Modernising Medical Careers (MMC) was introduced to reform postgraduate medical education in the UK. While well-intentioned, the initiative triggered widespread concern following its flawed implementation and the collapse of the Medical Training Application Service (MTAS) in 2007. This independent inquiry, led by Professor Sir John Tooke, was established to examine what went wrong, identify systemic issues, and recommend a path forward.
The report is based on detailed evidence-gathering, including public consultations, expert panels, and national workshops with junior doctors. It concludes that MMC failed to deliver a coherent, high-quality training system and did not align with the evolving needs of the NHS, patients, or the medical profession.
There was no clear or shared vision for MMC across departments or stakeholder groups.
Implementation was rushed, with inadequate piloting and flawed national recruitment systems.
The new training structure limited flexibility, undervalued experience, and disrupted traditional training relationships.
Engagement with the medical profession and alignment with service needs were weak.
Governance and accountability were fragmented, with poor coordination between the Department of Health, NHS bodies, and academia.
Establish clear, consensus-based objectives for medical education and workforce planning.
Create a new national body to oversee postgraduate medical training in England.
Strengthen professional engagement and governance mechanisms across all four nations.
Restructure postgraduate training to allow for greater flexibility, breadth, and career development opportunities.
Merge regulatory bodies to streamline oversight and improve quality assurance.
The report presents 47 recommendations to guide reform. It calls for urgent, coordinated action to avoid repeating past mistakes and to ensure the UK’s postgraduate medical education system meets the highest standards.