Doc here. Or technically, baby surgeon here.
I’m actually not *fully* supportive of strikes and wasn’t sure whether to partake. But I saw a BBC article on the strikes today, and it was significantly twisted to a point where I felt genuinely upset. The issue of doctors *becoming a consultant* needs some major clarification.
**LINK**: https://www.bbc.co.uk/news/health-64907379
Career progression is a major problem that is not mentioned in any of the news articles, and is a much bigger issue than pay IMO. Pay isn’t as much of an issue *if you are able* to work up a ladder. But we can’t move up, and thousands of doctors with dead careers are looking for pay as compensation.
—
**Typical career progression**
Off the top of my head, the rough numbers are as follows:
– 10% of straight A-grade applicants successfully get into medical school.
– Of those getting into medical school, there is a 5-10% drop out rate every year because of exam failures. So less than 75% actually have the skills and determination to qualify.
– On qualifying, most get a foundation job. Less than 5% are left without a job despite qualifying.
– Of those 70% or so, the first training stage is ‘core training’. In most core areas, jobs are 3-5 applicants per job. For my core training in surgery, my place was a 9 to 1. So eight doctors stagnated behind me and couldn’t move up. This is *just* for me to achieve the most basic level of *pre-specialty* training.
– Although I got into basic training, it is deemed a failure unless I pass two exams within 2 years, each with only have a 40% pass rate amongst a cohort of already exceptional achievers. Took me four attempts, so £3-4000 of my own money before taking into account courses and travel/hotels/etc.
– I’m now applying for specialty training. The job ratios are again 4 or 5 to 1. Only one opportunity to get in every year, judged through an intense 30 minute oral exam. Progression is not linked to your actual job skills or reputation. In fact, the examiners are blinded to this.
– So, looking at my current level… Before I’ve even got to ‘middle grade’ status, I’ve had to be top 10%, then top 75%, then top 20%, then top 40%, then top 40%, and now I’m faced with the challenge of being top 20% of this elite group to actually enter the *middle* of the hierarchy. To worsen things far more significantly, candidates are only eligible to apply two or three times at each stage before they are deemed to have failed too many times – and become stuck at their level permanently. Progression is reserved only for those with unwavering success and continuous progress.
Complicating factors include:
– At each application stage, there are multiple extracirricular activities that are almost mandated because of competition. I work inside and outside of work. I spend 2-3K/year on courses purely to demonstrate effort. After spending 100-200 hours per article to make some research, only some will be considered for publication, and that actually costs me £500-1K per article to have it printed. I audit the hospital in my lunch breaks. I got an extra teaching degree which cost £5K and took up my evenings across a year. If I want to move up, these are not optional. Over my 7 years since qualification, I’ve had the same target every year of ending up: 1) *not in debt* and 2) *not mentally unwell enough to force a counter-productive career break*.
– Those who are successful have no control over their location. I’m over 30, and I’ve had 14 addresses since qualifying, including rotations in England, Scotland and Northern Ireland. Imagine how hard it will be to find a partner. What about my partner’s job?. Kids – not possible. Buy a house – Nope. Dreamt of a dog since you were a kid (me) – not possible. And I’m also paying extra charges all over the place due to this instability – for example internet companies only do 12 or 18 month broadband deals and won’t do shorter periods for exceptional cases. I’m rarely registered with a GP, and I’ve had 2-3 un-investigated health problems because I’ve moved out of area before a specialist can see me.
– Lastly, and importantly, is that this is all EXTRA effort on top of our job in order to have *any* chance of climbing the ladder. We have to do this *alongside* 50-60 weekly hours of high risk service provision. One mistake, dead patient, struck off and potentially imprisoned. Last year before my exam, I didn’t revise. The day before the exam, I was cutting through someone’s sternum for the first time, so I could access their heart. This ended up being a 13 hour operation, which started at 10pm and went through the whole night.
—
**Broken rotas**
While not my main message, hospital rotas also contribute to this problem.
Hospitals can’t function while taking into account multiple levels of training and years of experience. As a result, they generally group people into three/four tiers. F1/SHOs, middle grades and consultants.
I am a good example of how this problem manifests. Despite my training, my local rota is configured in a manner that still groups me within the lowest rank of doctor. I’m on the same pay – and doing the same job – as a 2nd year doctor who never got into basic training, has never performed any surgery or passed any exams. So my pay has not increased as the media seems to suggest, and seniors view me as an overqualified person stuck on the bottom rung. And I’m one of the moderately successful stories.
I can’t move up to middle grade, partly because this middle rung is full of people who are in their 40s and 50s who are stuck there, and I can’t compete with their experience. Alongside this, these gaps can also be filled by consultants from abroad, who will usually come to the UK and settle in a middle grade role with better pay and less responsibility than they had abroad. Again, I can’t compete with someone who is already fully trained.
—
**My situation**
I’m over 30, with an indefinitely suspended personal life, and constant existential career threat. As the training application disadvantages those with too much experience – within the next 12 months I’ll be forced to become part time, or take a career break if I can find a job at a local coffee place. This is the ridiculous end point of the current system.
I don’t even want pay that much. I want to progress, and if that comes with pay it is a bonus. The vast majority of doctors don’t progress up the ladder. This is what *everyone* in *every* media outlet fails to recognise. Career progression is not some step-wise natural progression of being a UK graduate doctor.
—
**EDIT: To clarify the issue of over-competition while also having contradictory staff shortages, I will explain as I’ve commented a few times below:**
To me, there’s a mis-match in our current system:
As an example, a typical hospital department will have 5 trainees, within a total of 30 lower or middle grade posts (i.e. ‘junior doctors’).
Each training post is competitive at 4-5 to 1 on average. Go to something like cardiothoracic surgery, and it’s 19:1 – but these numbers all still apply. As a result, the threshold for entry becomes *whichever of the fully qualified and competent candidates over-qualifies themselves the most, before hitting the experience limit*. The training post and training it provides is often below the true level of competency for most candidates, but they need the ‘TRAINING’ label to actually progress.
So while these guys are competing over 5 *training posts*, the hospital still needs 25 doctors for *non-training posts*. These doctors do the exact same job as the training post they were just rejected for, with the same responsibilities – but no compensatory pay increase, no chance of progression, no training, no study budget/leave, etc. Obviously, this non-training majority are under-satisfied with their job, and have no incentive for extra effort. It also becomes hard to fill these undesireable non-training posts – filling them instead with international recruitment or locums at 3-4x the hourly pay. Let me be clear. These posts are filled by *the same people* who were rejected from this exact same job, arbiet the ‘TRAINING’ label.
So our current limitations on training and progression have artificially created staff shortages for what is a notoriously over-subscribed specialty. Young surgeons who fail to access training get frustrated, as they can see all the empty spaces above them. And because people are pleading for them to work in under-staffed posts that they literally just got rejected for.
The alternative would be to increase the number of training posts, and reduce the number of stagnant non-training posts. With this, the barrier to entry moves to a more sensible place. For example, training could be reliably accessible to those who meet all competencies for their current level, and now ready to progress onto the next stage.
Obviously, there will not be space for everyone to enter training. But if every department went from 5/30 trainees to 20/30, that takes a 5 to 1 ratio down to a very reasonable 1.2 to 1. With this, the threshold for training moves away from arbitrarily restrictive numbers and competitive over-exertion – and towards true reflections of a doctor’s competency.
And within a few years, departments are full of doctors who are training and progressing. The majority of staff feel that hard work and investment gets rewarded, and the department’s quality and morale improve accordingly. That’s my theory anyway 😛
48 comments
Thank you for the explanation. I knew the medical profession was messed up but had no idea how bad it was.
Would be genuinely interested to hear your thoughts on what reforms could be done to fix this? Would it be something like a better tiered system where either people who perform great or have x years of experience are moved to a higher grade? That way recognising the impact of their experience, rather than holding them down levels because of inaccessibility to further exams and vacancies?
Is there any upside? That seems like a shitty way to live.
Interesting to know the variance across other pathways and specialities, I’ve always assumed surgical is one of the more competitive areas, which may compound the issue more.
Super interesting to hear of your experience. It does sound like a lot of the issues that junior doctors are facing a due to the competitive nature of the job. Seems like a restructure of progression and other areas (eg not making you pay for your own exams) would do a lot more than a higher wage. But equally got to make that stress and effort worth it.
It is eternally frustrating to see people use consultant pay as some kind of excuse to not pay doctors below this level anything like their true value. Very similar in academia, people look at senior lecturer and top level professor salaries, and never see the struggles it takes to get to that level, or the amount of attrition before that point. You’re supposed to get a reward at the end because the path to get to that end is fucking brutal, to the point that most normal people *couldn’t cope*, it would literally break them (and breaks plenty who make the attempt). And at this point lets be honest even consultant pay is not *that* amazing, I know plenty of people in tech on similar wages or higher already in their 30s.
Salaries in sectors like that are just “supply and demand”, but somehow when it comes to other sectors, healthcare being the most extreme but increasingly anything linked to public pay is the same, if you’re earning more than a couple of quid above minimum wage you basically have no right to complain even though you spend 12 hours a day attempting to handle a workload and navigate systems that make Takeshi’s Castle look well balanced.
We are now in a situation where simply hopping across the ferry to Ireland can immediately double the salary for a junior doctor. I don’t know about reforming the workplace but that alone has to be seen as a pretty serious problem, surely. Even the supply and demand folks must be able to see that.
Are you suggesting that those 8 doctors that didn’t get into speciality training continue applying year on year for the same speciality until they do make it? Or surely they are more likely to apply for a different speciality and get that one?
Also what about any of the other points the article makes?
Your comments on career progression are interesting, I’m married to a ST5 general surgeon and feel the constant push to become a consultant is unnecessary. There should be defined exit points where trainees can say “nope, enough is enough I’m done”, and then exit training and just focus on “easier” surgeries like gallbladders, appendices and lumps & bumps.
It’s very expensive for the NHS to have lots of consultants, the health service should focus on having more associate specialists who can do core service provision and have consultants just looking after the more complex patients.
To somewhat play devils advocate, CCT is not the only route through training, you can create your own training pathway and CESR, and if you play your cards right you can do most of it in one or two hospitals. Obviously, your mileage may vary by specialty, hospital/trust, deanery and country. It seems it’s somewhat easier to CESR in medicine than surgery, but that’s part of another conversation with regards to surgeons gatekeeping their profession.
As someone who enjoys the work, has jumped though all the hoops and nearly made it to consultant level, it’s not much better either.
I am nearing a decade of postgraduate training now (in addition to 5 years at university).
I work an average of 48hrs/wk including frequent evenings, weekends and nights. I anaesthetise people for elective and emergency surgery, where mistakes during even routine procedures can be rapidly fatal. I look after women during labour, administering pain relief and providing time-critical anaesthesia for emergency caesarean sections where the lives of both mother and baby may be at risk and seconds really count.
I am frequently the most senior resident doctor responsible for the patients in the ITU overnight and ‘end of the algorithm’ for critically unwell patients elsewhere in the hospital or unstable patients coming into A&E. I will be the person you see at 3am who explains that I’ve had to put your loved one on a ventilator following their cardiac arrest, or that they are dying and there is nothing more we can do.
I worked through every lockdown looking after hundreds of ventilated patients in ITU, all whilst wearing a mask I purchased with my own money because I couldn’t rely on the hospital providing consistent PPE.
This is all in a deteriorating system under immense pressure, facing complaints from patients and relatives, criticism from the media, and recognising that we can no longer provide the quality of care we should be able to (despite maximal individual effort). I also work under the fear that I can be struck off and my career ended at a moment’s notice from a single mistake.
I pay at least £1k per year in registration fees to professional bodies. I’ve spent years of my life and thousands of pounds of my income on professional exams to become a Royal College fellow.
I can move hospitals as frequently as every 3 months. Each time involves a weekend of filling in horrendously inefficient paperwork and attending pre-employment checks at my expense. We are frequently infantalised and treated like transient students as we attempt to negotiate the beuroceacy of HR departments and absorb a new inconsistent set of local policies and SOPs.
I have a long-term relationship, but it (as I’m sure is the case for many medics) is with another medic and held together by a mutual understanding of working hours, emotional burden, etc. We are just getting on the housing ladder in our 30s and, despite being a “respected” profession, finding out that mortgage lenders don’t like that we only have short fixed-term contracts.
I’ve had colleagues die through suicide resulting from toxic training and working environments.
How much would you say this is worth an hour? Probably more than the £27/hr it averages out to for me at the moment, after 10 years of being told “but, but, pay progression!!!”
Once a consultant I’ll be earning ~£40/hr, facing an even greater degree of pay erosion and moral injury whilst picking up additional responsibility in propping up a failing system. The clinical excellence awards that used to push salaries into the mid-100k level for many are now being quietly enhanced away and more a perk of the ‘old boys’ than something a new consultant can bank on. A newish consultant can expect £95k as a realistic salary for being top of the chain.
I know people who have left for industry jobs and instantly doubled or tripled their pay. Yes the NHS pension is pretty good, but it’s irrelevant if you can self-invest the excess of your 3x greater salary. We have valuable degrees and transferrable skills that can and are accepted elsewhere.
So far the interspersed joys of the work have kept me in it. I love helping nervous people through their high risk operations. I love the mixture of technical understanding, procedural dexterity, evidence-based knowledge and touch of creative flair in planning and enacting a high quality anaesthetic. It is also incredibly rewarding to make a good save in ITU, taking snap-second high-stakes decisions that turn around a catastrophe and hopefully get to see that person walk and talk again a few days or weeks later.
Many of us accept a certain degree of undervaluing and disrespect because of this, but the balance has been pushed too far. We’ve been overdrawn on goodwill. Furthermore, it is now the stoicism of frontline healthcare workers clutching the precarious web of threads just about holding the remnants of our NHS together ‘at the coal face’. For the first few years it feels like you are ‘doing your bit’ to power through, but after a while it just becomes indescribably draining to recognise that your efforts are simultaneously a little bit significant (you’ve helped that one patient, done your bit, and the system would collapse if everyone withdrew this extra effort) and yet totally insignificant (not going to reverse the systematic decline). Unless the government turns this around, I fully expect to finish my training to consultant level then leave the NHS.
Improvement of pay does not fix all these problems, but it would at least shift the effort/risk/reward balance for many and retain the medical workforce needed to maintain some kind of health system. Everyone wants cheap public services until they’re on the sharp end of needing healthcare and find it’s been picked away to the bones.
The pay increase being requested admittedly appears large as a percentage, but simply reflects that doctors have seen even greater pay erosion than the other professions also currently engaged in industrial action. It would restore the real-terms level of pay that was normal 15 years ago and no more – it would not leave us buying yachts and popping champagne. My hourly rate would still be far below that I could get elsewhere, but it would encourage me to stick around.
Lastly, Steve Barclay can do one. Wasted months of potential negotiation time. Didn’t turn up to a meeting between DHSC and BMA in the daytime on Friday, then starts tweeting at 10pm that he wants to open negotiations on the condition of strikes being called off. Then drops a paywalled opinion piece today telling us to check our consciences. Pure political theatre and media spin. I’ve checked my conscience Steve and it’s telling me to withdraw my labour tomorrow.
Reading stuff like this reinforces my fear that if I see a doctor I’m getting my advice/treatment from someone who is stressed out, under slept, under paid and potentially on the edge of a nervous breakdown. That can’t be safe.
They’ve misreporting nursing wages too. Really boils my pisswhen they describe band 6 as a wage for an “experienced nurse”. You don’t get that wage automatically, you get it when you apply for a band 6 wage. There are considerably more experienced nurses than there are band 6 jobs.
I wanted to become a doctor when I was younger… your post made me glad I didn’t pursue that.
From a police officer who can’t strike, I fully support you and your colleagues who can, regardless of the outcome.
Just join the picket line tomorrow mate. Student nurse here and even some of my nursing and AHP colleagues don’t appreciate the hardship you guys have to go through, do you really expect an average Joe sit down and listen to you? Keep the message simple and ask for the pay restoration that you guys deserve.
All I can think is, why the fuck would you be a doctor? Thank you for what you do.
What’s the solution in your eyes?
Other than the obvious of getting these fascist corrupt tories out of government.
Thank you for sharing your experiences and perspective!
I work in the NHS as a Science Technician, within Specialist Technical Services, and as such I don’t often interact with other healthcare professionals outside of my own bubble and pharmacists/oncology consultants. It can be incredibly frustrating during these times to hear all the negativity surrounding the impending 72 hour strike, and all of that which came before during the nurse strikes, and be quizzed by loved ones and friends about the state of the NHS when I frankly can only speak to my own experience in my very niche career.
It’s staggering to see what goes into medical training, how many hoops you have to jump through as well as the external commitments made to the job. I can certainly see some of the same backwards institutional thinking that I’ve come across in my many years since first starting as a junior pharmacy assistant to the place I am at now – the lack of support, the overexaggerated expectations, and the burnout that comes from competing with your peers just for getting onto the career ladder itself.
I’ll be thinking of you during this week’s strikes, and all your fellow Doctors. Godspeed!
The simple answer is for you to go abroad to qualify, move up their oh-so-easy grades, then come back and compete against those Johnny foreigner doctor types, where you have the distinct advantage of speaking English. Unless you’re Scottish, of course.
I must admire your persistence in your career, which seems to pay less than the minimum wage, and takes no notice of your skills, experience, or knowledge.
What I can’t understand is why someone with your undoubted intelligence doesn’t find a better-paid job with standard hours.
Otherwise, you may find yourself like 99% of the population doing a miserable insecure job, stuck at the bottom because they started too late.
Nothing to do with Doctors. For some it is about pay.
My partner is a Cleaner at the local hospital. Started in 2010 at below full pay, which was supposed to increase by 1% each year for the first 5 years at which point they will be on the full pay.
24 out of 25 union members voted to strike. The remaining people in the same dept are not in the union so dont get to vote, but somehow those people counted as a no vote therefore the threshold was not met & so the union members were not allowed to strike.
The following table shows the contracted pay rise (eg the 1% for 5 years) or the pay rise the government announced, vs the actual pay rises they recieved. Plus the MPs pay rises for the same period.
(In 2018 they was promised 29.6% over 3 years, I have taken the liberty of marking this as 9.8% for the relevant years which is 0.2% below what it should add up to at 1 decimal place)
​
|Year|Contracted or Announced|Recieved|Additional cuts|MPs pay rise|
|:-|:-|:-|:-|:-|
|2011|1%|nil||nil|
|2012|1%|nil|||
|2013|1%|nil|Parking free|1%|
|2014|1%|nil|Parking £10/w|1%|
|2015|1%|nil|Parking £50/w|10.3%|
|2016||||1.3%|
|2017|||Parking banned (nearest car park 20 mins walk)|1.4%|
|2018|9.8% (1 of 3 year pay deal)|nil|15% Overtime pay cut. 3 days less holiday. Loss of premium payments for antisocial hours. Increased employee pension contributions. Decreased employer constributions. Pension age increased.|1.8%|
|2019|9.8% (2 of 3 year pay deal)|2% (1 of 3 year pay deal)|12% Overtime pay cut|2.7%|
|2020|9.8% (3 of 3 year pay deal)|nil||3.1%|
|2021|3%|1.8% (2 of 3 years pay deal)|||
|2022|9.3%|nil||2.7|
|Total|46.7% (added seperate %s)|3.8% (added seperate %s)||25.3% (added seperate %s) or 28% calculated on 2011 wages|
end
The BBC article is absolutely horrendous and one sided.
It looks like it was written by the Department of Health.
On the BBC article – “But while medicine is undoubtedly tough, it remains hugely attractive.”
​
TO WHO? Definitely not the doctors I know.
We are telling young people “go to university, it doesn’t matter if you rack up £tens of thousands in debt because you’ll progress so fast and so far that you’ll be laughing all the way to the bank”.
Then you graduate and realise there is a hierarchy – a number of people who never progress beyond a certain level – whether that’s down to ability, desire or sheer bad luck.
Then you realise that unless you progress quite some way up that hierarchy, your degree isn’t actually going to pay for itself at all. Quite the reverse, in fact, because not only are you earning less than someone making sandwiches at Pret, you’re lumbered with an extra 9% “tax” in the form of loan repayments. And progression has been getting harder and harder.
I’m not surprised junior doctors are on strike. They were systematically lied to, they’ve started to recognise the lie and they are (quite rightly) absolutely tamping mad.
Bravo on taking the time to write all this out. Full solidarity from your allied health professional colleagues 💪
I’m a senior nurse and despite working closely with junior doctors for the last 9 years I still find the training process slightly baffling and it seems like a total nightmare.
Even if you get onto the training programme you want in your “area” you can be sent to multiple hospitals over a big area.
I know a (very senior) junior doctor who hasn’t got onto the training programme he wants several times (highly sought after training programme) – he has to stay in our region though as he has a wife and young kids (I’m sure he’d have got into a training programme if he wasn’t restricted to just our region).
I know so many junior doctors making crazy commutes after long days.
People don’t understand.
A 35% pay rise sounds high, but really it’s doctors earning £14 an hour wanting to be paid £18 an hour.
Even at the top end of the ‘junior’ doctor payscale that’s less than an £8/hour pay rise that’s being asked for.
I fully support the strike. But I don’t really agree with this post tbh.
Maybe I’m a bit salty because I didn’t have the ‘skill and perseverance’ to stick it out like OP and I don’t want to feel like a failure or ‘stagnant’.
Or maybe my non linear career path in different sectors has given me a bit of maturity to understand that being in the top 1% at GCSE/A-level doesn’t mean that it should be that way for the rest of my life.
Or maybe a bit of both.
Doctors are underpaid. It would be disingenuous of me to pretend money wasn’t one of the reasons I left medicine and never went back. I was on the picket in 2016 to show solidarity but unfortunately it seems not much has changed including the inverted self flagellation.
Thanks for your service. I have two cousins who are specialist doctors, both had wanted to be their whole lives. When things get hard for them I have heard them wish they had taken a different career path. So upsetting to hear, everyone in the NHS deserves better
FPR is only the first step.
Training comes next.
Training bottlenecks are intrinsically linked with pay, since HEE budget is set by the government, which limits places.
Don’t call your self a baby doctor. Its demeaning, and part of the problem.
Thank you for doing what you do and thanks for explaining this so well
This is a great example of just how hard it is to succeed. I perhaps did not recognise the difficulties of progression.
Good on you OP highlighting the more extreme end of this. Being a surgical trainee seems hellish and I’m glad I was never interested in it or come from a highly sought after region of the country.
It would be like saying its fine for minimum wage pret employees to be paid £14 per hour(doctors starting salary), because when they become regonal manager they’ll be on £84k a year (consultant salary).
Pay the job people do, not the job they could theoretically do in 10+ years time if they get 6 promotions.
How the ‘gas and air for labour’ has been presented in the media really sucks.
Deteriorating labour wards were having leaks which were causing serious longterm harm to doctors, midwives, nurses. So instead of rebuild the buildings, gas and air was removed and no longer offered by some trusts.
Patients complaining to the media. Like they have a right for staff to experience permanent harm so they get their prefered pain relief.
Its all ‘so and so hospital let me down’ not ‘where are those 50 new hospitals you promised Rishi?’ NHS staff having to operate in a deteriorating enviroment and get the moral injury from the substandard care that results.
Thanks for one *helluva* clear explanation.
As a recipient of help from multiple specialists in multiple areas over years, I’m truly grateful for all the effort you & your colleagues all make just to put up with me. I knew some of the problems but not just how deeply things had already sunk. Despite late night chats & 3am poker with nurses & even floor docs on rare Q-word nights, I hadn’t heard *just* how much sacrifice is now required well past residency.
Politics *must* be removed from medicine & medicine *must* be protected from politics.
Under Atlee, Labour’s Bevan basically founded & constructed the NHS. This was based much in part on the system built by the Kaiser plants in the US *during* the war a few years earlier. And even then Churchill and Tories complained, *despite* Churchill’s recognition of the need for — and national benefit from — such a service.
Don’t forget that many women doctors having kids also take a step back from career progression (and either locum or take an extended maternity leave.
Holy shit I had no idea. The amount of motivation you guys must have to make it as a doctor is incredible
It’s almost like the ultra-competitive culture has led to a toxic work environment?
Haven’t you heard of human factors in the medical profession? If so, why hasn’t someone flagged all of your points to, in order or precedence:
1. Hospital management.
2. Trust management.
3. CEO NHS (Amanda Pritchard for England).
4. Health Secretary.
5. UK Employment Tribunal.
This culture is untenable and needs to be challenged. It’s quite frankly dangerous to expect people to make life or death decisions in the workplace with so many additional stressors in their lives.
More money won’t make a fucking difference. You need someone to go through the above list, fight tooth-and-nail for reform. Or just crack on and continue to burn out the brightest minds in the UK, putting lives at risk in the process. 🤷🏼♂️
I hope this blows up so people can see how it actually is
If you don’t like it get another job /s. GP here who briefly flirted with the idea of something ultra competitive. I’m glad I didn’t for the reasons you so eloquently explain.
I think the fact is that the general member of the public doesn’t see that far past the end of their own nose, and when they only see you work for 5 minutes when you pop in to assess/confirm what you’ve already worked out from reading before seeing them then they assume that’s all you do. Not all public by a long stretch, but enough to be able to twist a media narrative and have a sizeable portion believe it.
No other job has the amount of training or work backing it up so people don’t understand the massive amount of effort we all go to every day. And because the most doctors with any experience can do an efficient history, examination and plan in 5 minutes people feel short changed because they want to offload their life’s problems on you and when they can’t it’s because we’re lazy – never because those problems aren’t relevant or I can’t fix them if I tried. There’s a reason everyone loves the fresh faced F1 because they spend longer with them. I’d GLADLY spend 20 minutes with each patient, but then everyone would moan that I wasn’t seeing enough. Ah well sorry to rant 😂
don’t let the bastards get you down, strike til your demands are met.
the nutjobs running this country were more than happy to get every fucker to “clap for the nhs” but also don’t want to pay you fairly or allow any career progression at all, fuck em.
best of luck comrade.
When a system is devoid of respect for the clinicians who work in it and goodwill facilitates function you need to leave. I did that within the Australian health system to the betterment of my well-being. I did not signup to be a load bearing pillar placed in quicksand.
I am pessimistic about the BMAs luck in getting a meaningful win. I expect a hearts and mind smear campaign against JMOs and it will get much dirtier than with the nurses. Our craft group does not have the same optics with the public.
Lastly, to quote Churchill, You cannot reason with a tiger when your head is in its mouth. Rishi has already stated he won’t put in jeopardy financial prudence.
My plan A would be fight and agitate, while lining up plan B – move to Australia.
I’m a clerk in a hospital and I fully support these strikes. In our practice we are dangerously understaffed and management just can’t seem to understand that cover must be found for annual leave, emergency leave etc. We have emergency cases coming in that we do not have the staff for, so we have to reschedule patients to make room. Something has to change. I’m so tired of having to cancel and reschedule patients over and over just because we don’t have adequate cover and we’re just told its “not in the budget”. We’re overworking our doctors and expecting them to find cover when they’re needed elsewhere. It cannot continue like this.
Well documented. Thanks for sharing your experience. Let’s hope this industrial action gets the message across and change happens soon. Otherwise people like you will be heading to Australia.
Maybe get Gary Lineker on the case.
The BBC article is written by the brother in law of a Tory MP. So much for being impartial
As an aside. I do worry that there must be some strange secondary effects to society as a whole if everyone who reaches the higher echelons of their field has to have as, a matter of course, foregone friends and family for most of their lives. I’ve met many wonderful consultants but for people dealing with the very human problems of others, they can often seem ‘poorly socialised’ for lack of a better term.
It’s truly a fun job, but the archaic training pathway, lack of humanity from bureaucrats who can’t understand we are humans who want a life outside of medicine and the shocking pay given the time invested and responsibility. I have 80k of student debt that’s accruing interest faster than I can repay it.
My decision to pursue medicine after my undergraduate degree was in 2012 and I qualified 4 years ago. In order for my pay to be equivalent to what it would have been for a comparable role in 2012 it would need to be about 15k more a year than what I’m currently paid. We were sold a rewarding job that while on an international comparison was already well behind Oz/NZ/US/Can/Sui/Ger in terms of pay, was still possible to be comfortable within a couple of years of graduating. I’m now on the wrong side of 35 living paycheck to paycheck whilst living in hospital digs (I pay out of pocket) 2 hours away from my surgeon wife because there aren’t enough training jobs and despite coming in the top 20% applicants I can’t get a job closer to my home.
It’s sad that mainstream media are totally ignoring this strike action and are focusing on the Gary Lineker / BBC story.
I’m in my 30s, so not far from you age wise. A long time ago I wanted to study medicine. Got the grades and all but for whatever reason, i couldn’t get into med school.
Which was actually turned out to be a great thing for me because i doubt i would have been able to progress anywhere with how the training pans out. My sister is a doc and seeing how her life was on hold until she sorted out training, certification, and whatever over the years after graduating also made me feel better about my failure when i was 18 lol.
Brutal and eloquent Sir. Thanks for being a Doctor.