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Summary    Objective   To track the success rates in obtaining a specialist training (ST) post of a cohort of medical training application system (MTAS) applicants, as well as canvassing their views of the process and measuring symptoms of psychological distress during application and after job allocation.Design   A follow-up cross-sectional survey.Setting   Two large south London psychiatry training schemes.Participants   101 MTAS applicants.Main outcome measures   Success in obtaining an ST post, respondents' views about MTAS and General Health Questionnaire-12 (GHQ-12) scores.Results   48 of the original sample responded to the follow-up survey. Data were available about post-MTAS job status for a further 41 trainees. 64% of candidates obtained an ST post. Of those, however, 12% were only offered a fixed-term post. Most unsuccessful candidates were doing locum (34%) or non-training grade (21%) jobs. UK/European Economic Area (EEA) doctors were more successful than non-EEA applicants in obtaining an ST post (odds ratio 5.5, 95% confidence interval 2.1–14.3), as were women candidates compared to men (3.7, 0.5–9.3). The respondents' views about MTAS were globally negative (even if they were successful in obtaining an ST post). The median GHQ-12 score for respondents was 7 out of a potential total score of 12. 79% of the sample scored above the threshold (GHQ-12 ≥4) for psychological distress and 21% experienced significant distress (GHQ-12 ≥8).Conclusions   MTAS was a flawed system. A considerable proportion (36%) of candidates who had been on a Senior House Officer training scheme were left without a training post after MTAS. The system seems to favour UK/EEA applicants. Applicants suffered significant psychological distress during and after the MTAS process.

Stress, lies and red tape: the views, success rates and stress levels of the MTAS cohort