The first set of doctors to commence run-through training started work in August. Many others though face an uncertain future. MMC and MTAS have taken many casualties but the full extent is yet to be known – round two of appointments continues through to November. The government has released 1000 more training jobs for appointment after that date but eligibility for these jobs involves having been interviewed but not appointed in round two.

Back in May, unsupported by the BMA, Remedy UK launched an unsuccessful judicial review, challenging the legality of MTAS and MMC – the resulting disappointment amongst junior doctors was palpable. The presiding judge did however describe MTAS as a 'dreadful mess' and suggested that individual cases should be open to scrutiny by employment tribunals. The final report of the MMC Review Group expressed concern that large numbers of British graduates will be unable to find training places in the future. [1] An independent review of the process for specialty posts, chaired by Professor Tooke, is due to report in December.

Promises abound, but integrity is often in short supply. During round two we are seeing stealth advertising with job applications posted and taken off the internet over a weekend. It is difficult to know whether the Department of Health's promise – that no junior in a substantive post would not be recruited – has been honoured as the BMA has not received co-operation in trying to assess this. Juniors are complaining to the BMA that NHS trusts are trying to get out of paying relocation fees.

There have been senior casualties too. March saw resignations by both Sir Alan Crockard and Professor Heard, as MMC National Director and National Clinical Advisor respectively. James Johnson resigned as Chair of the BMA in May after juniors were slighted by his pro-MMC letter. Sir Liam Donaldson continues to face calls from senior BMA officials for his resignation. [2] Patricia Hewitt's demise as Health Secretary is seen by many as directly related to the issue of MMC.

This issue affects us all, seniors as well as juniors. We all need to act. Back in the spring I talked about affirming God's sovereignty, prayer, giving and taking advice and the need to fight for justice. [3] Are you in a position of real influence within your royal college? Do you know juniors in need of support and prayer? Join a pressure group. Invite a junior round for dinner. Raise conversation with your colleagues. Above all, pray.