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Some lessons must be swiftly learnt from the Medical Training Application Service (MTAS) experience.1 The BMA and the Academy of Medical Royal Colleges have been made to look feeble and ineffectual after entering into “partnership” roles with the Department of Health. The postgraduate deans have been notably silent and have behaved as willing accomplices in the promotion of MTAS. The deaneries have declined as an independent force in medical training and are struggling to fulfil their correct role in providing quality educational leadership because of over-dependence on political approval linked to their funding mechanism. The reputation of UK medical training has taken a damaging hit.
The royal colleges, threatened by loss of power and influence and undermined by the emergence of the Postgraduate Medical Education and Training Board (PMETB), seem to have been all too easily lured into partnership agreements, using a set of desirable motherhood and apple pie objectives that were seductively easy to sign up to. The trap was then sprung and the poorly drafted and unworkable operational details released deliberately late in the process. The timetable of the action plan became a higher priority than the quality of the project itself. Website design and selection procedures were unfinished, and consultation on details was token or non-existent. Bullying tactics created an unstoppable momentum for MTAS implementation, regardless of the obvious problems piling up and the well based objections of a majority of consultants. The colleges are protesting that they have been misrepresented, although manipulated would be more accurate with junior doctors feeling disconnected and unsupported until it was too late. The government, anxious to displace blame elsewhere, insists they were fully on board.
These “partnership” arrangements have become a damaging form of pseudo collaboration. The end result has been a major system crash between the Department of Health and the profession, which is now much deeper than the single catastrophe of MTAS.
Competing interests: JJT is a consultant and educational supervisor.