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Birmingham consultant Dr David Nicholl is still trying to work out whether the controversial new recruitment system for junior doctors - Modernising Medical Careers - is a game of two halves, or three.

It is quite difficult for anyone to quite understand the rules of MMC, even to those of us who are doctors. It's a bit like explaining cricket to an American. In my more surreal moments, I have started thinking of MMC as a game of rugby or football with 2 halves- Round 1 and Round 2 of interviews.

Candidates get a certain number of points and the one with the biggest number of points is the winner. Simple!

If only the makers of MMC could follow that simple formula, my life would be easy!

Instead, each week they decide to change the rules - which is somewhat like altering the rules of rugby part way through the game and awarding 5 points for a try rather than 6.

Each Friday, with baited breath, hospitals the length and the breadth of the land have awaited the next stupid rule change from the MMC panel. Over the last 3 weeks, they have not disappointed.

The system that MMC developed was unproven and untested but rather than scrapping it and starting again, the ‘independent' review panel (independent is a somewhat loose term as the BMA walked out after a week leaving only the people that designed this half-baked system to review it themselves) have managed to think yet more novel ways to screw up.

First we had the ‘every junior doctor can have an interview' system, without asking the consultants or Deaneries who organise them whether they had the resources to do several thousand additional interviews.

This is a bit like saying every member of an English rugby club can turn up for selection for the England rugby team on a given weekend.

Next we had the Russian Roulette system announced by the ‘independent' review panel. All the junior doctors can have one 30 minute interview somewhere in the country. Essentially it would be like a footballer's entire career (OK, so the beautiful game is a better analogy than rugby from here on) being decided on one penalty shoot out.

If he misses, he does not get to play professional football ever again and needs to think of a different career outside of football. If he scores, his team gets to progress to the next round.

If you think this sounds surreal, this week we have the game of three halves! On Wednesday, the Deanery phoned me and asked if I would like to put my neurology posts into round 1b of MTAS (the half-cocked computer system that failed so badly with round 1a of MMC) with a much smaller round 2 in July. At that point, I turned into a stroppy Wayne Rooney and told them where they could put their round 1b.

But also I realised, in a flash,……I'm the bleeding referee, without me the game doesn't take place. It doesn't matter what on earth Patricia Hewitt or anyone else says, without the ‘referees' like me who run the interviews and all the other work - NOTHING can happen.

So I quite politely told them, no thanks, I won't be running a round 1b as round 1 a didn't work, I will be having an interview on June 22nd but onlyif everyone follows the rules and fair play takes place!

Game on!

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