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Modernising Medical Career - 12-06-2006, 11:45 AM

Statement of the four UK Health Departments on transition into specialty training

The four UK Health Departments have agreed the principles of transition. These are set out in the annex. Implementation will be approached flexibly in each country.

The new model of specialist “run-through” training programmes will begin in August 2007 (the term specialist is used here to cover GP programmes).

There will be specialist/GP competitive run-through training opportunities for doctors:
  • successfully completing the Foundation Programme in July 2007 or in the case of non-UK graduates demonstrating equivalence
  • currently in Senior House Officer (SHO) or Non-Consultant Career Grade (NCCG) posts.

There will be entry points at different levels into programmes. This will allow doctors who do not hold a national training number to compete with those of similar experience and training to get into the new programmes at a level suitable for their educational needs. This will mean, for example, that more experienced SHOs will compete with other SHOs with broadly the same level of training and experience. They will not enter programmes at the bottom in competition with doctors graduating from Foundation Programmes but will be able to take up places at a higher level. For instance, those with the necessary training and experience may be able to compete for places at the second year or third year of specialist training.

Not everyone will get into run-through training programmes or into the specialty of their choice as this is a competitive process. This has always been the case.

Doctors unsuccessful in getting into a run-through programme will be able to apply for fixed-term specialist training appointments (FTSTAs*), or career posts if they have appropriate experience and training. There will be further competitive opportunities for them to enter run-through training.
*The UK Health Departments have asked the UK Strategy Group to decide on the job titles for both run-through training places and FTSTAs.

From now on, Employers should not appoint to SHO posts with contracts which extend beyond 31 July 2007. From August 2007, entry to the SHO grade will be closed.

Doctors currently in Specialist Registrar (SpR) posts will have their contracts honoured while they are completing their training programmes. Recruitment to substantive SpR jobs will cease by late 2006.

After successfully completing a run-through training programme, doctors will be eligible for entry to the General Practice or Specialist Registers.

The transition to run-through training is an opportunity for the NHS to align service and training in the light of these changes and the Working Time Directive.

There will be a single start date in August 2007 for the new programmes. Employers should have plans in place to ensure a smooth transition and to ensure high quality patient care.

Selection and recruitment

Doctors will apply to specialist/GP training programmes through a simplified, co-ordinated process that will cut down on the present complex multi-application system.

For the first time, there will be national, standardised documentation (for example, application forms and person specifications).

The timetable for recruitment and selection will be nationally co-ordinated so that successful ‘foundation doctors’ will be able to enter a specialist/GP training programme directly from the Foundation Programme. There will be a simultaneous application process for SHOs and others.

Recruitment and selection will be fair, open and legally robust. Selection methods will be specialty specific, but the minimum requirement will be a formal interview. The methodology is being designed by leading educationalists and recruitment specialists.

NCCGs

The four Health Departments have agreed to work together to take forward the principles of Choice and Opportunity for non-consultant career grade doctors.

ANNEX B. 1 - OVERARCHING RULES TO FRAME DEVELOPMENT OF DETAILED GUIDANCE

All information on transition, as agreed by the four UK Health Departments, to be communicated clearly, widely and in good time.

From August 2007, entry into all Specialist Registrar (SpR) training programmes will be closed. No National Training Numbers in any specialty should be recruited to after 1 January 2007. This is to develop capacity for recruitment into the specialty training programmes that will deliver the curricula approved by the Postgraduate Medical Education and Training Board (PMETB). Recruitment to fill short-term vacancies arising in SpR programmes, for example, Locum Appointments –Training (LATs) and Locum Appointments – Service (LASs) may continue. Preferably, contracts for LATs should not extend beyond the end of July 2007.

From August 2007, entry to the Senior House Officer (SHO) grade will be closed. Any substantive SHO appointments from now on must have an end date of July 2007 at the latest.

All recruitment will then be into:

Specialist/GP training programmes designed to deliver the curricula approved by PMETB;

Fixed Term Specialty Training Appointments (FTSTAs) – at Specialist Training 1 (ST1) and Specialist Training 2 (ST2) level.

Recruitment will be based on person specifications following the work being undertaken on selection methodology requested at the March meeting of the MMC UK Strategy Group.

All SpRs currently in Type I (Certificate of Completion of Training - CCT) programmes or Type II (Fixed-Term Training Appointment - FTTA) programmes will complete training in those programmes, subject to satisfactory progress, but will have the option, in discussion with their local Deanery Training Committee, to access the new curricula in full (Type I trainees) or in part (Type II trainees) in completing their programmes.

All trainees not already in SpR (Type I) training programmes who wish to enter programmes leading to the award of a CCT will have to compete for a place in the new training programmes designed to deliver the curricula approved by PMETB.

Pending clarification from PMETB, it is recommended that there will be two or more entry levels in each specialty, one at the successful completion of foundation programme training and others at a more advanced level to take account of trainees at a later stage of training such as SHOs or applicants from the Non-Consultant Career Grade. This will enable fair competition between trainees in their peer groups to take place.

Everyone appointed as a trainee in the new MMC specialist training programmes leading to a CCT will be allocated a unique training number.

SUMMARY
1. There are 9000 trainee posts per year in the UK.
2. From August 2007 all these jobs will be advertised from a central place on line.
3. This includes GP training and hospital training.
4. The candidates will be allowed to apply on line-only and they can select 2 specialities and two geographical areas
5. Then the candidates will have competency based selection.
6. There will be scoring and ranking.
7. No more HO, SHO or Registrar posts.
8. All these posts are called "Specialist Training (ST).
9. ST 1, ST 2, ST3 ………..ST7.
10. GPs have three years and hospital specialities 5 to 7 years.
11. Sub-speciality selection will be separate.
12. There will be structured interview and aptitude test.
13. Multiple assessment test by trained assessors.
14. Transparent scoring system. (Interesting to read!)
15. Current SHO grades will be absorbed in ST1, ST2, ST3, ST4.
16. NTN will be awarded to those successful until they finish their training.
17. National advert will be placed in November 2006.
18. Deadline for application – 5th January 2007.
19. Selection completed by April 2007.
20. Recruitment completed in June 30th 2007.
21. There will be lot of posts "Fixed Term Speciality Training".


Anil Tuladhar MRCP(UK), FRCPCH
University Hospital of North Tees
Cleveland
UK
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SHOs forced into the cold-01/06/06 - 12-06-2006, 01:07 PM

Thousands of SHOs who are currently in research or non-standard posts could find themselves stranded following the introduction of specialty training in 2007.

Modernising Medical Careers (MMC) and the DoH are expected to make a formal announcement on run-through training within the next two weeks. However, Carrie Goddard, MMC director of communications, has already discussed changes informally with a group of ophthalmology trainees.

Early indications from MMC were that the old-style higher specialist training, or Calman training, would continue until 2009. However, Hospital Doctor now understands that all three years of specialty training (ST1, ST2 and ST3) will start simultaneously in 2007. Junior SHOs will be permitted to enter at ST2 and doctors ready to start their first year of SpR training will move into ST3.

In 2008, there will be no ST2 entry for SHOs and only a limited number will be allowed to enter at ST3. This means that any SHOs who do not enter specialty training by 2007 could find themselves frozen out (see case study).

Dr Jo Hilborne, chairman of the BMA's Junior Doctors Committee, said: 'Our advice is for SHOs to do the best they can to move into a standard post as they are then more likely to be counted in the new specialty training. Even better would be to get an SpR post and national training number this year.'

Mr Peter McDonnell, vice president of the Royal College of Ophthalmologists, said: 'After 2008, entry to specialty training will mainly be ST1. We are suggesting slightly reduced numbers in ST1 and ST2 on an ongoing basis so that there will be a small number of continuing ST3 opportunities after the first two years of transition to accommodate juniors who have done research.'

A DoH spokesman said: 'All eligible doctors, including those in research or career grade posts, will have the opportunity to compete for places in the new programmes.'

Case Study

Closing window of opportunity for researcher

New timings on the switch to run-through training could cause a brain drain to the detriment of UK academic medicine, according to Dr James Teo, a clinical research fellow at the Institute of Neurology at the National Hospital of Neurology and Neurosurgery, London.

He is threatening to leave the UK if he is unable to secure an ST post. 'Many countries, such as the US, Australia and Singapore, are now competing for doctors with research experience. There is no reason to hang about in an environment that does not appreciate your work and experience,' he said.

Dr Teo warned that he and his peers now face 'burning their bridges' with academic institutions in order to progress through specialty training.

He said: 'Anyone like me who is doing a PhD that will not finish by 2007 should quit now and go for specialist training.

'It will also affect at least four other people in my laboratory, and I believe a significant number of doctors will have no choice but to leave research prematurely. Research training will have to wait.'

He also believes the effect on academic medicine will be catastrophic. 'In certain fields like neurology and oncology, where research experience is central to specialist training, it will mean a significant drop in the quality of future specialists,' he said.


http://www.hospital-doctor.co.uk/hd_...1&Section=News
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Re: Modernising Medical Career - 12-06-2006, 02:27 PM

MMC is a big mystery for everyone here. lack of forward planning resulted in present job crisis where even local grads faced unemployment. this has lead to sacrifice of many hardworking and faithful international medical graduate with this new visa rule.many of the local grads are now lured by new zealand and australia jobs as there is no certainity of job for them.this transisiton period has given rise to so many questions and critism as well. hope things will work out soon, but what we know is gates are totally shut for the new international medical graduate seeking for a future here .though there is small ray of light at the end of tunnel for people who are already in the system and qualify for hsmp visa.
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Re: Modernising Medical Career - 12-06-2006, 02:53 PM

This is a posting from BAPIO Vice Chairman Dr Umesh Prabhu:

Dear friends,

MMC is about to advertise 9,500 training posts in the UK. Hopefully
we will have some clear answer from the court within next four weeks
regarding VISA changes. Please keep on reading MMC website.

No more SHO jobs from August 2007
No more SpR or NTN jobs from August 2007
There will be 4000 or so Fixed Term Training posts which will be
advertised as well.
There will be 20,800 doctors applying for these jobs.
Even SAS doctors, LAT and LAS, SHOs, Trust doctors can apply for
these posts.
Doctors will be allotted depending up on their training and
experience.
To be eligible we got to change the VISA ruling and if not IMGs will
be considered only if there are no EU doctors.

Keep a close watch on MMC website regularly.

With kind regards

Dr Prabhu


Anil Tuladhar MRCP(UK), FRCPCH
University Hospital of North Tees
Cleveland
UK

Last edited by Anil Tuladhar : 12-06-2006 at 02:56 PM.
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Re: Modernising Medical Career - 13-06-2006, 01:40 AM

Quote:
Originally Posted by autowreckers
MMC is a big mystery for everyone here. lack of forward planning resulted in present job crisis where even local grads faced unemployment. this has lead to sacrifice of many hardworking and faithful international medical graduate with this new visa rule.many of the local grads are now lured by new zealand and australia jobs as there is no certainity of job for them.this transisiton period has given rise to so many questions and critism as well. hope things will work out soon, but what we know is gates are totally shut for the new international medical graduate seeking for a future here .though there is small ray of light at the end of tunnel for people who are already in the system and qualify for hsmp visa.
it's not just the international people who are affected by this, even the local graduates are under a lot of strain as to what is to happen. As i've been told in a scornful way...it's not MODERNISING...it's MURDERING Medical Careers!
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Re: Modernising Medical Career - 13-06-2006, 03:33 AM

you are absolutely right demon.
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Training post debacle - 16-06-2006, 07:30 AM

Consultants have been told to lobby their medical directors and deaneries to create extra posts for specialty training, under Modernising Medical Careers (MMC) reforms.

It prompted representatives at the BMA's seniors conference last week to voice concern that the Government is seeking to devolve responsibility for workforce planning.

Prof Shelley Heard, national clinical advisor for MMC, told delegates that the exact number of entry points into specialty training in 2007 will depend on the number of national training numbers (NTNs) released in each deanery and for each specialty. MMC expects there to be a minimum of 9,500 entry points for all three years of specialist training.

Prof Heard said: 'All the royal colleges have been calling for more NTNs, so if you want to convert SHO posts into middle-grade posts then now is your chance. Consul-tants should see which posts can be aligned to the new specialty programmes and say: "Look, I've always wanted another SpR".'

Dr Jo Hilborne, BMA's Junior Doctors Committee (JDC) chairman, said the move was an 'abrogation of responsibility' from the Government. 'These proposals would mean that the consultants who shout the loudest will end up with the most trainees,' she said.

'It seems ludicrous that individual consultants, in individual specialities, in individual trusts, should shape the national workforce. This is not the national manpower planning approach that the BMA has been calling for.'

Dr Paul Miller, chairman of the BMA's seniors' committee, said: 'It seems a random and haphazard method to ask consultants to push for jobs. Prof Heard's speech left me anxious about what will happen to junior doctors and also whether the funding from the old SHO posts will be preserved for the new posts.'

Dr Miller said many consultants were worried by the transition to specialty training, and delegates warned it could lead to unemployment.

Prof Heard also told BMA members that the transition to specialty training would release a large number of NTNs for 'recycling' in deaneries. For instance, in general surgery, where 99 NTNs are available each year, in 2007 this figure could rise to 300, she said.

The JDC will push for clarification on the exact number of speciality posts when it meets with MMC this week.


http://www.hospital-doctor.co.uk/hd_...9&Section=News
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