London Calling

I’ve not blogged for a while mainly because things have been changing quite a lot for me in the last couple of months. A couple of years ago (two years, I can’t believe it’s been that long!) I pretty much decided that I didn’t like the particular part of the country that the MMC lottery had placed me in. I didn’t want to spend the remainder of my youth there and I devised a plan to move.

To cut a long and convoluted story short, my plan has now come to fruition. I am now the proud owner of a training number in London and I will now complete the ret of my post-graduate training there. Since Christmas, I’ve spent most of my free time sorting out the practicalities of the move. I’ve been packing, sorting out my paperwork, having multiple conversations with various people at the deaneries

Anyway, after what seemed like an eternity, last week I finally started working in the big smoke and it’s certainly been the case of so far, so good. London hospitals have a reputation for being large, unfriendly and extremely competitive, but the people I’ve met and worked with so far have all been really nice and I feel I’m really going to enjoy working here.

On a more personal note, me and FashionGirl have moved in together and so far, things are going really well.

It’s been a bit of a long haul, but are really slotting into place for me at long last. I’ve got a feeling that I’m really going to enjoy myself over the next few months and years.

I heard it through the grapevine...

I can find very few people who think that MMC was a good idea, but still, the juggernaught rolls on, messing up the lives of junior doctors and causing untold stress. One of its so-called "advantages" was to give us a fairer, cheaper and more stream-lined recruitment process so that 

a) Hospitals would employ the highest quality junior doctors to look after their patients

b) Junior doctors would have a transparant method of apply for training jobs and be able to compete on a level playing field.

After the MTAS fiasco in 2007, we were told that the recruitment process was going to be sorted out and that the system would ensure that the best doctors are appointed to jobs and that no patients would come to harm because of the changes that MMC brought in.

Do you think that these lofty aspirations have been attained? Let me tell you what I'm hearing through the grapevine.

What the consultants are saying:

“We’re really worried about what we are going to do in August. When the current batch of junior doctors moves on, we’re concerned that there’ll be no one to replace them. The deanery are meant to be sorting out appointing people and hiring SHOs and registrars, but they’re telling us that we’re only going to be given a couple of each. How on earth are we supposed to run a service and an on-call rota with three SHOs and two registrars? It’s ridiculous. We’ve tried advertising for non-training junior doctors, but nobody seems to want those jobs, so we never get any applicants. Who’s going to look after the patients? We’re all really worried. There’s a crisis coming and we don’t seem to be able to do anything to prevent it.”

 What the deanery are saying:

 “We’ve advertised for people, but we don’t seem to be getting many applicants for the jobs. Some of the people we do get applying for these jobs are certainly, shall we say… inappropriate. We can’t appoint people to positions we don’t think they’re qualified for. For some reason, there’s a shortage of decent quality junior doctors that we can give our SHO and registrar jobs to. All we can do is keep trying to advertise, but I don’t see how things can improve.”

 What the junior doctors are saying.

 “I somehow have to find myself a registrar job for August, but it’s really difficult to actually find where these jobs are advertised. You used to just be able to look at the BMJ for job adverts, but now you have to search every day on each of the 16 deanery websites. The websites are often un-navigable and confusing. Half of them, you have to register with – which is a hassle - but, even then, they still don’t tell you when they have the jobs out.

“Then the application forms are all different and they take a couple of days to fill in. Then after all that, you know that there’ll only be one or two jobs in the whole area and they’ve probably already been promised to “local candidates” anyway. You just get really disheartened after a while and feel like giving up. I don’t understand why they make it so difficult to even apply for the jobs in the first place. I think it must be some sort of screening mechanism. You know ‘if you can find the application form – then you’ve done most of the hard work and we’ll probably offer you a job!’”

So there you have it - MMC a fair and transparent way to ensure that the best junior doctor are appointed to training jobs. The system is working well!

Mangling Medical Careers

When I started this blog, I deliberately tried to avoid writing about Modernising Medical Careers (MMC) because the whole debacle pissed me off so much and I’d just get really angry whenever I thought about it.

It’s now two years since specialty training and recruitment came under the MMC umbrella, so I thought I’d revisit the subject to see if the powers that be have managed to iron out the problems the new system had at its inception.

One of the key concepts of MMC, the new post-graduate training system for doctors, was to end the “lost generation” of Senior House Officer (SHO) junior doctors who spend far too long in SHO posts and face far too may barriers to career progression.

A quick look at the MMC website shows how beneficial the changes have been to junior doctors. They’ve got rid of the name “SHO” and given us names like CT1, ST2, FTSTA2, ACCS1 etc… etc… but the jobs that we are doing are essentially the same, so I’ll refer to all these posts as “SHO” in this post to try and avoid confusion. All SHOs would like to progress to being a Specialist Registrar (SpR) with the long term aim to complete our training and become a consultant.

MMC has renamed the SpR posts as “ST3”

Now, lets say that you’re a junior doctor and are coming to the end of your two or three years as an SHO and want to move on to an ST3 (SpR) job next year to progress your training. Oh, and lets say that you want to stay roughly where you live at the moment because that’s where your friends and family are.
For the specialty of anaesthetics, let’s see exactly how many jobs there are to apply for in England & Wales in 2009.

East Anglia and the East of England – 1
East Midlands – 2
Kent, Surrey & Sussex – ZERO
Manchester, Lancashire and the North West – ZERO
Newcastle & the north – ZERO
Oxfordshire – ZERO
Cornwall, Devon & Dorset – ZERO
Bristol and the Severn area - 1
Wessex – 1
West Midlands – ZERO
Yorkshire – ZERO

All of Wales - ZERO

In fact, the only places where are any vaguely sensible numbers of jobs are Liverpool and London. If you happen to live anywhere else, you’re going to have to move. In the whole of the country, there is a sum total of 55 jobs available in 2009. My back-of-an-envelope calculations tell me that there’ll be in the region of 350-450 doctors wanting one of these 55 jobs. What happens to the people who don’t get one of these jobs? Nobody knows, and the impression that I get is that nobody really cares. The situation is even worse for doctors who want to be surgeons, paediatricians or physicians.

Remember that the stated aim was to PREVENT barriers to career progression. How can a system that’s been six years in the making fuck things up so badly?

You're Fired (or maybe not...)

I was watching The Apprentice the other week and the candidate’s task was to put on a themed dinner in a pub. As per normal, general chaos ensued. One of the teams was in the market, trying to buy tomatoes but they really didn’t know how many they needed and so had to try and wing it. Sir Alan Sugar was not impressed and he said something like:

“It seems to me that you had no bleeding idea how many tomatoes you were buying. You had no idea how much soup you were expecting to sell so you had no idea how much soup you needed to make and how many tomatoes you needed to buy. What did you do? Did you just pluck a figure out of the air did you? That doesn’t seem to be a very smart way to go about business if you ask me…”

The reason I bring this up is that it strikes a chord with the ongoing MMC fuck up. One of the biggest errors of MMC 2007 was around workforce planning. The Department of Health seem to have no idea how many consultants they will need, how many they want to employ and thus, how many junior doctors they want to train. How on earth can you plan medical school numbers and training positions for junior doctors without this most basic of information? I know that people aren’t tomatoes but the principle of basic planning surely applies. No wonder it’s all going tits up.

The House of Commons Health Care Committee has released its third MMC report and it seems that they agree with me that the people who ran MMC had “no bleeding idea” how many doctors they need in the NHS (see paragraph 19 on this link).

I’m sure Sir Alan Sugar would have had no truck with this level of staggering incompetence, but unlike The Apprentice, Liam Donaldson hasn’t been fired. He’s still sitting pretty in his job after screwing with the lives of literally thousands of junior doctors.

Is there a doctor in the house?

I wrote before about the bizarre state that we find ourselves in regarding staffing. Despite the ridiculous shambles of MMC 2007 that left the majority of junior doctors in specialist training either displaced or unemployed, we now find ourselves in a position where there aren’t enough doctors in the hospital to staff a rota.

The situation has now been picked up by Channel 4 and The Telegraph (the BBC, as always remain silent).

Junior doctor jobs are vacant, and trusts up and down the land are having to scrabble around to find emergency locum appointments at the cost of thousands of pounds per week.

The situation is getting worse and worse on almost by the week. Doctors are completing their training and are taking up consultant jobs, taking a break or going to work elsewhere and, because or MMC, NewTown NHS trust is not able to replace them until August.

This means more positions are being left vacant, more pressure is put on the remaining doctors to do the work and the NewTown NHS Trust is having to fork out more and more money to pay for locums to cover the shifts.

To put into perspective how bad things have become, in February 2007 (pre-MMC) there were 12 junior doctors (SHOs) on the anaesthetics rota at NewTown Hospital, today, there are five. Five doctors are doing the work of twelve.

This is obviously unsustainable and in reality, it’s meant that the consultants are doing many of the duties previously done by the juniors. This is good in that the work gets done and our patients don’t suffer delays or poor treatment, but you have to ask; is paying locums and consultants to do the work of junior doctors a sensible use of resources?

I think not.

My colleagues in general medicine and surgery say the situation for them is very similar.

Once again, I’ll say that Liam Donaldson has a hell of a lot to answer for.

Stick

I’ve made up my mind and I now have a plan.

Thank you all for your advice – I’ve decided to stay where I am (for now).

I’m doing a job I really enjoy but have a seven year contract in a city that I really dislike. I’ve been trying to decide whether I should apply for another training job elsewhere in the country and give up my training contract where I am.

A couple of weeks ago, I had pretty much made up my mind that I was going to leave this to seek work elsewhere, but now I’ve changed my mind and the reasons are as follows.

The Royal College of Anaesthetists have always said they thought that some changes to anaesthetic training made by MMC were a crock of shit. Specifically, they didn’t agree with idea of a 7-year “run-through” training programme (this is the type of contract that I currently hold) and, backed by the Tooke Report, they’ve decided to get rid of this. Those, like me, who managed to get a “run-through” job in 2007 will have their contracts honoured, but there will be no more 7-year training programmes offered. Instead, training will be “decoupled” and split into two consecutive 2- and 5-year contracts. Doctors would have to reapply at the end of the 2-year “basic” training part. The idea is that it gives doctors in training a chance to change locations or specialties part-way through their training.

In a nutshell, the abolition of “run-through” training gives me an opportunity to move to a different part of the country in 2009 and this is what I plan to do. I’m going to stay here in NewCity for another year and then apply for registrar (ST3) jobs elsewhere next year.

Last year, the application process made my life a misery for months and months and the thought of doing it all again now makes my heart sink – especially as competition for places is going for be even fiercer this year.

It won’t be plain sailing though. In order to be eligible to apply for jobs starting August 2009, I’ll need to have passed both parts of the fiendishly difficult anaesthetic post graduate primary exams before January of next year. Because of the timing of the exams, this means that I’ll have to pass both sections on my first attempt, plus I’ll have to sit the first part after only a few months of anaesthetics. It’s going to be a huge ask but I think that the prize of Escape from NewCity will spur me on to study harder than I’ve ever studied before!

So, it seems I’ve found the “3rd way” as a solution to my problem. I’m going to stay put for another year and aim to leave next summer. This means that I won’t have to stay in this crap city for the remainder of my youth, but at the same time, I won’t have to navigate the medical job application system four times in four years either. The down side is that I’ll spend most of the next 12 months in the library studying like a fiend.

In the meantime, I’m going to follow the advice of some readers to this blog. I’m going to get a new hobby or two, get a girlfriend, kick back and appreciate what I have achieved so far. After all, I’m doing something I love every single day and getting paid for it.

Now, how many people can honestly say that?

- Michael

The Tooke Report

If I were a Victorian war novelist, this is how I would end one of my books…

The dust has settled, the bodies have been counted and the smell of cordite no longer assails the senses. The old general regards the battlefield and sheds a tear as he thinks of how much was lost fighting another man’s cause. One thought revolves around and around his battle-wearied mind like a moth slowly circling an oil-lamp:

“What was the point? For what did we sacrifice so much and achieve so little?”

------------------------------------------------------------------------------------------------

The Tooke Report (the independent inquiry into the MMC fiasco) came out today and here’s what it said…

"The structure of postgraduate training proposed by MMC is unlikely to encourage or reward striving for excellence, offer appropriate flexibility to trainees, facilitate future workforce design,
or meet the needs of particular groups (e.g. those with academic aspirations, or those pursuing a non-consultant career grade experience). It risks creating another ‘lost tribe’ at FTSTA level."

It just begs the question… What was the point of MMC? For what did we sacrifice so much and achieve so little?

Stick or Twist? A New Year's Dilemma

Happy 2008 to one and all.

The New Year marks a time for new beginnings, new hopes, new aspirations and, in my case, a huge new dilemma. It won’t come as a surprise that my dilemma is, once again, related to MMC. For those who don’t know, MMC (Modernising Medical Careers) was the government’s attempt at reforming medical training. The idea was that doctors would get a clear career path and a structured training schedule. It’s failed, all that the government succeeded in doing was fucking up the lives of thousand and thousands of junior doctors, created endless reams of extra paperwork for us to do (taking us away from our patients) and the “training” is exactly the same as before – the big difference is that we now have less of it.

Not exactly progress, if you ask me.

The failings of MMC and last year’s MTAS fiasco have been discussed no end on the web, in the papers, on the radio and on the telly, so I won’t go into all that again but I will explain to you the dilemma that MMC has left me with and maybe you guys can help me out.

Last summer, I was working as a doctor in general medicine and MTAS/MMC fiasco left me staring down the barrel of unemployment. With only 9 days to go until I had to sign on to the dole, I managed to secure a “run-through” ST1 job doing anaesthetics in a different part of the country. “ST” jobs were like gold-dust and the competition for them was fierce, so I was very pleased to be offered one and accepted the job offer with much relief.

I then relocated myself to a different part of the country, found myself a lovely apartment to live in, and set about seeing if a career in anaesthetics was for me. After working here for 5 months now, I love my job. I find it the most interesting, exciting and rewarding job that I’ve ever done and I KNOW that this is what I want to do for the rest of my working life.

So far, so good and you may now be wondering what my dilemma is.

I’ll tell you. It’s this city. I really enjoyed where I was living before but my new city (NewCity) just doesn’t have the vibrancy, the character and the things I enjoy. My first impressions of NewCity were that it was ugly and uninteresting and, after living here for almost half a year now, I know that my first impressions were correct. NewCity is just a bit rubbish really. Entertainment comes from the “Let’s Go Out, Drink 12 Pints, Dance To Cheesy Music And Try To Get Off With A Slightly Overweight Bird” school of good times. I’ve nothing against this once in a while, but my problem is that there is NOTHING ELSE to do here and the “living for Saturday Night” mentality gets a bit tedious after a while. I don’t know – maybe I’m just getting old!

Another part of the problem, I feel, is that I am now living hundreds of miles away from my family and old friends. This isn’t as huge a deal for me as it is for some people because I’m pretty good at making the effort to visit people or call people. Also, I’m a pretty affable and sociable person and tend to make new friends quite easily. That said, I’m not at the “popping round unannounced to your mates house to watch the footy” stage of friendship yet, and I think I miss that a little too.

So my dilemma is this. Should I stick with NewCity? As things stand, I have a seven year Specialty Training contract here. The fact that I’m doing a job I really love and have found a gorgeous apartment to live in would suggest sticking with it. But then again, should I remain in a place I don’t like for seven years (the rest of my youth)?

Leaving would mean giving up my run through training and I’d have to navigate my way through the quagmire of the applications process once more. There is even more competition for training positions this year than there was last year, so if I decide to leave, there is a real chance I won’t be able to get another job and end up being unemployed.

The 2008 application process began on Saturday, so I have to make a decision pretty quickly.

Should I stick or should I twist? I really am torn, what do you guys think I should do?

- Michael

b.t.w. the system does not allow me to transfer my contract to another part of the country because my reasons for wanting to move are not “compelling” enough.

Where have all the doctors gone?

Last week, New Town anaesthetics department had its “Junior Doctors Forum.” This is basically a place where we juniors get to say what I working well and what is not working well within the department.

Unsurprisingly, straight out of the gate was the state of the on-call rota. Basically, there aren’t enough junior doctors to fully staff the rota. This means that we are constantly being asked by medical staffing to do extra shifts. The consultants frequently have to carry the on-call and cardiac arrest bleeps and the hospital trust is having to fork out huge sums of cash to pay for locums (it costs the hospital £3185 to pay for a locum anaesthetic registrar to cover a week of night shifts). The problem is going to be even worse in the new year, when a couple of the more senior SHOs leave to take up registrar position elsewhere in the country.

In the meeting someone asked if there were any plans to employ more juniors and the reply I got was something like this.

“We’re trying. We’ve had a couple of adverts out for a while now, but we only had one applicant and that person pulled out of the interview last week.”

I was flabbergasted. When I applied my job as a Medical SHO, human resources told me they received nearly 900 applications for 2 positions. Now, a couple of years later, they can’t even attract a single applicant? It begs the question – where have all the junior doctors gone?

The answer is obvious isn’t? It’s another legacy of MMC and the MTAS fiasco.

On the face of it, you’d have thought that a shortage of junior doctors was never going to be a problem. In January of this year, there were 33 000 doctors simultaneously applying for only 21 000 jobs and we junior doctors were fretting about unemployment - indeed I came within nine days of the dole queue.

It seems that what’s actually happened is that the suits at the Department of Health and the MMC have seriously overestimated how much shit junior doctors are willing to put up with.

What is now becoming apparent is that thousands of us have “Just Said No.” This has led to a mass exodus of junior doctors from the NHS. I personally know of 13 doctors of a similar experience level to myself that have left the NHS this year. Multiply that across the nation and you’re talking of a huge number of doctors who were simply unwilling to be treated in such an unfair and callous way. I think Dr Rant hit the nail on the head with this post.

The funny thing is, not one of my friends who have left the NHS regrets their decision. Whether they’ve gone to work abroad, or just given up being a doctor completely to do something else, it seems that they’ve found working conditions far better outside the NHS and, as things stand, none of them have any intention of coming back.

"MMC & MTAS 2007 – a post-mortem" or “Lies, bad advice and how I got my job”

Last week, Hospital Phoenix wrote about some nonsensical advice that was given to one of his friends at his trust induction. This got me thinking about MMC once more. There are many things that are horribly wrong about Modernising Medical Careers and the Medical Training Applications System but, as someone who actually had to negotiate this disaster, the single thing that I found most galling, most frustrating and most stressful about it was the utter lack of information about the scheme and how it was intended to run.

In spring 2006, when the changes to the medical training system started to change from vague chatter on the college websites to firm plans, I tried and tried to find out how certain aspects of my training and experience would fit into the new system and what I should be doing to get a job. It was all in vain. I lost count of the number of times that my questions were met with a shrugging “I don’t know.” In December 2006, I was getting more than a little stressed by it all and contacted, in rapid succession, – MMC, the royal college of physicians, the royal college of anaesthetists and PMETB about what I should do when the application process began. Nobody had any idea. Here are a few of the responses I got:

PMETB: “I don’t know, applications are nothing to do with us.”
MMC: “I don’t know, you should just apply to whatever you think and not be too picky about where you want to work.”
RCoA: “I don’t know, you don’t fit into any of our boxes do you – ask MMC”
MMC (the second time): “I don’t know – maybe you should do an FY2 year.”
RCP: “I don’t know, but you have your exam so I think you’ll be OK.”
RCoA: “If you do find an answer, could you come back and tell us because we’d be interested to know too.”

Do you feel my pain? Finding any sort of useful information was like drawing blood from a stone and the information I did manage to extract was either unhelpful or just plain wrong. The consultants at the hospital I where I was working at the time were less than useless and I took gossip about the changes among fellow junior doctors with a pinch of salt. I discounted rumours like “they are going to sacrifice a whole generation of SHOs to make the new system work” and “there are going to be thousands of unemployed junior doctors” and “families will be torn apart by this” as scaremongering by the hospital stress-heads. Surely they wouldn’t do that to us? I thought.

I was wrong. As you probably know, the actual reality was far worse.

Advice from consultants about getting a job through MTAS was appallingly bad. They just trotted out the same stuff that had helped under the old system and I don’t think they realised that the goalposts regarding job applications had fundamentally changed. This is part of the reason why it came as a surprise to many when high quality candidates weren’t even being short-listed in Round 1 (later renamed to Round 1a). At various times during the application process, various consultants told me things like; “It’s very important that you have your [post-graduate] exams, it’ll help you stand out” and “It’s always worthwhile contacting and visiting the department [of the job you’re applying for] before the interview” and “Make sure your CV looks good” etc… etc…
All this advice sounds reasonable, but was absolutely useless when it came to applying for jobs this year. I very much doubt I’m alone in being told these kind of things by my seniors but the facts are that if you paid attention to your bosses and actually followed advice like this, you’re highly likely to be unemployed right now.

The MMC themselves recognise that misinformation and a lack of useful information was one of its (many) major failings this year and, to be fair to my former bosses, they were probably as much in the dark about the changes as we were.

The thing that galls though is that, as the system fell apart and as it became increasingly apparent that you needed to do something different in order to get a job, the old advice still stuck.

I’ve commented before about how I feel let down by Liam Donaldson and the government for instigated and overseeing the MMC fuckup. I also feel let down by the senior doctors, the consultants, during the whole affair. Generally, I felt the majority of them just didn’t care at all, the advice given by them was often a load of bollocks and the way the BMA (led by consultants) behaved when they sided with the government against us juniors was truly disgusting.

I was interviewed four times in Round 1a, including once for the position I was working in at the time (effectively being re-interviewed for the job I was already doing), and didn’t get any job offers.

Round 2 was a total fucking debacle. Jobs were (or weren’t) advertised ad hoc, in random, hard-to find places for stupidly short lengths of time. Some deaneries made life as difficult as possible for applicants and, in places, what MMC said about how things were meant to run bore little or no resemblance to what was actually happening.

Here are some examples of skulduggery by the deaneries in round 2, all of which are DIRECTLY contrary to what was published on the MMC website. The London Deanery advertised and then closed its Round 2 anaesthetics jobs BEFORE round 1 had even finished and then appointed only current London-based trainees to the positions. The Round 2 Core Medical Training jobs for the South Yorkshire South Humber Deanery were PHYSICALLY IMPOSSIBLE to apply for from outside the region because the application form was only made available on the day of the deadline and they insisted on having 10 paper copies. The Leicester, Northampton and Rutland Deanery didn’t even bother publish a deadline for its Round 2 anaesthetics jobs.

These are just examples that directly affected me and I’m sure there are many, many more examples across the nation. By the way, if any of you do know of any more, I’d be interested in hearing about them.

Anyway, after many hours spent filling out endless application forms, I got myself short-listed in Round 2. I was successful at interview and was given one of the much-sort-after ST run-through positions. I was very lucky indeed.

I was on the phone to my old registrar the other day and, apparently, the new junior doctors on the firm are less qualified and less experienced than we were. This begs the question, “how come they got the job and I didn’t?”

The answer, I think, goes back to what I was talking about at the start of this post – bad advice. If I could go back to December 2006 and give myself one piece of advice it would be to sort out my portfolio and this is the advice that I give to anyone still negotiating the system.

I thought I interviewed very well in Round 1 and was actually quietly confident about getting a job. I was wrong. The computer said “No.” I thought I interviewed very well in Round 2 and was quietly confident about getting the job. I was right, I dodged the dole office with about a fortnight to spare and am now really enjoying my work (though I’m lamenting the fact that I’ve had to move hundreds of miles from my friends and family).

The difference between Dr Michael Anderson in Round 1 and Dr Michael Anderson in Round 2 was that, by the time Round 2 came, I had buffed my portfolio to the max.

I’d gone round and asked my medical students to sign something to say I’d taught them how cannulate and read ECGs, I asked the senior sister to write a letter saying I was nice to patients and staff, I’d got a consultant to write a letter saying that I can ably cover CCU and HDU, the list goes on. I have to say at this point that this wasn’t EXTRA stuff I was doing after failing in Round 1. I was doing all this stuff when I had my Round 1 interviews - it just wasn’t in my portfolio at that time.

Whether you think that I was incredibly shrewd and learned from Round 1 and “sold myself in the best possible light” or you think I “shamelessly played a flawed system to get a job” will depend on your standpoint.

The fact is that in MTAS 2007, this sort of portfolio stuff is considered more important than previous experience, publications, post-grad degrees etc… and this is a fundamental change that my seniors and the majority of my junior doctor colleagues just failed to realise. Whether or not this is the way it SHOULD be is a matter for another debate. Personally, I’m praying that MTAS 2008 will be drastically different to MTAS 2007, but I have my doubts.

You see, as we enter September 2007 and contemplate the applications for next year, I don’t see that a great deal has changed. As was the case in September 2006, it seems nobody has a clue about how the system is going to run next year and everyone is still “waiting to find out.” I’m willing to bet that a junior doctor seeking advice about how to apply next year will find getting any useful information virtually impossible – just like I did last year. To quote a great woman “It’s all a bit of history repeating.”

I hope I’m wrong. Time will tell.

New Beginnings

I have a job.

MMC has meant months and months of dark days, heartache and stress for myself and thousands and thousands of other junior doctors. The powers that be have shown their colours and have fed us and the public misinformation and lies time and time again. There have been many tears shed and thousands of lives have been changed forever this travesty which went all the way to the highest court in the land.

Since the computer said “No” after round one, I have contacted hospitals in New Zealand and Australia and received some very positive feedback regarding job opportunities. I’ve joined two locum agencies so I could earn some money in the meantime. I’ve written a non-medical CV and asked some friends in London about how I’d start a career in finance. I didn’t want to do any of the above but felt I had to formulate plans B and C because the spectre of unemployment was looming larger and larger hour by hour.

I really feel like I’ve managed to snatch victory from the jaws of defeat. Like I’ve scored a last-minute equaliser or gained a death-row reprieve. I feel kind of shocked that, for me at least, all this hassle is over. No more frantically checking NHS jobs and BMJ careers every single evening for positions that come and go faster than fireworks on bonfire night, no more endless hours filling out sprawling application forms, no more trying to explain to perplexed people why I was going to be an unemployed doctor. The bitter shame is that MMC has left thousands of doctors just like me still fighting and desperately trying to find a job or deciding what they’re going to do when our contracts end next week.

You know, the ultimate irony in all this was just how straight-forward the round two interview was. They looked at my CV and my other achievements. The interviews and the exam took about an hour and a half altogether. I didn’t say anything stupid and at the end of it all, they decided that they liked me and offered me a job. Easy.

It does raise the question that how on earth could something so simple turn into such an unprecedented disaster?

So, here it goes. A week on Wednesday, I start a new job in a new deanery a couple of hundred miles from where I’m living right now. A new start, a new challenge, a new specialty – I can’t wait.

Bring it on.

Stop The Clock!

I have a job offer.

Dr Anderson is back in the game!

Days to unemployment=21

I got an email today informing me that I have a round 2 interview next week.

It's not over yet...

29 days to unemployment

I took a break from work and from blogging just to get away from it all for a while. To be honest with you, I’m tired of job applications. It’s endless. I spent god knows how many hours doing it last year and right now, history is repeating itself.

Some application forms for round 2 jobs run to 30 pages and they’re each taking me at least four hours to complete. The rota has me working between 68 and 72 hours a week every week this month and I resent spending ALL my free time on applications. But it has to be done because as it stands, I have 29 days to unemployment.

The thoughts going through my mind are:

I don’t want to move to far flung areas of the country to get a job. I’m especially loathe to do this for a non-training position. I’ll be destroying my life outside medicine leaving my family, my sports club, my friends etc… and then I’ll probably have to do it again in a few month’s time so is it actually worth it?

Unemployment doesn’t actually scare me too much from a non-career point of view. I’m a bright lad and I live in a capitalist society. There’s always ways and means of making money – plus I have no wife or children to look after.

What I AM worried about is my career. MMC have repeatedly said that August 2007 is my best chance to get a training job. If I don’t get one now, then everything becomes orders of magnitude harder next year. With this in mind, I realise that if I don’t get at least a trust grade (non-training) job, then I’ll be more or less unemployable come this time next year and this is very worrying indeed.

To quote the recent single by electro-popsters Unklejam, “What am I fighting for?” Trying to get our ward to run smoothly is – not to put too fine a point on it – fucking hard work. I have to work overnight on a regular basis. I have to give up my weekends and I there’s lots of stuff I’d like to do outside work that I’m not able to simply because I don’t have time. The job itself is hard work. It’s very rewarding but it’s sometimes very tough and I find that I have to try my best to be all things to all people. Like any job, there’s bits I enjoy about it and bits I don’t but at the end of the day being a doctor isn’t SO AMAZING that I’m willing to give up my entire life for it. Willing to move away from my family, friends and hobbies for, willing to move to a whole different COUNTRY for – forever. I honestly believe that if I was in a different career or profession, then I wouldn’t make those sorts of sacrifices for my job, so I’m not sure if I’m prepared to for hospital medicine.

So I’m in a quandary. I’m continuing to use my free hours to apply for jobs but after nearly a year of bullshit doled out by the government, I feel like my “fight” left me. I feel let down. The people who dreamt up the MMC system, the people who thought it would be a good idea, have either been sacked or resigned but at the end of the day, the MMC system marches on and it’s left this junior doctor with only 29 days to unemployment.

A small diamond in the dirt

I have a brief reprive. The people who are running the MMC have said that junior doctors like myself who have jobs at the moment will be able to continue working in our current positions "while we progress through round 2."

Reading between the lines, this means that I won't be forced to sign on in six weeks' time, but witll have probably until the middle to end of October to try and get a job. Obviously, I'm really relieved by this because it means that I can continue working and treating patients for a while longer and have a bit longer to try and save up some money to tide me over if I don't get job this year. It's one thing less to worry about.

This is the only piece of good news that I've had from the MMC people.

Computer says, “No.”

So here we are. The offers have all been made by the deaneries and I don’t have a job. Come 1st of August, I shall be unemployed.

Gutted? You bet I am. After all that has happened since February regarding my career, the prospect have having to do it all again is soul-destroying. After all the time and effort I put into the application process, I have achieved fuck all and have gotten nowhere.

The prospect of unemployment has been hanging over me for several months and now it’s actually happened I don’t feel as gutted or distraught as I thought I would. Don’t get me wrong, I’m not exactly singing from the rafters but I appreciate that things must move on.

I’m quite lucky that I have no big ties. A few years of ignoring my parent’s banging on at me to get onto the property ladder has actually worked in my favour as I now have no mortgage to pay. My previous (wannabe) international playboy lifestyle has meant that I’m not in a committed relationship and I have no children. Most importantly, I’m still young enough to retrain in a different career if it all goes really wrong and I decide to stop being a practicing doctor.

I’m not willing to move just anywhere. There are things in my life outside medicine that mean I’d try my hardest to stay where I am but I’m more flexible than some and, should push come to shove, it’s relatively easy for me to move if I have to.

There’s still a chance I could get a job this round because re-offers are being made up until 22nd of June, but I’m not putting my hopes on it. To use a quote from military strategy theory, “If plan A doesn’t work, you should move to plan B and NOT to plan A repeated.”

I have a plan B.

Hopefully, the next round of applications will be less random and hopefully they won’t disregard a year’s worth of experience as “irrelevant” like they did last time.

If you take a step back and look at it objectively, the situation seems even more bizarre. Right now, I’m working as an SHO on an incredibly busy firm and doing my job well. MMC are basically saying that I’m not good enough to do the job that I’m already doing. I applied for the job that I’m doing last year and they decided at the time that I was good enough to do it. Given that I now have several months MORE experience, have done MORE audits and MORE courses, can do MORE procedures and have learnt so much MORE than I knew then, it’s seems bizarre for them to say that I’m no longer good enough.

But computer says no so there’s no job for me – tough titty.

I was short-listed four times for interview back in March (round 1a)

Getting Nervous

I’m getting nervous now.

I haven’t posted much about MMC or MTAS because, let’s face it, it’s pretty well covered elsewhere in medical blogosphere but it’s getting me down again. The application process has been dragging on and on and on since December and I’m just tired of it. Last week and this week, the deaneries actually started making job offers via email... at different times to different people. This means that some people have secured a job already – good on ‘em – whilst others are still waiting.

I’m still waiting, I’m still hoping, I’m still checking my inbox two to three times a day for any news, still wondering if I mis-typed the email address on the application form, still gob-smacked at being told by one of the consultants that interviewed me that a year’s worth of SHO experience in A&E and surgery was “irrelevant,” still staring down the barrel of unemployment in 57 days.

As each day passes, I get euphoric texts and calls from my doctor friends who have been made a job offer or two. While I’m really glad that my friends don’t have to worry about it anymore, every text message brings more sharply into focus the fact that I have nothing.

This is horrible.

It feels like A-level results day in that you know your future for the next five years is going to depend on the letters in that white envelope. That day, emotions were running high and it seemed that everybody was either ecstatic or distraught.

For me, this is much, much worse than that day. At least then, you knew you were going to get an answer. Now, I just don’t know. If I haven’t got a job, I won’t know until the 20th of June. The not-knowing is sickening and it’s getting me down.

I’m going to try and get some sleep and I’m hoping I feel better about it in the morning.

Goodnight.

Better to have loved and lost?

Things are going well on the ward at the moment. This is mainly because for the first time in months we are fully staffed. It’s great. Today I was able to see all my patients, spend a reasonable amount of time with them, get all the test organised, see the results and act on them, and I was still finished by half past four! It’s fantastic and I’m definitely going to enjoy it while it lasts.

My evening out with Gemma the physio at the weekend was really good fun too. I already knew that she was sweet and really fit and, over the course of the night, I found out that she’s a really funny, bright, likeable young lady basically, I think she has “the package.”

If you’re thinking there’s going to be a “but” you’d be right. Here it comes.

Gemma’s great and I think she quite likes me too but I think if anything is going to happen between us, it’ll be the Big Romance. You know, flowers on the doorstep, dinner with fairy lights, cuddles on the sofa, walks by the river, that kind of thing. Ordinarily, I’d be dead keen because, even though we’ve only be out the once, I can really see myself falling for her. The problem is, the MTAS applications process means I don’t know where abouts in the country I’m going to be living and working come the summertime. I’m worried that if we start something now, we might not be able to carry it on. And if that’s the case, is there any point in starting it?

On the 8th of June I find out two pieces of information that will be crucial to my life. Firstly whether or not I’ll be employed, and secondly, whereabouts in the country said job will be. Come the 8th of June, I could find out that I’ve got the job I want and will be able to stay close by. Or I could find out that I have to move hundreds of miles away from here… hundreds of miles away from her.

Is there any point in starting something when I know there’s a good chance we’ll have to end it in five week’s time? I don’t know. The cliché says that it’s better to have loved and lost than to have never loved at all, but the thing is - I HAVE loved and lost in the past and it hurts… a lot. And I don’t think that cliché is true.

So what am I supposed to do? I don’t know.

In the meantime, last week brought two more huge fuckups from the people at the MMC/MTAS who are in charge of our careers. Have a look. The mind boggles. The people running the online application process don’t seem to have grasped one of the FUNDAMENTAL truths about the internet. Once information is out, there’s no way to get it back again and EVERYONE who is interested can get hold of it. Every schoolchild knows this. Paris Hilton knows this. The people running MTAS really should have known this.

It's all over... or is it?

I've just had my fourth and final MTAS interview for specialty training in London. The interview itself was absolutely fine and I just feel this enormous sense of relief right now.
To be honest with you, I've found the this last month really stressful. We've been almost over-run at work and preparing for these job interviews takes a lot of time, practice and mental energy.
I'm glad all my interviews are over with and now, I can concentrate on actually doing my job and trying to enjoy myself outside work.

Maybe I'll get a job, in the summer. Maybe I won't but now it's all out of my hands and I can relax a bit in the knowledge that there's nothing more I can do change my destiny. I've got a couple of days off before starting a week of night shifts (again) on Thursday, so I'm visiting friends in the capital and I'm going to have a good time.

Que sera sera

Is anybody actually in charge?

I’m employed by a company to do a job and I do it well. Unfortunately, the people who run my company have decided to sack all the people doing the job I am and make us re-apply again for the jobs we are already doing.

They said I can only apply for four positions in four different areas of the country. I’m not happy about it, but I dutifully go through the processes and, because I do my job well, I get shortlisted and interviewed for all four positions I’ve applied for.

I spend a lot of time, effort and mental energy preparing for the series of interviews to try and perform to the best of my ability, after all these interviews are important and I don’t want to be unemployed come the summertime. These interviews are also very stressful but I try my hardest at each of them.

On Friday night my employers email me to let me know that they’ve changed their minds (again) and ask me to guess which interview I’ve done best in (they’re not going to actually tell me which I’ve done best in). Then they say that I can only apply the job in which I believe the interview went well and the rest of the interviews will count for nothing.

My contract is being terminated in the summer and I only have one opportunity to apply for one job to replace it.

Currently, in my company, there are 32,300 people doing my job. These people are competing for about 21,000 positions and come summertime, a third of us will be out of a job.

If anyone told me about a situation like this, I’d advise them to change companies to one that actually valued the hard work of its employees and didn’t treat them in such a slipshod, slapdash, disdainful manner.

Trouble is, my company is the NHS and my job is a junior doctor.

I don’t want to leave the NHS but I’m asking myself, with increasing regularity, “Is it worth it?”