Stress, lies and red tape: the views, success rates and stress levels of the MTAS cohort

Abstract

SummaryObjective To track the success rates in obtaining a specialist training (ST) post of a cohort of medical training application system (MTAS) applicants, as well as canvassing their views of the process and measuring symptoms of psychological distress during application and after job allocation.Design A follow-up cross-sectional survey.Setting Two large south London psychiatry training schemes. Participants 101 MTAS applicants.Main outcome measures Success in obtaining an ST post, respondents' views about MTAS and General Health Questionnaire-12 (GHQ-12) scores.Results 48 of the original sample responded to the follow-up survey. Data were available about post-MTAS job status for a further 41 trainees. 64% of candidates obtained an ST post. Of those, however, 12% were only offered a fixed-term post. Most unsuccessful candidates were doing locum (34%) or non-training grade (21%) jobs. UK/European Economic Area (EEA) doctors were more successful than non-EEA applicants in obtaining an ST post (odds ratio 5.5, 95% confidence interval 2.1-14.3), as were women candidates compared to men (3.7, 0.5-9.3).The respondents' views about MTAS were globally negative (even if they were successful in obtaining an ST post).The median GHQ-12 score for respondents was 7 out of a potential total score of 12. 79% of the sample scored above the threshold (GHQ-12 $4) for psychological distress and 21% experienced significant distress (GHQ-12 $8).Conclusions MTAS was a flawed system. A considerable proportion (36%) of candidates who had been on a Senior House Officer training scheme were left without a training post after MTAS.The system seems to favour UK/EEA applicants. Applicants suffered significant psychological distress during and after the MTAS process.

Readability analysis?

“…This is in keeping with previous work myself and colleagues conducted on junior doctors using the 12-item General Health Questionnaire, albeit at a time when they were undergoing a period of extreme stress (the MTAS fiasco). 2,3 We found that 79% of the sample scored above the cut-off point for psychological distress and 21% for severe distress (i.e. caseness for treatment).…”

“…caseness for treatment). 3 What perplexed me about the paper, however, were the high rates of suicidality in the MedNet sample (nearly half) but the relatively low scores on the Brief Psychiatric Interview.…”

“…Full-time training helps to achieve training goals earlier but part-time training allows for a more balanced life and more free time for family and children. 2,3 Trainees move in and out of jobs and are committed to training and flexible working.…”

“…The original feedback was on a 5-point Likert scale ranging from 'strongly agree' to 'strongly disagree'. These are ordinal variables (variables which represent categories of a feature with some inherent ordering 3 ); however, they were converted into continuous variables (one which can take any value within a range 3 ) and analysed as such. Unfortunately, one cannot convert discrete categories into a linear scale in this way.…”

Trends in junior doctors' certainty about their career choice of eventual clinical specialty: UK surveys

“…Many doctors in this cohort had expressed concerns in their comments to us when first surveyed in 2006 about the new application procedures for entry to specialty training scheduled for introduction in 2007. These concerns are now a matter of historical record11 but they related in particular to problems applying for and obtaining training posts through a new national application process which was both untested and which proved to have technical faults. Since then, the percentages of graduates of 2008 and 2009 who were certain about their choice, or whose choice was certain or probable 1 year after graduation, have reached historically high levels.…”