Chris Lancelot on - The MMC Handover

Thankfully, August 2007 passed without incident as the Modernising Medical Careers (MMC) handover of junior hospital posts occurred. Few patients died - or at least, not in sufficient quantities to hit the national newspapers.

But the stain of MMC remains. 10,000 doctors are being excluded from the training process: they will either have to accept non-training jobs or emigrate. Still, this is a one-off situation and in the overall scheme of things it can now be forgotten - can't it?

No it can't. Not only has MMC blighted the lives and aspirations of large numbers of junior doctors but it risks impairing the nation's health for the next generation. Once consultants had a 10-year training period - but the new breed of seniors will achieve their goal after just six years.

Add in the effects of the European Working Time Directive and some new consultants will be appointed with only a third of the total experience of present-day new consultants.

I am horrified by this. At a time when medicine is becoming vastly more complicated and all of us are constantly expected to prove our competency, it is suddenly considered acceptable to train consultants in a third of the time. How would you fare if you had to qualify again as a doctor, but taking only two years instead of five? That is, essentially, the scale of things.

I have every sympathy with the objectives of MMC, which are entirely laudable.

To create a smoothly progressive system of training which dovetails into the needs of the NHS is excellent. But the way in which it has been introduced has been appalling, and the blind-spots of its creators have been as alarming as they were damaging.

Constructing an application system that got round the old-boy 'who you know' network is praiseworthy: replacing it with a system which takes no account of established competence is not. Some of our best young doctors are being forced to leave the country to find work, which by definition leaves potentially less suitable juniors to take their places on the already truncated consultant courses: a double whammy.

The nightmare of the Medical Training Application Service has been partially rectified in a month of face to face interviews, a restriction on consultants' holidays and a reduction in theatre lists: the real damage of MMC will unfold over the next generation.

MMC is a disaster - and it's only just begun.

Dr Lancelot is a GP from Lancashire. Email him at

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