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The Daily Rhino
Sunday, May 06, 2007

Patrica Blewitt
Originally published in the March issue of Medical Student Newspaper. just before the protest on the 17th of March.

THEY’RE calling it Black Monday. I had a stupid article all about bossing students around prewritten in my head, but felt there was no way I could ignore Black Monday and its implications. This month has been dominated by the plight of our SHOs.

Medicine is a career where both a strict hierarchy and a fluid camaraderie co-exist. The SHOs I work with are both my seniors and my friends. Mulling over their pathetic predicament genuinely makes me despair. This month’s news section details how thousands of SHOs have been shafted by MTAS. The almighty fiasco has been played out in the national media as well as in every doctors’ mess across the country. Black Monday was the 26th of February when seemingly all my SHO friends learnt they had not been shortlisted for any ST jobs.

Why has the system gone so spectacularly wrong? Why are so many gifted young doctors jobless? How could this country have caused thousands of its brightest to plan moving abroad? A catalogue of calamity has led to a situation where little can surprise anyone aware of what has been going on. When we hear that a Deanery has been using police cadets to shortlist the vast numbers of applications, we barely raise an eyebrow. It may or may not be true, but it’s hardly more farfetched than some confirmed details so far.

The news that the entire West Midlands surgical interview panel resigned en masse on the first day of ST3 interviews spread like wildfire. In some ways, British doctors have never been so united around one cause. Part of the reason doctors from every walk of life are taking an interest is that they were all SHOs once upon a time. GPs and hospital doctors were SHOs at one point. They often remember their formative years with fond nostalgia and that a generation is being robbed of their chance at medical training troubles many greatly.

When I was a student, especially in my pre-clinical years, actual doctoring was a world away and I had no concept of what issues juniors faced. Hence I wanted to try to convey the mood hanging over your future profession to you. I cannot recall any time in British medicine as dark as this. Countless doctors have written desperate accounts of how they don’t deserve to enter unemployment. I clearly recall my school careers adviser selling medicine to me as a field where I would “never be out of a job.”

In fact I recently ran into someone from my year at school, now an SHO. I took a gap year and did a BSc, he didn’t. He has not been given any interviews; I might well avoid this fiasco altogether. Two years of dossing around might have been the difference between being a doctor and signing on. The figure being widely quoted in the press is 30,000 doctors applying for 22,000 posts. However the number of training posts may be substantially lower as many are career grade non-training posts, into which MMC is trying to guide people.

There are specific reasons, other than impending dole queues, which have particularly angered SHOs. Government mouthpieces like Lord Hunt, the Health Minister, spouts lunacy like: “We know the system is working well in many parts of the country...Let's be clear, there has always been competition for these specialist training places and there ought to be because these are the senior jobs. It's important we get the right people.”

Getting the right people is laughably far from the reality. The minority of friends who have gained interviews have been allocated them in an inexplicable manner. My current SHO, a highly experienced and superb old George’s boy, has been given an interview in London, the most competitive of all Deaneries, but nothing in his three less-competitive backup choices.

Patricia Hewitt, the Health Secretary has been warned for years that the UK is forcing junior doctors abroad. Many of the Royal Colleges have been angered by the complexity of the scheme and statements by the government that the Royal Colleges were complicit with all plans. This prompted a rapid response from all the major colleges, to ensure applicants knew that the Royal Colleges had been kept in the dark as well.

The government has cynically utilised the fact that the vast majority of doctors are scared to leave the profession. Most jobless SHOs face three options. Some could emigrate, but this is impossible for many. The majority will not find alternatives in the UK but will not quit altogether simply because they want to be doctors.

Yet another factor unpopular with candidates has been the application form itself. Last month I gently poked fun at the F2 application form. However similarly inane questions make even less sense for ST posts. Doctors who have augmented their CVs with publications, courses and qualifications have found themselves no better off than those that haven’t. The system has earned itself a reputation as a lottery due to the conventional, tried and tested, system of a CV and references being scrapped. Only a few 150 word answers to generic questions determines your future.

Perhaps most embarrassingly of all are the number of errors. Some SHOs have received interviews in areas they did not apply to and a confidential booklet outlining selection criteria was leaked on the Internet. It detailed “methods & best practice for upskilling selectors”.

St. George’s and St. Thomas’ have written public letters of protest to Prof Elizabeth Paice, chairman of the Conference of Post Graduate Medical Deans, calling on them to "revoke the current fatally flawed system". Our friends are being treated like shit, show them your support.

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