Elspeth Isbister Aberdeen

Final year medical students in Scotland are having to undergo unnecessary interviews for preregistration house officer (PRHO) jobs because of a failure in the Scottish PRHO allocation scheme.

The allocation scheme fills the majority of PRHO placements in Scotland. It uses a sophisticated computer system that allocates medical students to clinical units throughout Scotland, based on submitted preferences (1-3) of both the medical student applicant and the employing hospital units.

Students have been interviewed for posts in hospitals where the post had been made non-compliant and removed. Trusts did this in the hope that the posts would be made compliant before August 2002.

Implementation of the new deal for junior doctors (agreed with the NHS in 1990) means that PRHO posts should not involve more than 56 hours a week (72 including on­call) from August 2001. Compliance of PRHO posts with the new deal was recently monitored, coinciding with the allocation scheme applications, in hospital units throughout Scotland. Forty one (5%) of the Scottish posts were found to be non-compliant, and therefore temporarily removed from the scheme.

A lack of communication between the postgraduate deaneries, under whose auspices the scheme operates, and medical students, combined with the ongoing reassessment of PRHO posts, led to some medical students being forced to gamble with their choice of jobs.

Students were advised that they could either make their initial second choice their first choice, or they could gamble and pull out of the scheme all together, re-entering on the second round of the applications procedure. The deaneries advised students to be cautious over the second option, as there was no guarantee that the non-compliant post they originally applied for would
be found compliant on a reassessment.

In January 2002 all of the 41 PRHO jobs which had been previously non-compliant were made compliant after reassessment. This angered those students who took the decision to accept their second choice of PRHO post. Some say that this has let some
less able and less qualified students get the better jobs. Those on electives have been penalised because of lack of communication.

Professor Stuart Macpherson, the creator of the SPA scheme and Postgraduate Dean for South East Scotland, said "I have enormous sympathy with the students." He blamed the problems on the fact that there are 130 more graduates in 2002 than before and new placements had to be created. Several hospitals also still had non-compliant rotas, he added. He firmly believes in the scheme and thinks it should be rolled out across the whole of the UK.