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As many as 45% of applicants for training posts starting this August have not yet been offered a job, according to a survey by a group of medical academics who joined forces this week to reiterate their growing concern at the problems surrounding junior doctors' appointments.
The Fidelio group, led by Morris Brown and Steve O'Rahilly, both of Cambridge University, announced the findings of their survey a few days before round one of the application process in England came to end on Friday. As the BMJ went to press it was still unclear how many applicants had not been offered a job. Because it was decided that individual deaneries handle applications rather than the centralised computer system, only individual deaneries hold this information (BMJ 2007;334:653 doi: 10.1136/bmj.39167.704086.4E).
“It's not at all clear where the data is going to come from,” said Professor Brown, who had collated replies to his own survey from 1300 applicants up to Monday 18 June. At that stage 45% of applicants had not yet received an offer, 32% had been offered one post, 15% had been offered two posts, 6% had been offered three posts, and 2% had been offered four posts. But he acknowledged that this was a small sample of the more than 30 000 applicants, who could still be offered posts before the end of round one.
The Fidelio group is hoping that the change of prime minister may signal an opportunity for a change of heart, possibly with the suspension of run-through training, after the foundation programme, when doctors train to specialise.“Gordon Brown is a great advocate of getting rid of red tape,” said Professor Brown.” We are asking him to take a red line to this.”
Richard Marks, of Remedy UK, the group set up in protest at changes in doctors' training and the medical training applications service (MTAS), said it was understood that as many as a quarter of posts could be held back for round two. “The big question is how many will be specialist training and how many not,” he said. “Trusts are starting to panic because they are not going to get people into post.”
Concern is also growing at the effect on academic medicine. Professor Brown's survey found unsuccessful applicants with first class honours and distinctions. He said the application process had been a “selective cull of the best” because it had failed to give enough weight to academic achievement.
“We've got one arm of government wanting better clinical research,” said Professor O'Rahilly, indicating that the Department of Health was failing to reflect the Treasury's push to make the United Kingdom a centre of medical research excellence, as outlined in the Cooksey report (BMJ 2006;333:1239 doi: 10.1136/bmj.39059.559213.DB).
“But we are taking our brightest people, and making it more difficult for them to get training,” he said.
Michael Rees, chairman of the BMA Medical Academic Staff Committee, agreed: “This whole application process has failed to take into account the needs of academic doctors. It messed up academic applications and discriminated against doctors with academic qualifications by providing too few posts for them and virtually excluding academic criteria in the application process.”
Meanwhile the BMA says that disappointed doctors—which it thinks could number as many as 18000 at the end of round one—should be able to take legal action sooner than November, which is the date currently given from when complaints can first be made. A small number of applicants may have a legal case, and the BMA says that it has issued guidance on this. It says that by the ends of round two there may still be as many as 12000 applicants who have not been offered posts.