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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 August 4; 335(7613): 227.
PMCID: PMC1939772

Lower your career sights, deputy chief medical officer advises future students

Medical students in the United Kingdom will need to scale down their career expectations in future, the deputy chief medical officer has warned, in the light of this year's problems in allocating junior doctors' training.

Speaking after an off the record press briefing on Monday, Martin Marshall told the BMJ that this year's job allocation process—including the flawed Medical Application Training Service (MTAS)—would have an impact on people's expectations when they consider a career in medicine in future because it has highlighted the tough competition for certain specialties.

“This has brought these issues to the fore,” he said. “I think it will change some expectations. But if that means we'll have more graduates applying for specialties that have been less popular in the past, that is a very good outcome.”

His comments came as the NHS sought to downplay the effect of the job changeover on 1 August, when some 30 000 recently appointed junior doctors were to begin work in their new posts.

The BMA had warned that non-urgent operations face potential cancellation. “The impact of Modernising Medical Careers on patient care is currently unknown,” said the BMA. “In some trusts, doctors are reporting that all routine operations are being cancelled,” said a spokesperson.

The BMA said it had anecdotal reports of consultants being unable to plan operating lists because they have had no idea which junior doctors will be on their team or what skills they will have; of junior doctors being forced to miss clinical commitments because of last minute interviews; and of doctors starting new posts without being given information about the hours they will be working or even what time to arrive at their new hospital.

The recruitment process was in confusion, the association said, with doctors who had a job lined up suddenly being moved to a different hospital at short notice. Trusts were not replacing junior doctors who had moved or were spending large amounts on locums. And doctors were being offered posts for which they are overqualified, including non-medical roles.

But the BMA sought to allay fears that the changeover might result in more risk for patients. “The large number of doctors starting new jobs does not in itself mean that there will be an impact on patient safety,” said the BMA.

“Research in the past has found no evidence that hospital deaths increase on 1 August. The vast majority of doctors are dedicated professionals who will never neglect their patients—their poor treatment at the hands of this system does not mean they will work to a lower standard.”

Sian Thomas, deputy director of NHS Employers, insisted there would not be a crisis. “Information gathered from employers indicates that trusts have been able to appoint very good doctors to specialty training posts this year and that the relatively small number of vacancies remaining can be covered through use of locums and other temporary staff cover,” she said.

NHS Employers admitted that the next few weeks would be challenging, but a spokesperson said that trusts were “well prepared to ensure that both trainees and patients are looked after.”

“The quality of applicants has been very high this year, and trusts have recruited the best doctors to the available posts,” she said.

About 1000 posts out of 15 600 in England are yet to be filled, and further training posts will be released later in the year, said NHS Employers.


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