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The Daily Rhino
Wednesday, May 16, 2007

The beginner's guide to the MTAS fiasco

Originally published in the May issue of Medical Student Newspaper.


ARE you a bit muddled with this whole MTAS business? Do you nod along politely when people talk about ‘all those poor junior doctors’? Do you secretly not have a clue about medical training? Are you Patricia Hewitt?

MTAS is no more. People are happy. You should know why.

The history

Four score and seven years ago, Aneurin Bevan invented a work experience programme for Indian doctors called the NHS. Some British doctors joined in and then we had a health provider the world envied. This glorious period, where all the developed countries in the world tried to model themselves on our free health service was truly a wonderful time. It lasted an entire Wednesday afternoon.

After a few decades, the Indian doctors opened a whisky distillery in Sheffield and the Brits retired to Eastbourne. And so it came to pass that new doctors began applying for jobs.

They used an ingenious system the Romans used to call a 'resumé'. For many hundreds of years this system was used to select junior doctors. But sadly it all came to an attractive end with the famous case of Professor Fry's colorectal firm which consisted exclusively of nubile Swedish female SHOs and one androgynous Thai boy.

Some f*cking genius suggested current selection criteria is outmoded and unfair and the seeds of MMC were planted. That genius had good intentions, but I'd sure like to punch him in the mouth.


A new way of choosing doctors

Deep in the desert forests of Shropshire, a small band of vegan peoples started shaping the future of medical training. Out of clay. They deemed it appropriate to do away with millennia of tradition and replace the CV with a form made from Satan's flatus.

They say the man responsible for the form designed it with only one hand, as the other is chained to a pipe in his mother's cellar. They say he owns an extensive collection of mermaid porn and rubs soup into his face for hours on end.

MDAP was born, but was so hypoxic at birth it had to be transferred to NICU. An inexperienced F2 had a stab at intubating MDAP but tore straight through its pharynx causing it to die horribly and in great pain.

From its twisted and mutilated neonatal corpse rose the spectre of MTAS. MTAS was a healthier baby than MDAP and made it to school, where it had no friends. This year MTAS put thousands of SHOs in a big pot and shook them around a bit. A few thousand fell out and they went in the jobless pile.

MTAS took a look at the other doctors in the pot and chose a few budbud, whop, spik and bongo names to chuck out, even though they were all Brits. Then MTAS got bored and emailed credit card numbers, pant sizes and sexual preferences of junior doctors to crack dealers, the Klan and C.H.U.D.S.

A Big Medical Association a lot of us pay to represent us didn't do anything to begin with. They were playing MarioKart 64 and kept hitting the lightning before the jump.

A group of sewer-dwelling radioactive amphibians called ReptileUK tried to murder the MTAS staff and the Department of Health with sharpened baguettes.

Some splinter members broke off and realised the key to success was a Facebook group and a flash mob in London. RemedyUK got an unwashed mass of junior doctors together with the promise of blood doughnuts. They protested. Then the Big Medical Association weighed in with immaculate - and by that I mean woefully late - timing.

Patricia Hewitt, meanwhile, dropped her purse into the toilet and lost her library card. She went to the library and asked for a new card. For some reason she explained to the librarian she needed a new card because she dropped her old one in the toilet. As she left, she silently thought to herself "why did I tell her?"

In the deep West Midlands, the ST interview panel walked out. Patricia Hewitt said MTAS was a rousing success. New Zealand, Canada and Australia opened special British doctor immigration lanes at international airports to cope with the exodus from the UK. Patricia Hewitt said any minister that makes an error should resign. She kept on workin’.

Senior deanery staff walked out. Patricia Hewitt said pulling out of MTAS "was simply not a credible option since it would be impossible to place the best candidates in posts and fulfil the service needs in time for August using the old system."

Yet with a mighty slash from Occam's razor, MTAS was culled and lived no more. One day before court proceedings into the fairness of the system began.


A newer way of choosing doctors - the future

Medical Student Newspaper can exclusively reveal what will happen next. Sure, we're told hospitals will be using the old CV system to pick jobs, but we all know this is jive man, pure damn JIVE!

It does seem apparent that an elaborate new system of assessments will form the basis of selection for ST posts from next year. Obviously many of the skills required will remain the same.

For example, the requirements for a surgical ST1 job will still revolve around the basic tenets of managing the acutely unwell surgical patient, operative experience, watermelon seed spitting and Turkmeni dancing. Interviews will be replaced by three-stage contests between rival candidates.

The first round will consist of a barefoot jump-rope endurance challenge, with ropes made of glass and a floor made of knives. The second round is obviously ostrich wrestling, now a core part of most medical school curricula. However all trash talk must be in a broad Irish brogue.

Lastly, potential specialist trainee doctors will be selected according to their performance in the petrol gargling clinical governance contest. Only four things will be required prior to short-listing candidates.

They will want a plaster cast of your ear, your thigh circumference, a portfolio of every venflon you've ever inserted (specifying the colour and volume of saline used for flush) and finally fourteen DOPS, twenty two mini-CEXs and eighty five thousand CbDs.

Joking aside, thousands of British junior doctors took up jobs in new continents, far from family and friends. Of those that remained in the UK, about 33,000 have been waiting to hear if they have one of 22,000 jobs or if they will fill a void by working in a short, stop-gap, non-training post. Worse still, they will be reported to the GMC if they choose to leave if offered a better post.

The £250,000 it cost the taxpayer to train each one of them and the streams of cash being poured in to try and rectify the situation are apparently collateral damage.

One can only hope that your year avoids the genuine heartache MTAS has caused. But spare a thought for those a few years above you, life’s been unfair.

If you really want to learn more about getting into the new medical training system, you need to buy The Foundation Programme: Getting In, Getting On and Getting Out. DO IT.

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