In his final report into the Modernising Medical Careers scheme, Sir John Tooke has labelled the online Medical Training Application Service (MTAS) as a ‘crisis, which has revealed profound concerns about the new system of medical postgraduate training.’
Sir John said that despite the failure of MTAS, which was abandoned by the Department of Health in spring 2007, IT should still be used in the future for recruitment purposes.
“A national electronic application process is a good idea. Candidates who have applied to UK universities through UCAS will already be familiar with the principle. It works successfully in other countries.”
The report identifies three key issues that must be resolved. First, the recruitment system should be secure and able to ensure that candidates do not cheat or plagiarise material. In addition, candidates should understand how they are scored; and the shortlisting process should be transparent to candidates.
Problems with the website first arose in March 2007 when the British Medical Association said the process had ‘descended into pandemonium’.
The website briefly made applicants confidential details publicly viewable. It also fell over twice due to demand, causing data loss and glitches to filing applications – failures that resulted in two extensions to the original application deadline.
Two months later, after much campaigning by the BMA and junior doctors, the Department of Health acknowledged problems and abandoned the system.
In his report, Sir John says that the rush to get the system out and working contributed to problems.
“Accelerated development of the system, changes to specification and an unanticipated increase in the volume and intensity of the applications that were received revealed technical deficiencies.”
However, management of the system also led to problems with the recruitment process, he added.
“The division between the management of the IT delivery system and ‘The Rules’ that informed its development created fundamental problems for a high risk project. Risk management was inadequate. Communication too, particularly with applicants and their mentors about the nature of Round 1, was deficient, fuelling the perception that the system had failed.”
This, he said ‘damaged confidence in the process as a whole.’ The DH now says it will use a programme board to develop a user-friendly and secure national IT system for use in the future, but for the time being, deaneries will continue to take charge locally.
Their responsibilities will include: advertising vacancies; using their own or speciality-based application forms, which must be structured, CV-based forms with speciality-specific questions; using their own shortlisting criteria and scoring systems; interviewing and selecting successful applicants; making offers and receiving acceptances.
Health minister, Ben Bradshaw said: “We have learned important lessons from the difficulties with this year’s recruitment process and have apologised to junior doctors for any distress caused to them and their families. We said we would listen to doctors and their representatives and today’s announcement reflects this. If new or national systems are to be used in the future, they must be rigorously tested and agreed with doctors, the NHS and others involved.
“Excellence and high achievement have always been at the heart of medical training in this country. As we continue to work with stakeholders on the future of Modernising Medical Careers this pursuit of excellence will continue.”
However, opposition MPs have been quick to use the report as a demonstration of incompetence by the government.
Liberal Democrat health spokesperson, Norman Lamb, said: “This is an extraordinary vote of no confidence in this Government’s stewardship of the NHS. There is now a consensus that ministers cannot be trusted with the money and organisation needed to train our doctors.”
The BMA said the report provided both an opportunity to deliver excellence in medical training, and an indictment of the government’s handling of doctors’ training.
Dr Hamish Meldrum, chairman of the BMA council, said: “This report charts a path that can lead us out of the current mess the government has made of doctors’ training.”
Dr Meldrum added: “This inquiry has resulted in a damning indictment of the failings of government training reforms. We must never go back to a system that so contemptuously ignored the concerns of the medical profession.”