It's that time of year again, when doctors just over one year out of medical school are being nudged into a straitjacket of specialty training before they've even experienced a small percentage of their possible career options. Yes, it's the annual expression of MMC (Modernising Medical Careers, from 2005).
Very many of us felt it was an unnecessarily doctrinaire and remarkably bureaucratic approach to careers, particularly when you're dealing with some very high achieving individuals who would not gain from stifling their career options, and nor would the taxpayer who paid for their education. In addition, Ken Calman's late 90's superb postgraduate training reform programme had only just bedded in, and it was a fantastic improvement from what had gone before. It was abandoned prematurely by the self-appointed 'great and the good' of UK medicine. Their mantra was 'something must be done for the SHO's'. In fact many SHO jobs were deservedly popular for lots of reasons, and it's a pretty odd motive for reorganising the whole training structure (again).
So why did we bother with MMC? Apart from glory hunting by ageing clinicians eager to reduce their clinical commitments, consultant oncologist (and top irritant of governments) Clive Peedell thought it was fairly obvious: to save money. He might be right.
I take the view that this was the then government's plan to undermine all those professions which retained the public's affection/respect despite their faults: teaching, the clergy, medicine and others. I still think that. Everyone has to be similar/dumbed down, everyone has to become primarily an employee, as opposed to a vocationally minded self-motivating highly expert clinician. It went in tandem with the disastrous and extraordinarily cynical changes to the GP contract - which has wrecked much of out of hours care - and the awful New Deal/EWTD that has badly damaged essential apprenticeship-style training. Simulated surgery is not the answer (I might return to that in another post).
The GMC did their bit by - in conjunction with the government - radiating an aura that doctors probably were not to be trusted after all, and the "presumption of innocence" rule in complaints and Fitness to Practice investigations virtually disappeared. Read the heartfelt comments at the end of this piece on the GMC's own website.
Anyway, back to Clive. This 9 year old piece still resonates.
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