mmc and the world after mtas

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MMC and the World after MTAS Ian R. Hastie

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Page 1: MMC and the World after MTAS

MMC and the World after MTAS

Ian R. Hastie

Page 2: MMC and the World after MTAS

MMC and the World after MTAS

Ian R. Hastie

Dean of Postgraduate Medicine, London

Page 3: MMC and the World after MTAS

MMC and the World after MTAS

Ian R. Hastie

Dean of Postgraduate Medicine, London

Consultant Geriatrician

Page 4: MMC and the World after MTAS

"MMC and the World after MTAS"

A Personal View

Page 5: MMC and the World after MTAS

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

Page 6: MMC and the World after MTAS

Time from Graduation to SpR (UK SpRs in London May 2006)

0

50

100

150

200

250

300

350

400

3 4 5 6 7 8 9 10

medicinepaedsanaesthsurgery

Page 7: MMC and the World after MTAS

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.”

Page 8: MMC and the World after MTAS

Postgraduate Training Programmes in Medicine -August 2007

F1 F2 ST1 ST2

BasicMedicalTraining (2 years)

Higher SpecialistTraining Program.

(3-6 years)

Foundation Programme

(2 years)

graduationFullRegistration CCT

ST3 ST4 ST5 ST6

AllocationAppointment

RUN-THROUGH

Page 9: MMC and the World after MTAS

2007 after Rounds 1&2

Posts All 15,684

RT 11,880

FTSTA 3627

Academic 177

Page 10: MMC and the World after MTAS

2007 after Rounds 1&2

Posts All 15,684

RT 11,880

FTSTA 3627

Academic 177

Eligible Applicants 27,849

Page 11: MMC and the World after MTAS

Success Rates after Round 1

% Successful %Unsuccessful

All UK (andEquiv)Graduates

71.9% 28.1%

AllInternationalGraduates

31.3% 68.7%

Page 12: MMC and the World after MTAS

Decision on HSMPs

Page 13: MMC and the World after MTAS

Lines of Responsibility

P rog ram m es an d Tra in ees

D ean ery

S H A

M M C B oard -in c lu d es rep s from th e B M A , A cad em y o f M ed ica l R oya l C o lleg es , N H S

D H

Page 14: MMC and the World after MTAS

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: IRHnobody 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

Page 15: MMC and the World after MTAS

“A national online application system has considerable merit and could potentially be more efficient

than previous systems…..”

Page 16: MMC and the World after MTAS

“A national online application system has considerable merit and could potentially be more efficient

than previous systems…..”

BGS Oct 2007

Page 17: MMC and the World after MTAS

?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

Page 18: MMC and the World after MTAS

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

Page 19: MMC and the World after MTAS

?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).

Page 20: MMC and the World after MTAS

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

Page 21: MMC and the World after MTAS

What about Run-Through?

• Trainees Appointed to RT in 2007

• ST1 --> ST2

• How do we move from ST2 -->3 ?

Page 22: MMC and the World after MTAS

Most Popular Medical Specialties and would move

location

• Cardiology 16%

• Respiratory 10%

• Gastro 10%

Page 23: MMC and the World after MTAS

Leave London rather than accept :

• Allergy

• Audiology

• Chem Path

• Oncology

• Genetics

• GUM

• Immunology

• Nuclear Med

• Paediatric Cardiology

• Rehab. Med

• Occup. Med

• GERIATRIC MEDICINE

Page 24: MMC and the World after MTAS

How do we move from ST2 -->3 ?

• Which specialties?

• Open or Closed appointment ?

• Local or National appointments ?

Page 25: MMC and the World after MTAS

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?

Page 26: MMC and the World after MTAS

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**

Page 27: MMC and the World after MTAS

Postgraduate Training Programmes in Medicine - ?August 2008 and Beyond

F1 F2 CT1 CT2

CoreMedicalTraining (2/3 years)

Higher SpecialistTraining Program.

(3-6 years)

Foundation Programme

(2 years)

graduationFullRegistration CCT

ST3 ST4 ST5 ST6

AppointmentAppointment

Page 29: MMC and the World after MTAS

Thank You for Listening(and not throwing anything)

[email protected]