Training row emphasises the importance of collaboration

Relationships between clinicians and managers are continually being tested.

At the moment, they are being tested within a context of increasing disengagement - among both clinicians and managers - with some of the current government reforms.

Our main feature examines research by the national inquiry into management and medicine, set up by Leeds University's Centre for Innovation in Health Management, which suggests ways to break a cycle of mistrust.

Some of the messages appear simple: communicate; create collective responsibility; collaborate. Simple to describe, perhaps. But not easy to achieve. Those taking part in the study discuss 'stomping discussions,' the need to 'take the grief' as well as harness the passion of their medical colleagues. It is not just about straight talking: the inquiry reports on the importance of organisational and leadership development, and of getting the structures right so doctors are involved in management discussions.

This week, anger and anguish over Modernising Medical Careers has created a particularly vivid backdrop for debate. (read the story here). This is not an argument that is going to go away quickly.

The government was right to respond to widespread concerns about the selection process, by scrapping the computerised selection process and returning to the use of CVs and structured interviews to select candidates.

But opposition to MMC is not confined to worries over the limits of the digital application process. Some fundamental concerns from among the medical profession are likely to remain: chief among them that the process does not provide the next generation of consultants with sufficient training, and that doctors are being forced to specialise too early.

The .medical establishment has a particularly difficult task ahead dealing with how doctors have been led and represented over this issue. But it is vital the inevitable blame game does not segue into a lobby for the status quo. MMC was designed to introduce transparency, fairness, and standardisation of training into a system that has for too long been marked by opacity, mystery and luck.