Layla's space

With all its sham, drudgery and broken dreams it is still a beautiful world.

Thursday, March 15, 2007

The sun is shining, the weather is sweet...and we might just get an interview after all

Everything just feels better when the sun is shining, doesn't it? Even though the wards seem to smell more than ever, and it's a bit stuffy on the Unit upstairs, and you can't see the X-rays on the screen properly because it's too bright.

The 'review' of the MTAS debacle continues, and the DoH review committee have gone so far as to issue us with this tantalising tidbit (9th March - running behind the times again) :

'The review has identified concerns that some excellent doctors may have been overlooked. The group has recommended all applicants who have not been invited to an interview should be given the opportunity to have their application form reviewed by a trained advisor. This may result in the offer of a first round interview.'

We are still waiting to hear how exactly that is going to work, when we can expect our applications to be reviewed, and what the definition of a 'trained advisor' actually is - it doesn't conjure up the image of a competent Consultant, more that of a trained monkey. But we shall see....

Worryingly though, the final report isn't due out 'til the end of March, which doesn't give them much time to review all the application forms they lost, sorry, fucked up, best to put it? Overlooked? In any case, the second round of applications starts at the end of April, so they have a month to look at the forms again, re-shortlist and interview. I don't think that will work.

The statement (found in full on the MMC website) continues:

'Significant changes will be made to improve selection in the second round. This will include changes to the application form and the scoring system.

'The Department has accepted the need for change and the revised approach will now be tested with junior doctors, selectors, deanery recruitment teams and employers, and agreed with the Medical Royal Colleges, Deans, trainee and consultant representatives and employers before they are introduced.'

I thought they said that the original format of MMC/MTAS was developed with the full support and input of junior doctors and the Royal Colleges? Someone's been telling porky pies.

Some people have been whispering that this review represents a capitulation, that everything will be OK and there's no need to march in protest against MMC on Saturday. No, you fools! This does not get you, or the government, off the hook. It is vital that we do march as planned on Saturday - we must keep the pressure up. I agree, the response and fuss that we have had is more than expected, but we must must must keep pushing. We cannot stand down until the entire mess is sorted out, and one review and a couple of Royal Colleges standing up to MMC do not a revolution make.

So put some scrubs on, daub some paint on a big piece of cloth and get your arses down to London. Saturday 17th March, 1030am at the Royal College of Physicians (Great Portland St tube) - I will see you there.

Monday, March 12, 2007

How has it come to this?

I have just had a very stupid argument with one of my work colleagues, let's call him John Smith. He is someone I regularly go out drinking with, and I enjoy his company. He has three MTAS interviews to my zero, but apart from a good-natured 'let's throw things at John because he got interviews' session, we've haven't let this fact come between us.

I haven't got much on this afternoon for a change, so I thought I'd make a start on a case report my previous Consultant asked me to write up for a well-known American medical journal. He asked me to write it up about six weeks ago, just before I changed onto another medical firm. I got the patient's notes and was reading through them when I found a consent form, from said American medical journal, signed by the patient and witnessed by my friend Dr Smith. 'How odd,' I thought. 'I'll just bleep John and find out what's going on.'

The conversation started fine - it transpired that my Consultant had also asked John to write up the case report. Unfortunately, this journal only allows two authors and our Consultant would have to be one of them. What followed was a rather prickly, unpleasant exchange. Examples as follows:

'I was on the firm when she was in.'
'So was I - we changed over halfway through her admission.'
'Well I clerked her in.'
'No you didn't - you only reviewed her after the F2 clerked her in.'
'I saw her on the ward.'
'So did I.'
'To be honest, if I get a job I might not bother.'
'Well I don't have a job. What do you want me to do, wait until you know if you have one or not?'

It was just stupid. I am annoyed at the Consultant for asking us both - surely he knew there might have been some disagreement? Apparently he also asked my previous registrar, but she couldn't be bothered. So one less person for silly arguments I suppose. And yes, I feel bad for bringing up the interview/job thing. I just felt provoked by the 'if I get a job I won't bother' line - I mean, who needs this more?!

It's ridiculous, fighting over scraps from the Boss' table. Desperate for anything that might give you extra points on your CV. Falling out with friends over a few lines in a journal.

Anyway, we decided to ask the Consultant who he wants to do it. John said, 'I'm sure he'll say to let you do it.' Let me do it? What am I, a charity case? I suppose I am really.

Friday, March 09, 2007


I feel flat.

I can't really describe it any further. The dust seems to have settled over the whole job thing, the shock has been absorbed and, worryingly, the outrage has faded. That longtime friend of the British medical profession has reared its head yet again - apathy. 'What is the point?!' it asks. 'We all know the march will achieve bugger all, even if it is well-attended, which, knowing us, it won't be.'

I must say, I agree with apathy on that point. I was part of the one million strong crowd who marched against the 2nd Gulf War - fat lot of good that did. If this Government can ignore one million people, from all walks of society, on such a wide-reaching issue, it can sure as hell ignore a small sample of one part of society on an issue that, let's face it, the general public don't really know too much about. I don't think people see how it will affect them, really.

I was disappointed at David Cameron's long-awaited reply to the issue. I think that's as much as we'll get out of him now. I can't believe I actually put some faith in the Tories, of all people, to help us (I am a bleeding heart liberal, I'm afraid).

Oh God, I feel like shit. Everyone's being so fucking lame about the march. I'm trying to organise a minibus to take us down to London on the morning. We will probably have to leave around 8am, and I can just hear the moans. 'Oh, it's too early, I was on call yesterday/I went out last night/I made plans already/blah blah blah'. Half the people who have said they'll attend will be in London already and have said they will meet us there. I'm not anticipating a huge turn out from those ranks either. 'Oh, I overslept/I'll probably meet you later/I made plans/I can't be bothered/it won't make a difference'.

Now, I agree, it won't make a difference. But at least we will have tried. At least then we won't just be taking it, like we usually do. So I, for one, will be there with bells on. I wish I could say the same for my colleagues.

Please, please, please, come to the march. Come and shout and stand up for what you believe in for once. Make a stand - what have we got to lose?

Wednesday, March 07, 2007

And another thing....

It seems I am behind the times already, having missed the DoH press release yesterday and only come across it now after having spoken to one of the Consultants. Actually, I'm not behind the times, I'm just really sodding busy.

Anyway, I have read it, and welcome it. I have a few issues with it however:

'Recruitment into specialist training is, and has always been a very competitive process.' - No shit, Sherlock. But at least with the old system one had as many opportunities as one wished to apply to a variety of jobs, advertisements for which came out at different times. You can't say, 'Oh it's always been competitive', and then hope to address that by making everyone apply for everything at the same time.

They will be discussing, amongst other things, 'eligibility criteria including IMGs and HSMP'. Anyone care to tell me what these are?

'We have stressed to those interviewing in round one that they should not appoint unless they are absolutely satisfied with the calibre of candidates.' Surely if 'those interviewing' had been involved in the shortlisting process they would be more likely to be satisfied with the 'calibre of candidates'?

'With around 18,000 new competency-based specialty training programmes available this year in England alone, MMC is working towards having more qualified doctors working within clinical teams, providing the majority of front-line, safer patient care.' Hmmm. Bit ambiguous, that. 'More qualified doctors' meaning more doctors in general? Why cut posts then and fail to fill vacancies? Or do they mean 'doctors who are more qualified'? How do they plan to achieve that by shortening (oh, sorry, 'streamlining') our training and producing generalists at the end rather than specialists (as evidenced by the dropping of the 'Specialist' from the 'Certificate of Completion of Specialist Training', which new Consultants gain at the end of training). Also, with the European Working Time Directive restricting hours from 56 to 48 in 2008, new Consultants will have clocked up far fewer hours of training when they gain this certificate than their predecessors.

So yes, I welcome the DoH review of MTAS. But I have a nasty feeling we will end up with a very similar steaming pile of horseshit to the one we have been buried in already.

Must go, my patient with a potassium of 7.8 has arrived. That is a very dangerous level of potassium to be carrying around, Mrs Hewitt. My patient will certainly die from it if I don't treat her correctly. I hope for your sake you never end up in my hospital with acute renal failure.

God bless the surgeons....

Fantastic, fabulous effort by the West Midlands ST3 surgical interview panel! They cancelled their interviews on the basis that the whole MTAS application process was a steaming pile of horseshit. Well, actually,the reasoning of the panel is lengthy and well thought out, and can be read in full on Dr Crippen's blog. Basically they said, 'We want to be able to shortlist our own trainees, not just interview whoever the muppets at MTAS deem suitable for higher surgical training'.

My favourite line was 'it fails to distinguish adequately between candidates, giving credibility to creative writing skills rather than hard evidence of competency'.

Bloody brilliant. I am so pleased, inordinately so I suppose as I'm still stuck in the same position as before. I hear other regions may be following suit - we shall see. From what I hear of the interviews so far, it seems that they have been almost as shambolic as the application process - people turning up to find they didn't have an interview after all, people who went in to find that the panel had not received their application form and had no idea who they were or why they were there....

They seem to have shortlisted an unprecedented number of arseholes (see Dazed and Confused's experience). Presumably arseholes are inherently talented at bullshitting, blowing their own trumpets and using buzzwords. I can almost imagine the breaking bad news scenario of one of these brand new MTAS recruits:

'I'm sorry, but your mother is dying. I must say, I'm feeling extremely empathic towards you and your family at this difficult time. Did I mention that I teach communication skills to local convicts? This illustrates my dedication to improving my CV and showing my motivation to rise to the top over the bodies of my fellow applicants. I mean doctors. Anyway, I've ticked all the boxes so far, don't you think? I found a quiet room, left my bleep with my house officer, sorry, with my F1 monkey, and brought an agency nurse in with me to wipe up the snot and tears afterwards. Anyway, the EWTD tells me that I have only thirty seconds left before I have to finish work, so any questions you may have should be quick. Otherwise you can contact the on-call ST1 if you like. They've never done on-calls or nights before and so will probably be too busy running around with their arms in the air to speak to you, but hey ho, needs must I suppose. Oh, while you're here, could you fill out one of my 360 degree assessments? Don't bother reading it, everyone just ticks 'excellent' and nobody reads it anyway but I need to send out 500 of them to the re-validation centre in Milton Keynes before tomorrow so that they can be filed in the round file marked 'bin'. Thank you for your time.'