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Baroness Ilora Finlay's recent editorial (JRSM 2007;100: 160-161)1 provides an excellent account of the failings of the Medical Training Application Service (MTAS). However, she holds the belief that the review group will be able to patch up the mechanics of the process for the future. I humbly suggest that if we fail to insist that the review group re-examine the fundamental concepts underpinning Modernising Medical Careers itself, we will be letting down our junior colleagues for a second time.
Have we all acquiesced to a system that cedes control of medical education and training to the politicians via the Postgraduate Medical Education and Training Board (PMETB)? Does the profession really believe in shortened, dumbed down training? The creation of dead-end, fixed-term specialist training posts to replace the lost tribe of senior house officers? Medical unemployment both post-foundation and post-certificate of completed training level? The near impossibility of young doctors gaining valuable experience abroad? The decline of part-time training for medical mothers and the splitting up of medical partners unable to obtain posts in the same city?
Never before has such a radical change in training been foisted on a profession without the opportunity for proper debate.2 I would submit that this is our last opportunity as a profession to reform this poorly thought-out system. We must seize back control of our training from the politicians who have little interest in and indeed some antipathy to professionalism, and insist that a subsequent independent review reforms the concepts—not just the process—of Modernising Medical Careers.
Competing interests None declared.