Juniors in the NHS. Topical Debate

Many are asking for my comments on the NHS situation back at home (the UK.) I always find it hard to strike a well-informed opinion when outside of the inner government decision maker’s circle; we do not have access to all of the information, as much as we believe we might.

That is not to say I do not have opinions however. Whether I agree or disagree with what is currently taking place, what I do feel strongly about is how undervalued junior doctors generally are. So much emphasis is placed upon the consultants. Yet in most times of critical in-hospital crisis, it is the junior team that are called to take care of you, your mother, your father or your child.

When I opted for a career in medicine, I had no idea just what kind of life I had prescribed for myself. I am out of the game as it were now, here in the UAE and out of the gruelling ward work.

That’s sad though, isn’t it? A UK, NHS trained clinician so disenthralled with a career in the UK hospitals that a move overseas seemed appropriate. And I am not alone.

A fairly chunky percentage of my university classmates have all opted to either exit medicine entirely, or at least take their specialty overseas. Having worked in Australia Emergency Department and experienced enviable working conditions, I do no blame them for this decision. In fact, I applaud them for considering their own lives of enough value to do this. Would I recommend a career in medicine to my children…well no, not if we were settled within the United Kingdom.

The reality is that medicine is just not as sexy as it used to be. People constantly assume you have money, but you don’t. Junior doctors earn less that my husband’s (absolutely wonderful might I add) secretary (but not medically trained in University for 5 years + endless training to reach consultant.)

Plus out of this wage they have to pay membership fees, exam fees – often up to 1000pound a time, GMC (General Medical Council Membership) fees, BMA (British Medical Association) fees and finance moves around the country every time you reach a stage in your career when you have to ‘re-apply’ and could be granted a job in East Anglia when you and your family have just bought a home in Dumfermaline.

Your life is simply not your own. Friends tag themselves on facebook in to bars and restaurants near by when you are on your night shift. You miss Christmas, New Years. You miss sleep! It is not uncommon to experience 12 shifts in a row of which many will be 12-13 hours in length. You get zero compensation for participating in research, zero compensation for having passed your exams and zero compensation for generally being motivated and doing a good job.

One night shift, two of my trusty Bic biro pens decided to give up the fight and die in my naked hand. One after the other. I was now unable to prescribe and unable to write up patient notes. As the only junior in my department, this was rather fundamental to my ability to practice.

Heading up to reception, I asked if I could borrow a pen. I was told, ‘doctors have to provide their own pens..’
‘What? But you have a stash there, and I can’t do my job without a pen. May I please just borrow one for the shift?’
‘Doctors provide their own pens.’

Admittedly, this lady in particular may have been a bit of a job’s worth, but still – it sums up my experience as a junior doctor. You are at the bottom of the rank. Treated as children, talked down to frequently by colleagues. nursing staff, consultants (not always. In some cases these guys are the saving grace) and clearly completely undervalued by the government and society. They give up their lives for you, the patients. And often that is without gratitude too.

I used to joke that I felt more like a politician looking after an elderly care ward than I did a doctor. Families queuing up to spark out at you…

Why is this and that test not delivered? Why is their partner still ill? Why have they now got a cough? Why is the consultant not here when they said they would be? Who is to blame for the death of my 99 year old Grandma?!!

Equipped and ready for duty, time after time, explaining that it was not your fault and the NHS had limitations to its system that we must appreciate. If you have to wait, this is a good sign! It was demoralising, sometimes hurtful and certainly burdensome.

Night shifts were beyond the worst. Completely out of your depth, looking after the sickest patients in the hospital. Bleep going…another bleep going. Answering the bleep was so consuming you often did not have the opportunity to actually run the errands requested. Seniors tied up in Resus, sleep deprived and incredibly lonely trekking ward to ward.

I have opinions as to why the NHS is so poorly managed compared to healthcare systems overseas. Think managers who do not know what goes on within the shop floor. But I may be wrong about this (though I doubt it, I am just trying to be diplomatic.)

Without junior doctors, or without any aspect of the medical team, the NHS will completely crumble from its already shaky scaffolding. To disrespect this work force further is a crime. Any doctor already left within the NHS should be thanked, valued and compensated. They are accepting poor conditions, poor pay, long hours for the good of the UK population. Not exiting for private conditions or those overseas.

I hope we do not continue to disrespect them further.

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