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Department of Health's response to 'Trainee surgeons left adrift'
08/10/2010 Dr Alison Carr and Mr Steve Buggle
Sir, Selection into higher surgical training (ST3) has always been competitive. Having introduced national co-ordination of selection into specialty training and electronic applications over the last few years, competition for ST3 surgical posts in England is now transparent and measurable. While the author selectively cites statistics from the Department of Health in this article, no distinction has been made between competition from doctors in core surgical training (CST) posts and from doctors outside training, who in many cases have made multiple previous unsuccessful applications over a number of years from non-training posts. The number of ST3 surgical posts available relates directly to the workforce need for consultant surgeons. Surgical specialties desire selection into surgery to be competitive. Currently the ratio of Core Training Year 2 (CT2) posts to ST3 opportunities overall is 2.3:1; however the Medical Programme Board, which oversees postgraduate medical training, has recently recommended reducing CST posts so ST3 posts available are more closely matched. We cannot influence the numbers of non-training posts, but we regularly publish the competition ratios for every specialty so applicants are aware of their chances of obtaining their chosen position. Since 2007, selection into specialty training has been carefully evaluated. The real issue to focus on, as referred to in your article, is for selection to place the right level of priority on career progression. The Royal Colleges, supported by the Department of Health, BMA and NHS Employers are working together to ensure selection methods used allow trainee applicants to demonstrate suitability for surgery and career progression rather than doctors being judged by the length of their surgical experience. Of the doctors currently applying for ST3 surgery posts who will not progress in the specialty to become consultants, some will continue to work in surgery while others will transfer their skills to other specialties such as radiology or retrain in another specialty. Some doctors will continue in service positions playing an extremely important role in the NHS. The Department of Health is committed to ensure selection into specialty training is robust and fair so surgical trainees with the most promise in the specialty progress to be consultants. Dr Alison Carr and Mr Steve Buggle Medical Education and Training Programme Department of Health (England)