Resident Doctors Committee statement on anaesthetic training competition ratios
We are once again bitterly disappointed to read the latest publication of competition ratios for anaesthesia from NHS England. The data show that there were 6,770 applicants for just 539 ‘Anaesthetics CT1’ posts, with competition ratios rising dramatically from 2:1 in 2013 to 12:1 today. At ST4 recruitment stage, nearly 300 residents were unable to continue their training. This is wasteful, unsustainable, disheartening and negatively affects our ability as a profession to recruit and retain the best doctors.
While there has been a small improvement at the bottleneck of ST4 applications, it remains unacceptable that there are hundreds of anaesthetists who have successfully completed their stage 1 anaesthesia training and are unable to progress purely due to an inadequate number of training places. It is a poor investment for the taxpayer to have funded this training only for it to end abruptly - when a shortage of 11,000 Consultant Anaesthetists by 2040 is predicted. Urgent action needs to be taken to rectify this. The Government has committed to an increase of 1,000 speciality training places over three years – when divided amongst all medical specialities this is a drop in the ocean.
Since the introduction of the Multi-Specialty Recruitment Assessment, this test has been used to try to control the numbers of candidate interviewed. Our concern is that the unintended consequence is that excellent future anaesthetists miss out on an interview because of a score obtained in an exam with little relevance to anaesthesia. Secondly, because of the nature of the exam being multi-specialty we are concerned that many residents are forced to submit multiple applications to multiple specialties, because of concerns about unemployment following their foundation years. While we empathise with residents, this effect drives up application numbers and competition ratios and makes the interview process unsustainable.
In the short term we would like to see the introduction of a ‘first-preference’ system into CT1 speciality applications – whereby only those choosing anaesthesia as their first preference were invited to the first and second round of interviews.
In the longer term we would like to see a review of recruitment for both CT1 and ST4 entry into anaesthesia and a move away from the portfolio ‘arms race’ that encourages anaesthetists of the future to focus on every aspect of their career apart from clinical excellence.
We look forward to the Royal College of Anaesthetists' forthcoming review of run-through training, having been actively involved in the working party from the outset. Finally, we call on the Government in its upcoming review into NHS workforce to commit to a properly funded plan for anaesthetic training for doctors to ensure the safety of patients in the future.