title: Psychological impact of systemic training failure on mental health and career satisfaction of UK trainees: lessons from an online attitudes survey.
abstract: OBJECTIVE
  This study aims to evaluate the psychological and career-planning impact of the new postgraduate training system Modernising Medical Careers (MMC) on junior doctor applicants in the UK. We hypothesized that certain junior doctor groups were more vulnerable to distress during the process than others.
  
  
  METHODS
  Online, anonymous, cross-sectional attitudes survey of applicants in June 2007. Participants were Medical Training Application System (MTAS) applicants of all grades in the UK.
  
  
  RESULTS
  Of 1,002 responders, 703 (70%) reported four or more depressive symptoms; 231 (23%) reported increased suicidal thinking; 932 (93%) increased stress; 856 (85%) increased worry; 374 (37%) consumed more alcohol. Some 941 (94%) attributed increased stress to ;MMC/MTAS'. Female sex (OR = 1.48, 95% CI = 1.12, 1.95) and not receiving a job offer (OR = 1.85, 95% CI = 1.35, 2.56) predicted higher number of depressive symptoms.
  
  
  CONCLUSIONS
  At the onset of MMC, MTAS applicants reported negative process experiences, psychological distress and poor coping (including increased alcohol use), with possible implications for mental health, career planning and patient care.
authors.affiliation: ST4 in General Adult Psychiatry, Highgate Mental Health Centre, Dartmouth Park Hill, London.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Lydall
authors.forename: Amit
authors.initials: A
authors.lastname: Malik
authors.forename: Robert
authors.initials: R
authors.lastname: Blizard
authors.forename: Dinesh
authors.initials: D
authors.lastname: Bhugra
mesh_terms: D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005260:Female; D006801:Humans; D020407:Internet; D007588:Job Satisfaction; D008297:Male; D008603:Mental Health; D010820:Physicians / Q000523:psychology*; D006113:United Kingdom