Thursday, February 15, 2007


I suppose I should write something about the whole MTAS issue, with yours truly shortly about to descend through its birth canal to A Job. But I just don't know what to say. I'm so bored of the moaning and whining about a system that despite being riddled with flaws, is still one we all have to endure.

[For those not in the know, this is the system used to allocate medical school graduates to their first jobs, now known as the Foundation Programme. The system it replaced essentially involved sending a CV, whereas the newer system is a nationwide scheme bringing the UK into line with the European Working Time Directive, which caps the number of hours a junior can work per week. Many trusts have realised that they can save money by having more experienced doctors on call alone, rather than supervising the less experienced House Officers, which neatly cuts down their working hours too. Another major point of the new scheme is that first year doctors can gain all their competencies in one year, rather than two.
The new system is a two stage application process, the first part allocating an applicant to a geographical area, the second to a post within that area.]

I found myself in the 93% of final year medical students who got their first choice - in my case the competitive North West Thames Deanery. Despite having a respectable academic score, my response to the 'interview on paper' questions appeared to let me down - I scored little over half marks in this section, which seems to bear little correlation to the amount of preparation that went into it.

This has ultimately left me in the position of being at least 225th in the queue for jobs, out of a possible 295 jobs available in my deanery (the UK has been carved up into different territories, each with specific trusts and their jobs). Essentially this means I'm unlikely to get one of the coveted 'London' posts (anything within the M25). Fortunately, I'm happy to work elsewhere, and in my view the jobs are all the same anyway (broadly, four months Medicine, four months Surgery, and four months of a Specialty).

Naturally pay, hours and location varies, along with the standard of the Doctor's Mess, as well as hospital accommodation. However, one of the more concerning flaws in this system is the fact that applicants have no idea of who they will work for, what banding their job will be (that is, how much their pay is), nor what hours they will be required to work. Is this not an infringement of basic human rights - the right to freedom of information, especially that pertinent to the daily dealings of one's life?

Considering public misconception of junior doctor's salaries, and the fact that Phlebotomists and check-out girls in Tesco earn more per hour than junior doctors (no joke), I find it perturbing. This country must learn that unless it treats its young medical staff appropriately, the shortfall of Consultants further down the line will be catastrophic. Sure, salaries are cosy enough for GPs, the workhorses of the NHS, but there must be an incentive to train, and the potential to earn more, not less, than the amount of debt medical students graduate with (in my case, currently in excess of twenty thousand pounds).

I don't really know what else to say. Of course I hope to get a post of my choosing, with a decent salary and not to be too badly overworked, but who knows? It's a lottery, and thus one must resign oneself to chance. I'd like to hear lay views on the prospects for medical school graduates - after all, it's our hands you'll be in.


Giskin said...

AJ, I really feel for you. It seems like medical students really do have to surrender that precious time of being a young adult to a constant series of pressures -- coursework, exams, debt, applications. There is no doubt that the system is flawed and efforts to improve it don't seem to be particularly succssful. I guess, given that there is nothing you can do about it, you have to make the best of things. What might be perceived as a crummy job could turn out to be a really enriching experience at best, and at worst, something to look back upon in future years as a trial you survived.

If you pin your job satisfaction on factors like your interaction with patients and how you can transform someone's medical encounter by your patient skills, the circumstances under which you work might become less important.

Of course, I'm in no position to pontificate having had a much easier time of my studies and transition into employment. But when the system gets me down, I find it helps to focus on my ideals and concentrate on individual encounters with people to keep the resentment at bay.

I have no doubt, AJ, that once you're on the job, your skills and abilities will begin to be appreciated, by your patients, but hopefully also by those that can make a difference to your career.

skinnyminny8 said...

This really is terrible. So you get the deneary you want and can still end up in a lousy job within that deanery??

What a joke.

Why do we choose to study medicine I ask you. Its a massive slog and committment, and this is how we are repayed. I only hope its all sorted out by the time I have to go through the system.

Good Luck and congrats on gettine NT deneary.

Anonymous said...

But what would you do differently? If there are c300 people trying to get c300 jobs you need to have a way to match them, and someone will end up getting the 300th job- so whatever system you choose, surely there will be some poor b*****d compaining???

aj said...

Yes, one could argue that. But don't forget, not everyone wants the same post, so they wont have an identical order of preference. Broadly speaking though, if you applied to London, you were after a job there, not in Devon, Cornwall, Essex, Guildford or Surrey, where about one third of the posts are located.