While I was writing this blog, a news story on the issue was posted on the site, but I make no apology for the apparent repetition - I think this is important.
Two years ago, a junior hospital doctor caught up in the car crash which was MMC made a posting on the online forum DNUK concerning Dame Carol Black, one of the fiasco’s architects. The posting was rapidly removed at the poster’s own request, but as I recall, it suggested a suitable proctological repository for the MMC/MTAS scheme, using language which was a little intemperate, but nothing that would upset the average Royal Navy stoker or surgeon.
The posting was seen by a senior medical educationalist, who took offence on behalf of Dame Carol and alerted Professor Gillian Needham, the postgraduate dean responsible for the training of the doctor in question. The end result was that the young doctor (who was rapidly granted the cyberspace nom de plume of ‘Scotjunior’) was suspended from his job. As you can imagine, there was considerable reaction to this series of events, not least on the DNUK forums. It was perhaps unfortunate that the three leading protagonists arrayed against and/or targeted by the doctor were ladies, a fact which led to much use of the C-word (no - ‘coven’, not the other one).
Any link to the admittedly scatalogical coverage of the affair by the admirable Dr Rant would no doubt be removed by this site’s lawyers, but the curious reader might find that googling ‘jobbygate’ brings up some lively contemporary comment, revealing that incoherent anger was not a rare commodity at the time. Indeed, you could suggest that Scotjunior was simply reflecting the junior doctor zeitgeist.
Scotjunior was eventually allowed to return to work, and there the matter might have rested. But then, last weekend, Prof Needham published a personal view in the BMJ re-hashing the whole affair, justifying her actions and asking us to sympathise with her concerning the adverse personal comment resulting from her role in it (the link will only allow you to see the abstract of her article unless you subscribe, but you can read the electronic responses, of which more below).
The result has been predictable - a second flurry of highly critical responses. You (well, some of you) will be able to read the whole article, but in it Needham makes much of the fact that she was prevented from responding to criticism the first time round because of her professional responsibility to Scotjunior, and also because he clearly ‘needed help’. I don’t know if he is still working in the same deanery; presumably not, as Needham seems to feel that her duty of care towards him has expired.
The renewed criticism centres on the fact that her article has drawn attention to the affair yet again, in a public forum, and intimated that she had concerns for the mental stability of the doctor concerned (yes - I know that ‘needed help’ could mean all sorts of things, but it would be disingenuous in the extreme to suggest that use of that particular phrase would mean anything else to readers of the article). The identity of Scotjunior will already be known to those who followed the initial events, and can be readily ascertained by anyone whose curiosity is piqued by the BMJ’s raking over of the ashes.
If Needham was hoping to elicit sympathy for her plight, a quick viewing of the internet traffic will be very disappointing for her, and she may eventually feel that the maintenance of a dignified silence would have served her interests better. But my reason for drawing attention to this in what is normally a lighthearted blog has nothing to do with the professor personally. More important is the lack of insight demonstrated in the article.
It suggests that some senior medical educators still fail to grasp the degree of distress and genuine hardship caused to a whole generation of junior doctors by the ill-conceived imposition of MTAS. Instead of griping about the language used by some of the victims, Needham and her colleagues should be asking themselves just how they came to acquiesce in the introduction of the scheme, despite repeated contemporary warnings that they were courting disaster.
And secondly, why did the BMJ publish the article? Most of us stopped regarding it as a ‘proper’ scientific journal when it began to view the generation of tabloid headlines as the true measure of its success. Even so, the publication of an article which appears to treat the confidentiality of a trainee so lightly calls into question its editorial judgement.
Incidentally, if it turns out that Scotjunior gave his permission for publication, we would need to ask just how valid that consent could be, when it was being sought for an article written by a postgraduate dean who had already allowed him to be suspended once.
I suspect there may have been some soul-searching within the BMJ editorial department over the weekend, because I can’t help noticing that, despite an immediate influx of rapid responses (some of them probably completely unpublishable in a family journal), the more measured replies only began to appear on their website several days after the article which prompted them. This may just reflect the fact that the editorial team all go home at the weekend, but since then, several of the responses seem to have disappeared and then re-appeared. Not surprisingly, all of them are, at the time of writing, highly critical of both the content of the article and the BMJ.
Not that the doctor at the centre of the affair will be finding any satisfaction in the negative reaction to Needham’s article. From the outset, he made it clear that he did not wish to become a cause celebre; having apologised and withdrawn his online comments, he just wanted to keep his head down and get on with his career. He should have been allowed to do so.