MTAS - It's Raining Shit

MTAS is now well and truly dead. The last death throes finished at the end of October, and junior doctors are now more-or-less stuck in whatever employment they have been able to obtain. A bomb has gone off in the cess pit of medical worforce planning, and small particles of shit are still drifting down from the sky.

Eminent Surgeon, Mr Salmon, has noticed a problem at his department. Junior doctors used to be called SHOs. He is not sure what they are supposed to be called now, so will continue to call them SHOs, even though their job titles are a mixture of terms such as 'trust grade', 'FTSTAs' and 'ST2s'.

In his department, there used to be eight SHOs. Now with the advent of MMC and MTAS, there are five. They no longer work speciality night shifts. Instead, they are part of a pool of 14 SHOs who work as part of 'Hospital at night'. So, usually, every other week, the department is down to four SHOs to get all the work done formerly by eight SHOs.

One of the SHOs was lucky enough to get a locum registrar job at the same trust. It will not help his career prospects much. However, it will earn him a little more, and he will enjoy his job more. However, medical staffing have found it difficult to fill his post. So, for a lot of the time, his department are down to three SHOs.

Two of the other SHOs were working three month contracts, offered as part of the MTAS round 2 deal. One of them found a job elsewhere. Medical staffing did not realise that he would walk out after three months. And he did. So the department was down to two SHOs.

One of those SHOs is an sensible ST2, who booked all of his study leave on the first week of the job. He is currently on a course for a week. So the department is currently down to one SHO, who is doing all the jobs that eight SHOs used to do.

Now, what have medical staffing been up to, Mr Salmon hears you ask? Well, they have been trying to obtain a locum. Except there aren't any. They've all fucked off.

The doctors who used to do locum shifts no longer exists.

Those in research have realised that MMC / MTAS does not reward them. A year doing an MSc or and MD counted as much as a one day computer ECDL course. So those research doctors have fucked off.

Those doctors who had come from a non-EU country to do locum shifts have realised that the UK does not value them. Locum experience will not get them a proper training job in the UK. Despite years of subcontinental doctors propping up the locum sector, the NHS has given them the cold shoulder. So these foreign doctors have fucked off.

And what about the doctor 'in-between' jobs? Some doctors were prepared to go without permanent work for a couple of months, and do locum work for a short spell. They waited for an ideal job to come along, in order to obtain a desirable CV. Well, that is no longer an option. Under MMC, the situation is 'a job in August, or bust'. No one really wants to hang around for FTSTA or trust grade jobs. They count for fuck-all on a CV. So, with the choice of go abroad or leave medicine, this group of doctors have fucked off.

And lastly, a year ago, it was easy to get locum work. You needed a GMC certificate, occupational health clearance, a CRB check and some decent references. Now, as well as the above, you need to complete a 'solo-practice' course (£14 please), a manual handling course (more dosh, please), sort out locum appraisal (guess what?) and complete further mountains of paperwork. Of course none of these improve patient care or safety one iota, nor would they prevent another Shipman type psychopath from having some fun. For those who would normally do a couple of weekend locum shifts to help pay the bills, well, they find the extra hassle not worth the effort. In other words, they ARE fucked off.

So, one of the results of MTAS is that medical staffing departments are trying to pour a quart into a pint pot. Or rather, pour in a whole fucking bathtub. It just cannot be done. Some things just do not fit.


Professor Crockard, Professor Heard, Patsy Fuckwitt and Tony Blair - why did you not foresee this problem?

Oh yes, it is because you are all fucking idiots.