SHA Deanery Programmes and Trainees
  14. 14. Learning from 2007 - DH • Criticism included – Big Bang – Rushed consultation – IT development not sufficiently controlled • Wide Consultation BUT; – Didn’t penetrate stakeholder community – Consultees didn’t take responsibility or own the product (nobody blameless: IRH) – DH didn’t hear some messages • Lessons learned from Review Group include – the need to address concerns – the power of stakeholder collective responsibility
  15. 15. “A national online application system has considerable merit and could potentially be more efficient than previous systems…..”
  16. 16. “A national online application system has considerable merit and could potentially be more efficient than previous systems…..” BGS Oct 2007
  17. 17. ?2008 • No National IT system • National Person Specs. • Local Application Form – Less ‘white space’ and more CV • Local Deanery Appointments (?interference) • Very Tight Timescale • Academic Posts • HSMPs
  18. 18. 2008 Recruitment Process • Most specialties will be local recruitment • A few will be national eg GP and Histopath • Separate Academic Recruitment • Mixture of Run-Through and Uncoupled in 2008 • Can apply for as many as want • Recruitment phase one 5th Jan to 16th May • Up to 3 recruitment exercises per year – Most ST1/2 in first exercise – ST3 spread across year depending on NTN availability
  19. 19. ?Clinical resource requirements in one deanery for 2008 recruitment • Across all specialties with 2008 recruitment, it is estimated: • 522 Consultants will be needed to shortlist 50 application forms each (assuming double scoring of 13,678 applications) • 528 days of consultant time will be needed for interviews (assuming panels of six consultants interviewing a maximum of 30 applicants per day).
  20. 20. Competition in 2008 • 2007 RT trainees will progress to ST3 – Many ST2/3 will be taken by RT • Therefore competition more severe in 2008 for remainder (numbers not totally known), – ?3:1 , can not give priority to UK trained – 5800 ST1 and 5000 coming out of FP – 2000 ST2 and 1200 FTSTA1s completing – ?900 ST3 posts with 2000 FTSTA2s completing
  21. 21. What about Run-Through? • Trainees Appointed to RT in 2007 • ST1 --> ST2 • How do we move from ST2 -->3 ?
  22. 22. Most Popular Medical Specialties and would move location • Cardiology 16% • Respiratory 10% • Gastro 10%
  23. 23. Leave London rather than accept : • Allergy • Nuclear Med • Audiology • Paediatric • Chem Path Cardiology • Oncology • Rehab. Med • Genetics • Occup. Med • GUM • GERIATRIC MEDICINE • Immunology
  24. 24. How do we move from ST2 -->3 ? • Which specialties? • Open or Closed appointment ? • Local or National appointments ?
  25. 25. Proposal for ST2-->3 for Medicine • Majority placed locally by closed appointment • 10-20% of posts put forward for „Headroom‟ • „Headroom‟ posts appointed in Open Competition – Local? – National?
  26. 26. TOOKE!! • Split Foundation • 3 year core training programmes • Uncouple Run-Through** • PMETB:GMC • Universities control postgraduate training • Set up Postgraduate Schools** • Profession to have more say**
  27. 27. Postgraduate Training Programmes in Medicine - ?August 2008 and Beyond Full graduation Registration CCT Appointment Appointment F1 F2 CT1 CT2 ST3 ST4 ST5 ST6 Foundation Core Higher Specialist Programme Medical Training Program. (2 years) Training (3-6 years) (2/3 years)
  28. 28. http://www.mmc.nhs.uk/pages/programme_board You may find it useful to read a paper on the outcome of consultation and decision on recruitment to specialty training in England in 2008: http://www.mmc.nhs.uk/pages/news/article?45B74A2F- AF7C-4963-8ED1-D4D5A9D76CF5
  29. 29. Thank You for Listening (and not throwing anything) ihastie@londondeanery.ac.uk

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