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Monday, April 30, 2007

Contender for greatest of all NHS failures- MTAS Junior Doctor application system

The crisis that is leading highly qualified junior doctors to head abroad is the result of one of the National Health Service's all-time great administrative cock-ups. It is has left 30,000 junior doctors bitterly disillusioned and angry. But it also has big potential implications for patient care.

Medical training is, quite rightly, being shortened and modernised. But the new system appears to have been brought in too quickly, leading to fears that there will be several thousand too few training posts come August.

A centralised, online clearing system that has replaced local job applications has gone badly wrong. Junior doctors say the system prevents them listing their full qualifications and experience, while concentrating on questions about empathy and leadership. Highly-qualified doctors have found themselves without even an interview, while less qualified candidates have been called for interview to the wrong jobs.

The system is being patched up for this year, with a second round of recruitment promised for those without jobs after the first round. An independent review has been launched on how it will all work next year.


Junior doctors go overseas after applications disaster

Highly-qualified junior hospital doctors are quitting the National Health Service for jobs in Australia, New Zealand and elsewhere following the fiasco over a new application system for training jobs that has left many without an interview.

The British Medical Association released a survey of 650 doctors yesterday showing that 55 per cent would be likely to seek a training opportunity overseas if their current applications were not successful.

Almost 5 per cent had already had overseas offers. This raised the possibility that many would take four- or five-year training posts that would deprive the NHS of their services for at least that long and perhaps their whole careers, the BMA said.

"The NHS could lose thousands of its best young doctors simply because of poor planning," said Dr Jo Hilbourne, who chairs the BMA's juniors' committee.

The threat is more than theoretical. Kate Bleasdale, chief executive of HCL, an agency that provides locum doctors, said it had already placed about 40 British doctors overseas since late last year, with demand strong from Australia, New Zealand and the United Arab Emirates.

"We currently have about 100 doctors who are looking to move abroad and there is worldwide demand for healthcare staff," she said.

Dr Richard Thomas, a senior house officer at Whipps Cross Hospital in north-east London, has already received an offer of a four- year post in emergency medicine at a hospital in Sydney, and says that he knows two other juniors who are going there. Aged 29, he qualified in 2003 with an extra year at medical school that gave him an additional research degree.

He has already spent a year in Australia to broaden his experience and has passed all his specialist exams at the first sitting to acquire the higher qualification of membership of the Royal College of Physicians. Speaking after coming off a 13-hour night shift, he said: "I have presented at international meetings in Boston. I have a first-class honours [degree] for my dissertation. I have full membership of the [Royal] College of Physicians. I recognise medicine is very competitive and I could not be more qualified.

"But I got no interviews at all from the medical training application service. The system is telling me I am un-employable in the NHS."

Dr Thomas said his goal was to work in clinical radiology, and if the latest attempts by Patricia Hewitt, the health secretary, to patch the system up resulted in a job offer, he would stay in the UK. Otherwise "it will have to be plan B" and a job in Sydney that was not his ideal choice.

Andrew Lansley, the Conservative health spokesman, said a strategic solution to the issue was needed, on top of the emergency measures the government was taking on interviews.

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