Tempus fugit: competency assessment in Modernizing Medical Careers

As Osbourne¹ highlights (JRSM 2006;99:56-7), the very nature of the Foundation Programme necessitates a significant investment of time in competency assessment. The advent of Modernizing Medical Careers (MMC), and resulting competency assessment, is beginning to have an even greater temporal impact on both the trainer and trainee alike. There has been a considerable amount of effort put into formalizing the process of competency assessment. I have noticed that the current crop of junior doctors wander the hospital corridors, stopping and asking anyone who is willing to listen to fill out an assessment form. If they were canvassing for election, then these would be the voting slips. Perhaps in some way they are; there is a notion amongst all that the more forms they have, the better their chance of getting a job. I am beginning to see the parallels with job seeking in the political arena!

In the spirit of MMC, I decided to perform a prospective audit assessing how much of my time was consumed with junior doctor competency assessment. Since data collection began in October 2006, I have spent 1135 minutes completing the various assessment forms. The median time is 62.5 minutes per week (range 30-120 minutes). Logistic regression analysis demonstrated that, if one assumes a linear trend, then my workload will increase by over six minutes per week (95% confidence interval 5.14-6.89 minutes). This translates to eight hours work per week by the end of February 2008!

Clearly, one cannot assume a linear trend, but if one factors in short-listing and interviewing—and indeed compulsory training courses for the aforementioned—then the linear trend may not be too erroneous. Only time will tell how much MMC will increase our workloads. However, I suggest the burden of competency assessment, short-listing, interview and selection will be significant. Perhaps consultants should negotiate a specific programmed activity (PA) for this?