MTAS ‘rushed and poorly communicated’

The Department of Health has officially dropped the use of a national IT system in favour of locally-led recruitment for specialty training, following publication of the Tooke inquiry, which found the Medical Training Application Service (MTAS) was “rushed and poorly communicated.”

Health minister, Ben Bradshaw, confirmed the move yesterday, which will see deaneries take control of their own recruitment process for most specialties, as reported by E-Health Insider last week.

In his report into the Modernising Medical Careers scheme, Sir John Tooke said that the online MTAS resulted in a ‘crisis precipitated by the perceived failure and abandonment of the online MTAS in spring 2007 which has revealed profound concerns about the new system of medical postgraduate training.’

He agrees, however, that IT should be used in the future for recruitment purposes: “A national electronic application process is a good idea. Candidates who have applied to UK universities through UCAS will already be familiar with the principle. It works successfully in other countries. "

Before this can happen, he says, there are three important issues which need to be resolved: the system should be secure and able to ensure that candidates do not cheat or plagiarise material, candidates should understand how they are scored and candidates should understand the shortlisting process.

Problems with the website first arose in March when the British Medical Association said the process had ‘descended into pandemonium’. The website fell over twice due to demand, causing data loss and glitches to filing applications, resulting in two extensions to the original application deadline.

Two months later after much campaigning by the BMA and junior doctors, the Department of Health acknowledged problems and abandoned the system.

In his report, Sir John says that the rush to get the system out and working contributed to problems.

“Accelerated development of the system, changes to specification and an unanticipated increase in the volume and intensity of the applications that were received revealed technical deficiencies.”

However, management of the system also led to problems with the recruitment process, he added.

“The division between the management of the IT delivery system and ‘The Rules’ that informed its development created fundamental problems for a high risk project. Risk management was inadequate. Communication too, particularly with applicants and their mentors about the nature of Round 1, was deficient, fuelling the perception that the system had failed.”

This, he said ‘damaged confidence in the process as a whole.’ Now, the DH says they will use a programme board to develop a user-friendly and secure national IT system for use in the future, but for the time being, deaneries will be in charge locally.

Their responsibilities will include: advertising vacancies; using their own or speciality-based application forms, which must be structured, CV-based forms with speciality-specific questions; using their own shortlisting criteria and scoring systems; interviewing and selecting successful applicants; making offers and receiving acceptances.

Bradshaw said: “We have learned important lessons from the difficulties with this year’s recruitment process and have apologised to junior doctors for any distress caused to them and their families. We said we would listen to doctors and their representatives and today’s announcement reflects this. If new or national systems are to be used in the future, they must be rigorously tested and agreed with doctors, the NHS and others involved.

“Excellence and high achievement have always been at the heart of medical training in this country. As we continue to work with stakeholders on the future of Modernising Medical Careers this pursuit of excellence will continue.”

Dr Hamish Meldrum, chairman of council at the BMA, said: “This is a detailed report with many far-reaching recommendations. The BMA will carefully consider them all and we will canvass our members’ views as part of the process.

“The report highlights the need for coherent medical advice on key matters of principle, and the importance of doctors being involved in the management of the health service – we couldn’t agree more. Failure to engage with doctors was an underlying reason for the disaster we saw this year.”

Links

Tooke Inquiry