I am a Junior Doctor about to go on strike, ask me anything.

[Lauralaaaa]

I am a Foundation year 1 doctor who started in the NHS in August. I have been reading some things online and have seen some quite differing opinions. I wondered if anyone had any questions.

Thank you for what you do

I was watching the news quoting the salaries but no mention of deduction or the continued learning that is done for exams which you pay for , student loans, registrations etc

I just want to say that I support the strikes too and to thank you for doing the job that you do.
It was a doctor like you who saved my life 7 years ago and again 2 years ago.

Thank you so much for what you do. I’m so shocked it hasn’t even really been on the news.

I hope we don’t lose you to New Zealand/ Aus but I’m afraid that we probably will with this current government. Good luck!

unfortunately I think we will probably end up seeing a mass exodus of anyone well educated in this country

Thank you for what you do and thus thread

Support to you and your colleagues. Best of luck and thank you.

I am working today! Will do my best to answer the new questions at lunch time (if I get one that is) Thank you all so much

That is actually disgraceful. I work at my local authority as an accountant and earn 34k working 37 hours. Normal hours, not messy ones, no nights or weekends, and I don’t have to worry about killing anyone in the process.

I can eat, drink and pee whenever I like.

I knew salary wasn’t great but I’d have honestly expected double.

I might bloody strike with you! (I jest, but you know what I mean).

I would just like to add to the OPs experiences (thank you for the thread by the way)

My longest duty period as a junior doctor was 76 hours, of which I was awake and operating for the first 34. This was as a 3rd year orthopaedic registrar, so 7 years into training.

As a consultant I was working from 7am yesterday to 1:30am this morning, I've just got up and about to start operating again from 8am till 5pm, and the same tomorrow, plus on-call from friday 7am till monday 4pm....

I'm afraid it gets worse before it gets better... particularly in some specialties.

I recently moved from the private sector to the public and into an area where I now am enrolling into a defined benefit pension scheme.

We have the possibility to sacrifice more of our salary in return for higher pension or receive more salary now and less pension.

my current pension savings are extremely low and I am putting as much as I can afford into my workplace pension scheme. I am older and scared of retirement poverty.

a) what is the percentage of your salary which is put into pension?

b) would you be happy to have the flexibility I have (to get that pay now)?

I think your pay is disgraceful and not being able to take a few days leave in a row is outrageous. Fully support your strike action as well as other HCPs.

That pay rate is unbelievable, and the cost of training, and the work conditions. 72 hours in a row - wtaf? Fully support your strike

Just came on to say I fully support junior doctors’ strike action. I couldn’t imagine working the hours you describe for the low pay and poor conditions. I’d also be terrified of making mistakes because of exhaustion. Added to that you have to carry a lot of student debt.

Over the last 10yrs + I’ve been reading about the difficulties NHS staff face because of an increasing population, austerity measures, a big increase in certain health conditions and lack of staff/low pay. I know it’s a big question but are there certain things the NHS and govt could do now to improve the situation or is it too late?

I gather you're in orthopedics 😂

But on a serious note, I don't understand how these kinds of hours can be considered safe? I know they're standard and just what happens, but we don't allow lorry drivers to work those kinds of shifts because it's not safe, yet it's acceptable for someone who quite possibly has your life in their hands, may be operating on you, working out drug dosages where the smallest mistake can be fatal?
And although I've not seen it here on this thread, people respond with the (already inadequate) pay as justification for it - since when does paying someone suddenly stop them feeling tired after 34 hours awake and concentrating? Or feeling fatigued after an 18 hour shift? All the pay increases in the world don't stop people being human and needing to do human things like sleep and eat.

I understand that certain operations for example can take hours and hours, but surely as a basic minimum, that should be the exception?
It almost seems that you can't be considered a decent Dr unless you've done (imo) unsafe (for everyone, including the Dr) amounts of hours. It's insane to me that it's not just allowed, but fully expected and supported.
Is this one of the things the striking is hoping to change?

@Maverickess i completely agree, it’s not just the money it’s the conditions. I think lots of people would be horrified how much responsibility is loaded onto FY1s overnight compared to their experience level. If I was designing the training I’d make it a supernumerary learning year, and then the starting salary of 30-40k (depending on rotas etc) would look about right. Drs qualify after 5 years with a great deal of knowledge but very little hands on experience of the role, compared to say nurses who have hours and hours of actual supervised supernumerary practice behind them.

I totally agree, my only experience really is as a patient or representative of one in a professional capacity, or stories from family who have nursed between them from the 60's up to the present day or are in allied professions.
But even with my limited knowledge, I can see that this situation is just not viable, and the 'It's a vocation' clap trap is just used to justify the pay and conditions - from the higher levels right down to the lowest (I was a care assistant so I know a bit about that end 😂).
These professionals put ££££ into their training, they put so much of themselves into it, their lives and there's still people who demand more and fail to value them.
My theory is that it's not so much that nurses/Dr's/teachers etc are finally drawing a line in the sand, for so many I feel that they just don't have anything left to give, yet the demands keep coming.

I did not get a lunch break as I expected. Was a busy shift, I got in nearly an hour early and left an hour late.
A normal day really unfortunately. Thank you all so much for your messages it’s so nice to get support.

@Maverickess
I think the main change I would like to see is more doctors staying in the UK. We have so many of our best doctors move to other countries for a better work life balance and better pay and it’s very sad. More doctors will mean we are less understaffed and will make work more bearable, leading to more people staying in the UK.

I would say I have quite a few patients that stick with me already. I’ve found death very difficult which I expected but you can never imagine it until it happens. I have had to get CBT for anxiety in the workplace after a particularly hard death.

Thank you so much

@Hernamewaslola1
I think there is such a culture of “oh I’ll just finish medical school” then “If I just finish F2 it will get better” and I think people seem to do that until they are a consultant and then depending on the speciality it’s better or worse. I think once I’m a consultant it will be better but that’s 7 years away. I am still unsure if it’s worth the Junior Doctor years. Maybe a consultants view would be useful for that.

@Maryandherlamb
Good question. I’m hopeful it only takes this one. However I probably would need to save if it went on for too long. The BMA do have help as @DoughnutDreams says, thank you.

@soomuchgoo
In F1 & F2, how much do they let you do? How hands on do you get?
We do a lot of taking bloods, cannulas, prescribing and discharge summaries. I’m surprised you didn’t come into contact with the juniors. We are usually the ones writing in the noses and running round like headless chickens.


Do they let you operate? If so, only with someone more senior there, or relatively independently? Or day, the consultant dors the surgery and you sew up? How much responsibility do you have for treating, prescribing etc, without having to get approval?

We do not operate ourselves at all.
Some keen budding young surgeons may assist at my level but no more then than. Registrars will operate. But it’s mainly the consultants.

It depends on the speciality with regards to treating a prescribing without approval. Urology the higher ups decide everything. On respiratory I was left to manage fully quite unwell patients, then ask afterwards.


You mentioned prepping rounds lists, is that who to see, their histories, the issues etc?
Yes exactly that. I get in an hour before rounds to make sure the list is ready.


I'm assuming that you do a lot of the background slog, even though we don't necessarily see it?

Yes I would say this is exactly it.


Do some specialisms not take trainees, if so, which?
I think all specialisms take trainees, but some don’t need F1s and F2s if there isn’t much background slog as you

@Hbh17

My registrars do hours like that. So if I wanted to do surgery it’s what’s to come. However I think most people would agree they don’t want their doctor doing more than 72 hours a week when in other jobs the average is 40.

Being of service to others wasn’t the main reason I went into it no, it’s a positive of the job though.
I know my consultants had it hard but they shouldn’t have it like that and we shouldn’t have it like this.

@MrsSkylerWhite
I wanted to be a doctor because I enjoyed science, communication with people, job security and money. Now I’m doing it because I’ve invested 6 years and feel like I may as well finish my foundation years and reassess.

@HooverIsAlwaysBroken
These are great questions about pensions which I should really know! At the moment it just comes out every month. I will look into it.

So, in my case last night, it does directly relate to pay and conditions - we have rota gaps as unable to employ suitably qualified juniors, this means the rota only has time for service provision, rather than training, which means people leave - a death spiral for the department.

Last night, my clinical fellow (core trainee equivalent) called in sick. No replacement could be found - not surprised at £40/hr for a weekend night 2 hours into a shift that had already started, when they know they'll lose >35% of that in tax. This meant my registrar had to step down to cover, and I had to step down to cover them in turn.

Better pay, means full rotas, which means better conditions, and that filters up the tiers.

@Lauralaaaa your points about not doing any operating are really telling - the real problems with conditions rather than pay started with Modernising Medical Careers in 2007/8 unfortunately the exact same time as the EWTD and the banking crisis / pay freeze.

As an F1 (PRHO for me) I was starting to learn 'simple' surgery like appendicectomy, hernia repairs, some vascular procedures, by the end of F2 I was opening laparotomies, doing hip and wrist fixations, even starting on some laparoscopic gallbladders.

It seems completely insane in the context of today's roles.

We have mapped our “elective” activity which will be cancelled:

2 full day cancer lists
6 2 week wait cancer clinics
2 (bad news) results clinics

3 full day “elective” theatre lists - elective covers anything not immediately life and limb.

It should be clear that “oh it’s just elective being cancelled” does not mean varicose veins and hernias. These are patients who have been waiting scared, in pain and unwell for a very long time.

And to rebook these patients will mean bumping the next lot of patients off their lists and on and on and on.

The same patients who were cancelled during the nurses strikes when it was “only” elective work being cancelled.

And this is just our division, 1 division out of 6. God knows what the total elective cancellations will be across our trust

Between this strike, the nurses strike, covid and staff sickness I am sick and tired, SICK AND TIRED of calling patients to tell them they are being cancelled AGAIN.

You can bet your last bloody dollar it isn’t the nurses or doctors calling them

@HooverIsAlwaysBroken drs get a 20.6 employer contribution over what they put in (which I think is 9). I personally think the government could discuss changing it and giving them the pay now instead and then making nhs pensions more ‘normal’. The pension is part of the compensation package but it’s not very helpful for juniors to be getting a gold plated pension in 40-50 years! a 10% employer contribution would still be massive by industry standards and would be able to facilitate a 10% pay increase across the board.

I suppose with any strike it’s the people at the end who suffer.

But there’s not much we can do it gets landed on us, after Covid and if you think about it too much it’s even more disempowering

I can’t tell you the anxiety I’m feeling already about this. I’m a bloodied ops manager and this might just be the last straw - I started looking through the theatres diaries for the strike dates, I know these patients, I know I’ve cancelled them before, I know that when I phone them (again because I’m not going to ask my team to do it) I’m going to get shouted at or even worse just get some poor resigned person on the end of the phone who “was waiting for this call”.

fuck it I’m going to get the wine