Modernising Medical Careers

It has been dogged by criticism within and outside the medical profession, and an independent review of MMC led by Professor Sir John Tooke criticised many aspects of it.

Under the old system, doctors had the flexibility to try a variety of different jobs before deciding what to specialise in, and this allowed them to build a broader base for their ultimate specialism.

After spending extensively on a management consultant to advise on how to go about this, MMC failed to resolve how this would be implemented and handed the decision at the last moment in July 2005 to the deaneries.

While these principles received broad support, their implementation has not, largely because the Department of Health has achieved an increase in the number of consultants by reducing the length of training required to reach the grade from an average of 21,000 to just 6,000 hours.

In keeping with this accusation, just 1% of doctors surveyed in the Tooke Report felt that run-through training would have a positive effect on clinical service delivery, and 58% believed patients would not benefit from MMC.

In 2008, following significant pressure from junior doctors,[7] the MMC Programme Board for England came to an agreement to revert to a local application process determined by deaneries and specialties.

[9] A number of criticisms have been made about the new MMC system, and it was perceived sufficiently poorly within the medical profession that its implementation was ultimately boycotted by senior doctors around the country.

In his letter of resignation to Prof Sir Liam Donaldson the chief medical officer for England, Professor Crockard stated that he was increasingly aware that he had "responsibility, but less and less authority" [20] and that "the overriding message coming back from the profession is that it has lost confidence in the current recruitment system".

[25] On 3 April 2007, during an interview on BBC Radio 4's Today programme, the Health Secretary Patricia Hewitt apologised to junior doctors over the crisis, saying that the application scheme had caused "needless anxiety and distress".

[26] Patricia Hewitt's apology was repeated to parliament on 16 April 2007, in which she stated that "the problems that have arisen relate in the main to the implementation process and not to the underlying principles of Modernising Medical Careers.".

[1] Later that month Shadow Health Secretary Andrew Lansley accused Ms Hewitt of failing to express genuine regret over the situation.

[28] On 1 May 2007 Ms Hewitt made another apology in the House of Commons after the suspension of the MTAS website due to security breaches that she described as "utterly deplorable".

[29] The MTAS website was suspended on 26 April 2007 after a Channel 4 News report stated that applicants had been able to see each other's files by changing two digits in the personalised web address given to each individual.

Although he ruled against invalidating the interviews that had already taken place, Mr Justice Goldring added that this judgement did not imply that junior doctors were not entitled to feel aggrieved, as "the premature introduction of MTAS has had disastrous consequences".