Sir Liam Donaldson and Dame Carol Black must resign and it is sad that thy may need to be pushed. They have presided over an extremely damaging assault on medical training with an unbelievable smugness and complacency. They are responsible and there will be little confidence in solutions for future years until they are replaced..

RA, Edinburgh,

Donaldson and Black both forced through the horrors of the MMC Fiasco despite virtually every doctor in the country - including medical students - warning them time and time again that this would prove disastrous. They would not listen to anyone, and insisted on ruining the careers and personal lives of tens of thousands of young doctors, let alone exposing our sick and vulnerable patients to poorly trained and demotivated medics. Their idiocy and contempt for the wishes and advice of their colleagues have now been exposed to the shock and disgust of the wider world and their positions must now be considered untenable.
Donaldson and Black HAVE to go, they have lost all credibility, respect and trust and are the pariahs of the medical world.

jonny, Durban, South Africa

I am amazed that Liam Donaldson has so little sense of shame he did not resign months ago, although for all his contribution recently he may well have done.

Ian, St Albans,

As the architect of MMC, Sir Liam Donaldson must now resign. His project continues to cause anxiety and suffering amongst junior doctors and, more importantly, it now emerges that his training ‘reforms’ may be to the detriment of patient care.

Sir Liam states that, in a conflict of government, doctor and public interests, his moral principle is that, ‘it is the public who wins’. His continued support for MMC puts him at odds with the best interests of the public and it is time he acted on his moral principle by stepping down.

Jack, Christchurch, NZ

Britain has always aspired to excellence, that is why medical post graduate training "was" considered one of the best in the world until the arrival of MMC which, in reality, is aiming to downgrade the role of the doctor within a health team in an effort to produce a production-line semi-specialised practitioners on the cheap. A terrifying concept as this will not only kill medical innovation and research in Britain but will definately harm patients.
That said, it seems that the "sorry episode" is here to stay, given that very bright British doctors will be made unemployed at the end of this month as well as the predicted 3:1 ratio for securing training in 2008. How long will it take to implement Tooke's recommendations and effectly do the impossible; organise and co-ordinate different bodies such as policy makers, workforce planners, the Royal colleges, the GMC ..etc to do so effectively, is anyone's guess if it could be done at all. The saga continues and the "sorry state" prevails

Sam, London, England

I hope they also think of ammending the "work permit requirement" policy, which had been a terribly fatal blow especially for Asian doctors like us who found themselves standing nowhere after passing PLAB and doing clinical attachments. I still see light at the end of the tunnel for many foriegn doctors like myself.

M. A. Siddiqui, Manchester, UK

The CMO must be accountable for this fiasco. He has built his career on disciplining poorly performing doctors, so is in an excellent position to apply the necessary action.

Mark Oliver, Stafford,

It does not take a genius to realise that MMC was fatally flawed. I speak as a junior doctor in the NHS who has read and thought about MMC and its implementation.

There are numerous people responsible. The Tooke report may not name them but they should have the decency to resign. This includes Liam Donaldson and Carol Black.

The BMA is now in an excellent position to call for change. As the voice of our profession they must take this challenge up

simon, crewe, uk, uk

Donaldson and Black must go. The sooner the better

Ciaran, Colchester,

In general terms, apart from strident criticism of the managers responsible, Tooke's Report suggests a return to the situation pre-MMC. The Foundation years - that holy cow of Donaldson's, is returned to a Pre-Registration Doctor (cf pre reg House Officer); the F2 year will be incorporated in Core training in 6 x 6 month tranches (SHO?) and then a break to have Higher Specialist training (registrars).

Whither Donaldson? Failed system, hopeless management, invisible when needed in June and July, surely he must expalin his position or be gone, or both!

The sensible approach of Fidelio, the senior doctors group suggesting the conversion of FTSTA posts to ST positions would solve the existing problem highlighted by Tooke. It should be done.

What is still needed is a system to encourage those doctors forced out of the country by lack of training posts to return into sensible training positions where furthering their NHS careers would also be in the country's interests.

David L. Cox, Loggerheads, UK

It does seem that taking responsibility for your actions or lack of them is not popular. Sir. John Tooke seems to be bucking the trend with honest and sensible review.

Paul Herdman, Truro, UK

The unneccessary and costly MMC and MTAS process were a vanity project instigated by Donaldson and Hewitt and supported by Black. Tooke's daming report is that the flawed policy failed -as predicted- on every level. Hewitt tried to dodge responsibility by saying that the policy was good, the implementation was bad, and was allowed to quietly resign. Clearly today's politicians do not believe in taking responsibility for their own decisions, a responsibility they insist on in others. Donaldson, the architect, must also go, and go soon.

Sparrow, aberdeen, Scotland

Sir Liam Donaldson and Dame Carol Black must now resign.

If it were up to the medical profession as a whole, they would be stripped of their peerages.

Could it happen again? It WILL happen again because it is unbelievable that these 2 have survived this long. Whatever forces have protected them so far will clearly act to protect similar disastrous leaders so willing to sell their colleagues down the river in exchange for political honours.

The UK is very good at conducting detailed enquiries or reviews. But we are hopeless at really changing anything.

An American who has been in senior management positions in the UK and is now non-executive board member of a PCT told me this 'remember, the British always, always temporise. They rarely do anything definitive until absolutely forced to do so'

MD, London, UK

Is there no end to incompetence? Just what we need, ill qualified inexperienced quacks instead of decent doctors.

I would say the world is going to the dogs, except the dogs get better medical care than we do. When a doctor is poorley trained, you get a poorley trained doctor. Hello, looks like a wake-up call to me! The British Empire drops even lower on the horizon!

evienita, Charlotte, USA

Surely it is now time for the most prominent 'named names' in this destructive and regrettable affair to do the decent thing?

David Bramble, Shrewsbury, Shropshire

I note that your contributors have called for the resignations of Liam Donaldson and Carol Black. Both clearly must answer for their parts in the mismanagement of the past year of MMC and should go.

To me it was noticcable that the Postgraduate Medical Education and Training Board, the QUANGO headed by the notorious Prof Rubin is to be 'incorporated' into the GMC, ie got rid of as it was not up to the task.

Prof Rubin, readers will remember, penned the Pilate-like 'not me guv' letter. Let us hope that now his QUANGO is no more that he too will, at last, do the honourable thing!

David L. Cox, Loggerheads, UK

I think Dame Carol Black and Sir Liam Donaldson have now lost the confidence of their professional colleagues and should resign.

Dr Peter Davies, Halifax, West Yorkshire

Liam Donaldson and Dame Carol Black should have the decency to resign.

Sarah, London,

Donaldson was the architect of MMC (in his policy document in which he described the Lost Tribe of SHOs). Tooke has now criticised the whole process of MMC - on BBC News he stated that there was no obvious reason for MMC nor did anyone know who was in charge.

Clearly Liam Donaldson was in charge. He must do the honourable thing and resign now.

Ben, Oxford, UK

James Johnson was forced to resign as chairman of the BMA over the MTAS disaster.

Chief Medical Officer Liam Donaldson and Academy of Medical Royal Colleges head Carol Black escaped scot free.

They share responsibility (with Johnson) for MTAS and should do the honourable thing and go.

Ben Kotzee, Watford, Herts,

Donaldson must resign!

Sue, London, UK

Donaldson must resign, he has ruined thousands of careers and forced many of our brightest young people abroad. He must go if he has one shred of integrity.

Sue, London, UK