Doctors continue to have little confidence in standards of training and care delivered under Modernising Medical Careers (MMC), a survey by Remedy UK reveals.
Despite a year passing since the Tooke Report, and two from the MTAS debacle, the overwhelming majority of doctors remain opposed to MMC. Seventy eight percent of 877 doctors claim patient care and postgraduate training is worse now than before MMC.
“I can’t see a single benefit,” one respondent lamented. “Honestly, I can’t. MMC has managed to achieve the exact opposite of everything it was intended to achieve – poor training, reduced flexibility, a lost tribe of SHOs and a disenchanted workforce.”
Fifteen percent did acknowledge that MMC has positive aspects but with the caveat that implementation was poor. Another respondent summed up many of the comments when they described MMC as: “Good in theory, very bad in practice.”
MMC is clearly having an ongoing impact on doctors’ morale. Just under a quarter of respondents expressed a desire to leave medicine and do a different job, while just over a quarter would not advise someone to take up a career in medicine.
“The job is neither stable nor well paid considering the number of hours worked,” complained another respondent. “Trusts work the system to ensure trainees receive minimum banding. Training is continually restructured in a way which is ill thought out and geared towards saving money. The role of the doctor is displaced by non-medical specialists with narrow and limited responsibility. And the consultant grade, which I have been aiming for, will be radically different by the end of my training and I will undertake it with a fraction of the experience of my predecessors.”
One doctor simply said: “Become a dentist or a lawyer instead.”
While many doctors were negative about MMC, there was a much more positive reaction to being a doctor. It’s still considered a good job, despite the changes. Of the sample, 52% are satisfied in their work against 29% who are dissatisfied. Many will also still recommend it as a career. One respondent commented: “Go for it! Things will get better and it’s got to be better than the City right now…”
But there is a price to pay for becoming a doctor. The survey shows that the average debt on graduation of these respondents was nearly £15,000. Nearly half were still paying off student loads.
There’s no doubt that many doctors remain angry with those responsible for MMC. Sixty four percent of respondents claim MMC has had a detrimental effect on their careers.
One described it as: “A disgraceful and catastrophic episode imposed by deceitful quislings who lied about their real intentions and who betrayed their colleagues and the profession.”
Another said: “It’s positive that I got the job I wanted. But it was a shattering and degrading experience. I’m now very cynical about senior doctors and politicians, and especially senior doctors who are also politicians.”
The Department of Health said sufficient efforts are already made to canvass doctors’ opinions. “The deaneries, colleges and the MMC programme have a range of ways of listening to and taking account of the views of doctors as part of annual planning for recruitment and postgraduate medical education,” said a spokesperson. “The current recruitment process and structure of training is based on feedback from consultation, an online survey of junior doctors and a programme of major discussion events with doctors across the regions that took place last year.”
Lindsay Cooke, co-chair of Remedy UK, wasn’t surprised by the ongoing resentment.
She said: “MMC is a political construct which offends almost every core value today’s doctors possess. It was untried and untested; it compromises individual autonomy and choice; it breaks the apprentice model of experiential learning; and it turns doctors from team member to shift worker.
“Doctors are special people, for sure, but they’re people first. MMC turns them into widgets or cogs in a medicine delivery machine.”
She believes the government needs to conduct a comprehensive survey into doctors’ opinion of MMC.
Remedy is also calling for full implementation of the Tooke Report. A DH spokesperson said: “Many of the changes were in the NHS Next Stage Review and are being taken forward.”
Cooke wants NHS: Medical Education England (MEE) – a new independent body advising the government on education, training and workforce policy – to be strengthened, “with teeth and led by those experienced in medical training would be a good start”.
“Advisory committees such as MEE have significant power and influence,” responded the DH spokesperson. “For example, Ministers have accepted every recommendation made by the MMC England Programme Board. In this way, advisory bodies can directly influence policy decisions. The authority and influence of MEE comes from the quality and clarity of advice that it provides to Ministers.”
Remedy UK Survey
