to think that medical students should be funded differently than students on other courses?

[ChunkysMum]

Their course is 5-6 years long so accumulated debt is higher.

Their long hours and reduced length of Summer holidays (2-4 weeks) makes supporting themselves through extra-curricular employment difficult.

There starting wage when they qualify is actually alot lower than many other graduates (five-six years after starting their degree).

They often have to commute to different hospitals.

Atm they get a bursary to cover tuition fees in the final year only, but for a low income student, the way that this works out with a reduced student loan they end up with £1000 less to spend on food etc in the final year.

Duh! Thanks to posters for pointing out my mistake and apologies to NCIS :-)

Just wanted to add my tuppence worth. I delayed going to Uni by two years to work and save for Uni (this after I had worked during my sixth form years too and saved up £2k). I held down two part time jobs at Uni whilst studying medicine and often my academic work suffered for this, however I still worked my butt off to do well in exams. I've still got over £25K in debt though at the end of med school.
Other careers in the NHS are funded differently to medicine and have bursaries and travel, etc. Medical students get some money in their final year (different for graduate entry students).

I have done 4 rotations of which only 1 was banded, at 40%, and in that rotation I can honestly say I've worked at least 20-25% more hours than I'm paid for (bearing in mind the banding included the fact that you work night shifts, weekends, 14 hour days/nights, etc). And please don't be under the illusion that night shifts are sleeping shifts...they're like a day shift without all the usual support around.

It's not as cushy as everyone makes out. The recent industrial action that doctors were taking about their pension wasn't very effective as it's completely against a doctors ethos not to help patients. I would imagine that if all the NHS staff worked to contracts (i.e. worked their exact hours, took breaks as required) then the NHS would come to a standstill!! I know that it's not only NHS staff who work voluntary overtime, but not having enough time to assess and treat sick people is SO very stressful. I often lie awake at night running through the patients again in my head and fretting that I may have missed something because I didn't have enough time to do everything properly. I have brought this up with senior doctors who were unsympathetic.

I don't think it's worth the money at the moment. Maybe one day when I'm a consultant...

Don't worry samandi I just wish you'd been right

Someone said dentists get their training paid for..? That's complete bollocks as are a lot of the wild assumptions abounding on this thread. I do wonder where some people get their "facts" from. If a Dr is on here posting ref their salary/debt etc, why would they lie about it?

SILVERSIXPENCE, where on earth did you hear dentists are funded for their studies? WE MOST DEFINITELY ARE NOT!!! and i earn much much less than my medical colleagues and i work for the nhs so there. perhaps check your facts before making comments. the amount of misinformation and prejudice against dentists is unbelievable and really winds me up aaarrghh am sure other dentists will agree.

crossposted with grumpy (waves) i know you feel my pain!

Regardless of how much money a doctor can earn the very fact that medical students will typically run up such high student debts will, surely, put off less well off applicants.

I think along with many things the student funding needs looked at. Bright poor kids are being put off doing medicine because of the costs. My lower middle class parents struggled to send me and that was in the era before tuition fees (I graduated in the early 2000s).

I am still in training (unlike the post above which claims 5 years post graduation that you will be a consultant) bollocks. I work in London. Most of my non medical friends (banker, solicitor, IT professionals) earn more than me and have been doing so for longer. They are therefore more established on the housing market. They also have the freedom and flexibility to book weekends away, have their holiday when they want it and most importantly with their partner. Middle grade hospital doctors (i.e. me) are increasingly being allocated annual leave. At the age of 35 not being able to go on holiday with your loved ones is a serious ball ache.

To recap the medical career path.

2 year foundation programme (basic salary approx 22 500) immediately after graduating. Many lonodn jobs are 1 year in a DGH or 1 year centrally = moving or commuting a long way is mandatory. During this time you have to pay your GMC fees to register (approx 100/ annum for both years and then 200 quid to upgrade to full GMC registration). You might start doing exams (typical exam 500 quid). You will do courses (you need to to get into specialty training. Your employer will not pay. Typical one day course 150 quid, Life support courses about 500 quid each. Most people do two). If you are fortunate enough to get a job with antisocial hours you will get an increase in your salary. Most trusts are abolishing these though as the educational supervision burden is high so many Foundation doctors only earn their basic salary. In london you get an extra 1900 quid. That doesn't go very far.

Then Specialty Training Starts
If you do GP you will do 3 years. If you do a hospital specialty you will do anything from 5 - 8 years (some of the surgical guys might even do longer, I'm not sure). Even the wannabe GPs spend 2 years in hospital. You don't get a huge deal of choice where you work. This makes establishing a base difficult. Towards the end of this time many people have kids. Basic salary during these years is £29000 - £46 000 but before you get excited remember the costs of maintaining that earning power. GMC/ Royal college fees/ indemnity etc cost me (and I'm an average doctor) around 2000 pounds per year. To get here I sat professional exams costing in excess of 2000 pounds. Exam fees/ courses and books are NOT tax allowable as they are not essential for maintaining your career but ensure progression. On top of this many of these junior doctors are paying huge amounts of debt.

In order to maintain my skill levels after I've finished my exams. I have to go on courses in order to do this. As I've said above they can be expensive. I get 500/ annum to pay for them. However this year I've spent about 1500. A single life support course (eg. advanced life support) which is ESSENTIAL for me and has to be repeated ever 4 years - I wouldn't' want someone looking after my Gran without it - is 400 pounds. So yes, the basic numbers look alright but actually once you delve deeper the take home pay is diminished due to higher rate tax and the high costs of maintaining your professional registration.

Even within medicine there are issues - there are real problems at the moment recruiting into the consultant present specialties because people don't want to do the night and weekend work. In order to reverse this the salary structure may well need to change to incentivise this.

I really don't think I would encourage my children into medicine. The personal costs are too high and the rewards too low.

This is special pleading. Having clever people do difficult things well benefits everybody.

Oops, "well" should be "well and legally". Fixing Libor doesn't count.

I don't know anyone in the last 5years (despite knowing people who regularly work more than their paid hours) who has EVER had a banding appeal go through to the 100% banding. The only banding supps which are legally payable now are 50% (48hrs and most antisocial) and 40% (48hrs and less antisocial) and 20% (never applies to my specialty so I don't know the definition).

It is very rare (I know loads of doctors all around the UK) to get more than 50%. The banding supplements were negotiated to try to force trusts to modernise our working practices. They have been very successful.

The number of Foundation doctors on banded jobs is diminishing. Other specialities are losing banding too eg. public health.

All of those bemoaning how much we get paid need to know that the labour government wanted to move doctors onto Agenda for Change (the pay scale the rest of the nHS workforce uses) it would be massively more expensive - london weighting for example is 20% of basic salary - for me that would be the capped maximum of 6000 quid rather than the paltry 1900 I currently get. AfC also gives nurses a premium for working out of hours. This is so punitive that hospital trusts try very hard NOT to have senior (i.e. expensive) nurses working out of hours. Obviously you can't do this with junior doctors as you need us there (you could argue that you also need senior nurses there too).

Gasman I could give you a number of examples of 100% supplements (including examples from this week), some where trusts have paid them as a result of monitoring and others which have come from appeals, but I dont want to out myself. The last time data was collected, there were over 200 doctors getting 100%, plus of course all those who are on an 80% protection supplement for the remainder of their contracts (that data was never collected). 1C is for non resident on call undertaken occasionally by the way - as an anaesthetist am not surprised you havent come across it

That said, I agree entirely that banding has worked as a way of modernising practise and in particular to drive down working hours. But...it has also been inflexible and divisive , and along with working time regulations, affected continuity of care hugely as trusts are so scared of breaching the rules.

I'm all for renegotiation of the JD contract, resulting in a more flexible way of paying doctors, upping the basic salary for juniors considerably but paying their out of hours in a way that more closely reflects the actual hours worked.

Follyfoot

So 10 years after the new deal some trusts have still not sorted out their staffing to the extent that they are having to make at least 200 doctors work illegal rotas?
Was 100% supplement not punitive enough for them? It seems like a waste of taxpayers money to be deliberately paying punitive rates for a rota rather than sorting out something legal. I would imagine also that it would be hard for the trusts to defend themselves if one of these doctors makes an error.

Ah if only it was all that simple fireice. You see sometimes in medicine, unexpected things happen. Drs have to stay later than their shift time states, maybe not get a break, something like that. If that coincides with monitoring, then there's your 'illegal' rota. Its not necessarily illegal by the way.

Sometimes there simply arent enough trainees to cover a rota, thats not the drs' fault or the trusts' , maybe there just arent enough drs in that specialty and with the changes to immigration rules, the supply of overseas drs is much smaller. Sometimes however hard the drs and the trust work, its almost impossible to find a solution which wont have an enormous impact on patient safety and medical training. Thats why a more flexible system would be better for everyone.

I'm aware of those issues follyfoot, but quite a lot of people do manage to avoid running non-compliant rotas, and it with no criticism of doctors who are working on these rotas (and I'm sure would rather avoid it), it is a waste of money. I'm shocked that anyone is still working a band 3 rota, I thought they were long gone.

Of course it is a waste of money. As I said though, its not as simple as people might think to always have compliant rotas - and certain rotas will always be at risk eg surgical sub-specialties. There are two entirely disparate sets of rules for drs hours which confuse drs and trust staff alike (eg when you said 50% bandings didnt exist) and lead to misunderstandings. Importantly, some of the rules have zero tolerance built in and that is also going to cause some non-compliance on occasion.

Finally, monitoring is an inexact science, where potentially large changes to working patterns and salary rest entirely on the validity of data entered days or even a week after a day of duty has taken place. That cant be good for drs, trusts or patients.

Medicine should not be a special case. We should not have fees set so high for our students. Its a big enough burden for those on 3 year degrees let alone 5 (of which med students are not the only ones and by no means the lowest paid) how will these people afford a house? What would have been better would be to scrap all the non-subjects you can do at degree level and leave funding for proper academic courses. (Media studies, anyone?) However I understand the logistical nightmare of putting this into practice, easier just to raise the fees :/