1. MMC and the demise of MTAS Dr Celia Gregson Specialist Registrar in Elderly and Internal Medicine Frenchay Hospital, Bristol

2. Objectives – 6 crucial questions: 1.What is MMC? 2.What was MTAS? 3.Why do I need to know about all this? 4.How is MMC going to affect my getting a job in the UK? 5.How is MMC going to affect the training I get in the UK? 6.How is MMC going to affect the future of the NHS?

5. Life before MMC…my life…. Year of TrainingGradeSpeciality 0Graduated from Medical School 1Junior House OfficerMedicine / Surgery 2Resident Medical OfficerA&E - Australia 3 – Med RotationSenior House OfficerCoE / Cardiology 4 – Med RotationSenior House Officer *MRCPResp / HIV 5Clinical Fellow LAT Specialist Registrar ITU / Oncology Elderly / Internal Med 6Specialist Registrar Year 1Elderly / Internal Med 7Specialist Registrar Year 2Elderly / Internal Med 8Specialist Registrar Year 3Elderly / Internal Med 9Specialist Registrar Year 4 Research - PhD Elderly / Internal Med 10Research - PhD 11Research – PhD 12Research – PhD Specialist Registrar Year 5Elderly / Internal Med 13CCTConsultant

6. Life before MMC….the perception.. CMO ‘Unfinished business’ SHOs lost in the system Lack of skilled doctors Excessively long and unfocussed training Bottle-necks for skilled doctors Multiple applications all year around Perceived favouritism

9. Life after MMC…… Year of Training New Grade 0Graduation from Medical School 1 JHOFT1 – Foundation Training 2 SHOFT2 – Foundation Training ST1 Selection 3 SHOST1 – Specialist TrainingCore Training 4 SHOST2 – Specialist Training ST3 Selection 5 SpRST3 – Specialist Training 6 SpRST4 – Specialist Training 7 SpRST5 – Specialist TrainingCCT AIMConsultant AIM 8 SpRST6 – Specialist TrainingCCT Other SpecialityConsultant Speciality

11. Modernising Medical Careers Phase 1 – Foundation Training –August 2005 Phase 2 – Speciality Training –August 2007

13. Foundation Training Programme National Curriculum: –Acute emergencies –NHS skills –Team working –Clinical Governance –Risk Management –Occupational Health Preparation for Specialty Training

14. Foundation Training Programme National Assessments –6 per yearMinicex –4-6 per yearDOPS –2 per yearMultiscore Feedback (Mini – Pat Tab) –6-8 per yearCase discussions National e portfolio

15. No. Only doctors who have not completed an internship (or equivalent training) are eligible for F1 posts. As you’ve had house officer experience and are entitled to register with the GMC, it is likely you have already gained competences comparable to the F1 year. You will be able to apply for F2 posts when they are advertised. These standalone posts are not recruited to through MTAS, but will be advertised locally. If I am settled in the UK and have house officer experience, can I apply to F1, rather than F2 training posts?

20. MTAS

31. Basic Neuroscience Training 2 year training post Foundation Training, i.e. ST1 & ST2 –Neurology –Neurosurgery –Neurophysiology –Neuroradiology –Neuropaediatrics –Stroke medicine –Rehabilitation –Psychiatry –Geriatrics –?GP

32. Other possible posts…. 1.Academic Run Through Training 2.Fixed Term Specialty Training Appointments (FTSTAs) 3.Career Posts - previously referred to as Non- Consultant Career Grades (NCCGs).

34. MMC Anxieties….. What was wrong with the old system? Fears of Service Costs – direct and indirect (consultant supervision and time) Disappearing SHOs Is it truly a fair appointment system Inexperienced F2 trainees How do you take time out –Research –Abroad –Personnel Reduction in Study time and allowances Who really benefits – Doctors / Patients / Politicians?

35. MMC Selection processes National, e based, deanery, speciality assessments ? The role of the CV The role of Royal College Membership exams?

36. PMETB Postgraduate Medical Education Training Board www.pmetb.org.uk 4 th April 2003 – Order of Parliament 30 th Sept 2005 – went ‘live’ ‘Independent’, reports to Parliament Regulatory body: setting and maintaining standards for education and training

37. Summary – 6 crucial questions: 1.What is MMC? 2.What was MTAS? 3.Why do I need to know about all this? 4.How is MMC going to affect my getting a job in the UK? 5.How is MMC going to affect the training I get in the UK? 6.How is MMC going to affect the future of the NHS?

38. www.mmc.nhs.uk www.bmjcareers.com Any questions?