About Modernising Medical Careers

Modernising Medical Careers (MMC) was introduced in 2007 as a programme of radical change to drive up the quality of care for patients through reform and improvement in postgraduate medical education and training.

Under MMC, a new system of recruitment and training was introduced, with the recruitment to the Foundation Programme in 2005 and recruitment to Specialty Training (ST) in 2007.

The main underlying principles of MMC remain unchanged, but the processes of recruitment and training continue to change and develop each year, informed by feedback from doctors and representatives of the medical profession and NHS recruiting organisations.

The principles of MMC

One of the intended benefits of Modernising Medical Careers (MMC) was to ensure a transparent and efficient career path for doctors.

The NHS Plan, published in 2000, included a commitment to ‘modernise the Senior House Officer (SHO) grade’. This was in response to the widely held view that there were many problems with training at SHO level, as these doctors had no clear educational or career pathways, no defined educational goals, no limit to time spent in the grade and a lack of distinction between service and training.

MMC was launched in February 2003 by the four UK health departments after widespread consultation around the Chief Medical Officer's report Unfinished Business.

The MMC principles:

MMC should have a fair, equitable and transparent recruitment basis
specialty training should be programme based and designed to deliver nationally agreed standards
where appropriate specialty training should begin with broadly based programmes
educational progression for individuals should be assessed by an annual review of the documented acquisition of competencies and clinical and professional competency
trainers and educational supervisors should be trained and supported to fulfil their wider role as educators, and assessors
training programmes should be time limited, extensions associated with problems with educational progression should be restricted
the satisfactory completion of training should be marked by entry to the specialist or general register
completion of training demonstrates that a trainee has achieved the level of clinical and professional competency appropriate to allow appointment as a consultant or general practitioner principal or academic equivalent, and for independent clinical practice
after entry to the specialist or generalist register, doctors will need access to continuing professional development to be able to respond to changes in clinical practice and allow for further professional development as well as revalidation, recertification and maintenance of professional regulation
arrangements for postgraduate medical education and training should be flexible and facilitate movement into and out of training, and between specialty training programmes
the provision of education and training will be underpinned by a commitment to provide less than full-time and other types training, where appropriate
the availability of specialty training opportunities will be based on a formal analysis of the needs of the service
trainees will be able to access career management support prior to and during specialty training

Better training standards

MMC aimed to provide consistent national standards for training through better-structured and managed programmes with competency-based curricula approved by the independent Postgraduate and Medical Education and Training Board (PMETB).

For patients, it was intended to mean that a higher proportion of care would be delivered by an appropriately skilled workforce. For trainees, the new programmes’ structures meant an assured high quality of training, better formal supervision and continuous development of acquired competencies, backed up by good evidence.

The Postgraduate Medical and Education Training Board (PMETB) was launched in 2005 to set the criteria and standards for training, including approving the curricula for the programmes.