The Department of Health yesterday reverted to more standard recruitment practices for junior doctors seeking training posts for next year after the chaos that surrounded applications this year.

But more fundamental reforms are needed and will take at least two to three years to implement, according to Sir John Tooke, who headed an independent inquiry into what proved the biggest administrative fiasco in NHS history. Sir John said there was still no consensus on the educational principles guiding the reform of medical careers and postgraduate training was still hampered "by unclear principles, a weak contractual base, a lack of cohesion, a fragmented structure and, in England, deficient relationships with academia and the service".