Friday 12th October 2007
at the Royal Society of Arts
"Officials 'to blame for doctors fiasco'"
"Online system for junior doctors scrapped"
"Training overhaul blamed for junior doctors fiasco"
"Inquiry raps doctor training reform"
Aspiring to Excellence
1. The implementation of the European Work Time Directive had highlighted the severe shortage of trained surgeons in the UK.
2. There was an urgent need to increase the number of General Surgeons who are fully trained to treat patients in both the emergency and elective setting and there should be a diminishing reliance on Staff and Associate Specialist Surgeons to support the NHS.
3. ASGBI strongly supported the introduction of structured training programmes, in which progress is determined by competence.
4. ASGBI recognised the need to provide emergency and elective cover throughout the United Kingdom which will necessitate variations in the provision of service and different models to suit different circumstances.
5. The Modernising Medical Careers concept that most hospitals should be staffed by General Surgeons who are only “emergency safe”, with relatively few specialists, was fundamentally wrong.
Time marches on. Currently we face the largest crisis to confront the National Health Service since its inception 60 years ago. The problems related to the introduction of MMC for August 2007 and the discredited national application process (MTAS) have significantly undermined education and training and the future provision of clinical practice. The Government, Department of Health, PMETB, the Deaneries, BMA, the Colleges and the Speciality Associations have all contributed to the confusion. It is difficult to identify who is to blame for the angst of trainee doctors and the concerns of patients. What is not in dispute is that many of the recommendations of MMC are ill-conceived, introduced in haste and deny training opportunities for many capable trainees. This is NOT a surgical problem, but impacts on the spectrum of medical disciplines. Voices of concern urging caution and more time to consider the issues have been deflected or ignored. The MTAS/MMC Review Group has done little to restore confidence in a flawed system and the Tooke Inquiry promises rigorous analysis of the problems over the summer.
We believe we need solutions and a more robust selection process for 2008. The delivery of surgical training and education should be returned to the Surgical Royal Colleges and Speciality Associations away from political interference and control. The Intercollegiate Surgical Curriculum Project (ISCP) provides a framework for future competency-based training and assessment, but the details need to be tested and refined.
Against this background the Association of Surgeons of Great Britain and Ireland (ASGBI), in collaboration with the Federation of Surgical Specialist Association (FSSA) and the Surgical Royal Colleges, will be hosting a one-day pan-surgical Consensus Conference on “The Future of MMC”. The conference will take place on Friday 12th October 2007 at The Royal Society of Arts, John Adam Street, London, WC2N 6EZ.