To wonder why we treat our Junior Doctors so badly?

[alfredomuretto]

These people have likely been the very brightest in their school, got very high grades, struggled through 5 years of university (£9k fees). Then they get to enjoy two years of being a junior doctor. They have to work very long hours, in appalling stressful conditions, direly understaffed, with nurses treated just as badly. Then they get a starting salary of £27k.

Why aren't we valuing them better?

27k definitely misleadingly. My daughters hourly rate worked out as less than the cleaners. Training was a bit of a misnomer too - get on with it and you’ll face being struck off if you screw up. Nights, days, nights hardly time to sleep between.
Told not to report breaches to Guardian of Safe Working Hours. Often had to work double shifts as no one else to cover. Consultants on call reluctant to come in meant decision making well beyond their pay grade.
It certainly wasn’t easy during foundation years. Nearly nine years training to date. The pay has gone up but so has the responsibility.

Partly it's tradition. You have many many older doctors like Babdoc who leap on any of these threads to tell us about the horrific practice in their time, forgetting that medicine is much more complicated now, and they weren't under the threat of being arrested and dragged through the daily mail if they inevitably fucked up.

It shouldn't be a competition. The no blame culture should actually exist (it doesn't in any way) and yes the salary (at least in London) is no where near competitive. Support if there is a problem is utterly dependent on chance- nice department- good, bad one =fucked. The BMA , the supposed union are useless.
The stress can be awful. I was at a course not long ago and realised the last time I'd been in that particular place I'd been with a friend who killed herself shortly after after a toxic combination of a patient complaint and failing professional exams. She's the third I've personally known and no doubt there will be more.

Yes, it can be rewarding but I'm not sure it makes up for the crap. If I knew then what I know more I'd never have done medicine.

And I am not the wealthy elite. I am from a working class background. I grew up in a council house. I started medical school at 26 and financially independent of my parents. I am 37 and do not own my own home becauseas a single parent I haven't been able to afford to yet. Don't believe everything you read in the daily mail.

What level are you at twistinmymelon?

They are limited to 48 hours a week and earn up to 100% on top of their salary if the shift pattern is shit.

48 hours per week averaged over a rota period (of up to 26 weeks), including your annual leave. Maximum hours over any single week is 72.

I am an F2 doctor and my rotas have varied massively over 6 rotations in different areas, but I've had 69 hour weeks in previous rotations, and they're pretty awful. In reality when you count up how long I stayed late (unpaid) on those weeks I'm sure I've accidentally gone over the 72 hour maximum a few times.

My gross salary last year was approximately 35K, and I think that's a very fair wage, and I'm not complaining about that. The issue is the working environment, the extreme pressure etc. We need to do better than the kind of working environment that lead me to the reception of my local psychiatric hospital reception last winter, sitting waiting for the crisis team, having been referred by my GP because I admitted I was considering suicide nearly every day, huddled over in my chair with my coat hood up, hoping that absolutely no one I knew (there were a few friends rotating through psychiatry) was going to walk past and see me. (I recovered by the way, and I'm doing very well now, so please don't worry if you're reading this!)

@AveAtqueVale - you will look back on your posts and laugh. Come back to us when you have done a year of F1! 😂

"To the soon to be junior doc up thread- I'm interested to see if you say you think £27 is decent once you've started and held all that responsibility on your head. When your ward cover on call on the first weekend and the SHO is off sick (or the rota just isn't filled) and the reg can't get out of a&e to help you.

Spoiler; you won't."

And when you have children to support and childcare bills to pay...

I will say that I live in one of the most affordable areas of the country and have no children, so my pay stretches a lot further than it does for many of my fellow junior doctors.

A non-medic, or even a medical student having an opinion on what it's like to be a doctor, is like a non parent, or first time pregnant woman, having an opinion on what it is like to be a parent. You really don't know what it's like. It's quite tough sometimes. Even if to an outsider it appears it shouldn't be...

I think a big part of the problem is lack of empathy/help from non doctors.

Many people think £27k as a starting salary! “I’m only on £30k myself and worked 10 years!They’re just greedy”

Well no Sandra, when you were having great teenage years with Donna drinking and getting 7 GCSEs at C, the future junior doctor was studying hard. Then that future doctor studied hard for another 8 years. THEN got that 27k, all the while you were earning from 16/18. So that salary also amount for lack of salary during those years. And that job as a junior doctor will involve twice or even thrice your hours at 5 times the stress level.

I have frequently not had time to piss, eat or drink all day. Much like having a baby.

It’s all worth it despite junior years being tough

The prices you pay are very high. It is all consuming. I have not been the parent, friend, or partner I could have or ought to have been because of my job. I sometimes wonder if I would do it again if I knew what it was really like. And I'm really not an awful lot better off financially than most of my friends who didn't do medicine.

Sacrifices have to be made. It’s the nature of the beast but it’s not forever.

Anyeay everyone will have their own experiences. GPing was previously seen as the easy option but that attitude seems to have changed over years as well

@Whitechocandraspberry - ST3, 5 years out of medical school. Had my daughter after 2nd year of medical school, always been full time.

It’s not two years. Two years of foundation, then two years of core training, then one year of GP training or five years of specialist training. Plus PhD in many specialties. I graduated at 25 (gap year plus intercalated BSc), and only CCT’d at 38, which is entirely normal in my specialty - many people are over 40 if they have taken maternity leave or spent extra time in research posts.

The 100% supplement was for people working illegal Band 3 rotas, and hadn’t existed in practice for many years. Most people were on 50% bands, which equates to working between 1:2 and 1:4 weekends and nights. And of course the banding system was abolished two years ago (hence the strikes), so no actually JDs are all on basic salaries now. The promised supplements for higher degrees/seniority etc have, as expected, not yet materialised “because there is no money to fund it”. Posts now pay approximately 20-25% less than they did two years ago, for exactly the same job.

I’ve moved over to Canada and the conditions are like might and day. Same pay, far lower intensity of work, far more training (and much shorter training times as a result - you go from graduation to fully trained staff physician in for years, five if you do an extra subspecialty fellowship year). Consultant pay and conditions are substantially better too.

And when you have children to support and childcare bills to pay...

I have two children already. We're currently in a tiny flat with no outside space, and we've been putting childcare on a credit card for months since I had to stop working in my 'spare' time to study for finals. So 27k will make quite a substantial difference actually. But please do continue assuming I have no grasp of economic reality.

Ave you could earn more than that as a 21yr old junior project manager in new media. You’d be on nearly double that as a media strategist or developer with five years of experience (which you would have aged 27 if you’d graduated at 21). It’s that discrepancy that bothers me - we are underpaid compared to people doing far less skilled jobs in the private sector.

And it is not me calling those jobs “less skilled” - it’s DH, who is forever pointing out how much easier our life would be if I switched to an entry-level job in his industry.

I’m an anxious person and worry about patients all the time when I get home. There are people who cope a lot better than me, but a lot of people are exhausted because when we come back from our day job, we have to make sure we have obtained all the required experience by getting signed off on procedures, discussing cases with consultants, writing reflections that can be used against us in court. If we do not do all this, we cannot progress to the next year/stage and after a while may get kicked off our training programme. Do they care if there is not enough staffing to let us get our required experience? - no. I come in on my days off hoping the right cases turn up.

Oh, and after that we have to study for our post graduate exams, do mandatory courses/training (some of which comes out of our own pocket), do mandatory audits (who has done audits including analysis during working hours?!), presentations, teaching peers and medical students.

Don’t think consultants have it easy either as they have to attend meetings, do clinics, write trainees reports, respond to complaints. Increasingly they do more out of hours on calls.

I would be ok with my pay if i didn’t have to do the extra stuff. DH works in software and all of that would be done on his normal working hours.

twistinmymelon - your will be aware of the salary scale for different grades. Clearly very different amounts for junior doctors all levels and consultants especially those with extra responsibilities

we are underpaid compared to people doing far less skilled jobs in the private sector

Or they're horribly overpaid... . But yes I do take the point. I just don't particularly enjoy being patronised think pay is quite a lot less important than some of the other issues.

I do find it bizarre that the people who have most responsibility - keeping people alive and well - have to work crazy hours. How do they work for days on end on barely any sleep and not make errors in judgement? Why is it acceptable to make doctors work these long shifts

it is a vocation, a dream, an ambition