To think medicine isn't a great career choice

[Medicmog]

Growing up, I dreamed of being a doctor. I was bright and motivated, and worked hard at school, and did lots of volunteering, extra curricular activities, and work experience, to gain admission to medical school. It was encouraged by my school and parents, as something worthwhile to aspire to.

I worked hard to complete six years of medical school, while non-medical friends graduated after three or four years and walked into highly paid jobs (generally £40k+). Two or three extra years studying, and I started on little over half this (plus an antisocial hours allowance on some jobs). Fine, I never went into medicine for the money.

What I find difficult is that doctors (and moreover all public sector workers) are so vulnerable due to current politics, public confidence in the progression is at an all time low, bullying in the progression is rife, and it is such an absolutely thankless job, where your employer treats you appallingly.

I have been injured at work, due to my workplaces negligence, and they illegally docked my pay subsequently, despite my continued working. I have been sick, and had consultants say they don't care about occupational health recommendations.

I had a serious illness, and when I emailed work, together with a sick note, I was told that it would be a great inconvenience, and to get back as soon as possible.

I have felt unwell at work and told that I wasn't allowed to sit down.

I have been shouted at and bullied by colleagues.

I have been threatened by patients and relatives.

I have been pressured to do physical work while pregnant that endangered my health.

When I went on maternity leave I didn't get so much as an email wishing me well, let alone a card.

My children have suffered from the long antisocial hours, including the significant amount of unpaid overtime I have done.

I'm at breaking point, and genuinely dreading going back to work after maternity leave. Why would I want to leave my baby, in order to pay more for childcare than I earn, and be treated like shit?

I realise this is a self indulgent post, but in some ways it is cathartic to share. I wouldn't ever recommend someone to join this profession, and I think young people considering it should be given a balanced perspective.

I have many medic friends and some medic relatives.
Those who are burning out or have quit the profession went down the GP/medical speciality routes.

Those that have made it through and enjoy their careers are radiologists, pathologists, anaesthetists.

Admittedly, this is a small sample size but the main differences between the careers of those who left versus those who stayed are the latter have:

• no inpatient work
• no continuity of care
• no patient-related admin

Radiology and pathology seem to offer the most flexibility in terms of your working week from many discussions/rants.

One radiologist stayed at the same hospital trust throughout his registrar training except for a few months secondment in his first or second year. I think he know about this well in advance.

Choose your specialty carefully.

Money is still relatively crap by all accounts - BMA salary scale shows you top £100k after 20 years as a consultant.

I’m one of “those” members of the public.

I hear you talk about the conditions, the bullying, the dread and I’m really sympathising and paying attention...but then......comes an utterly naive absurd statement about what people earn in the public sector and I switch off.

In my GPs surgery they show a video in the waiting room about GPS being so stressed that they are retiring early. We all sit there thinking “wow! To get to retire early! Wow! “ because for most people it’s out of the question. We don’t have that choice.

So I guess I would say stick to talking about the conditions and be more careful about the pay comparisons.

Good luck with your choices.

“Money is still relatively crap by all accounts - BMA salary scale shows you top £100k after 20 years as a consultant.”

Prime example of my point. In what world is £100k not great pay?

What about public health? Especially if you’re good at maths and like stats.

Or move to Australia or NZ where the training is still hard but the employers aren’t as abusive.

I went to a certain university where lots of people with decent science degrees went to London for jobs with very high starting salaries. Probably equivalent to £30k - £40k now. Finance, consultancy, engineering, software, corporate law etc. They had good degrees, often masters, from a great uni and most importantly the highest earners were in subjects where there is a lack of graduates which can really push up their value. Lots of these people did internships etc over summers so the companies knew they were good and wanted them back

My friend works in the engineering sector outside London / south and they are advertising a graduate position for £37k currently - it was previously much lower but there has been a reduction in good applicants with strong engineering type degrees in recent years and decent ones can command good salaries.

So it isnt beyond the realms of possibility that the OP knows of people with 40k salaries after a year or two in London. Of course this isn't the norm though.

I do think the people that I know in the private sector that earn over 100k work extremely hard though and they do put in the hours and dont have much work life balance. Overnights are expected at the end of a project for example and there is often a culture of been seen to do 12 hour days. But I only know a few at this level now.

From what I've seen, although their jobs are stressful, it is incomparable to the toxic environment of the NHS

And I dont work in a high paying job at all (over average salary but not by loads) and I get access to a free gym, regular perks like lunches out, can work from home etc and only have to do a max 1 hour unpaid extra a day in busy periods. I dont think this is right by the way. I just dont think OP is way off in her perception of the private sector depending on what jobs her friends do.

name nic thank you for reminding me about the Chris Day case. Sooty this just further illustrates how absurd a statement it is that doctors can just 'walk out'. He is an example of a whistle blowing case, which resulted in him losing his job, for highlighting unsafe staffing levels. He was prevented from going to an employment tribunal, as HEE argued he had no lead employer. After some decidedly dodgy BMA dealings, he had to crowdfund to raise legal fees. It's shocking the amount of public money that was spent trying to prevent him, and other junior doctors, from having whistleblowing protection.

Tube what utterly naive statement have O made regarding public sector pay? I have said what my fellow students earned on graduating, and the average starting salary for my university. This can be easily checked. I have said what companies/sectors fellow students have gone into, and posters have acknowledged that these do in fact pay these amounts. I accept that for those who go to other universities, the starting pay may be less.

Regardless, yet again, this isn't about the money, but everything else.

appropriate adult and no work life balance

Thank you for the alternative work suggestions

@medicmog are you on LinkedIn? Could you reconnect with other uni peers and see what they’re all doing? Not all the medics I was at uni with became doctors.

Did you know anyone who did Biochem or similar whose doing well - perhaps arrange a few coffees!?

poo willy not on linked in, but definitely an idea. I know there are a few that left medicine, it would be a good idea to ask more about it.

I think one of the issues is that actually the job hasn't changed so dramatically ( although the bureaucracy has definitely increased) but expectations have. It has always been a really tough career with heavy time demands and a difficult work/life balance and trying to fit it to a 9-5 is really challenging.
Part time trainees have a particularly difficult time as they have a very protracted training, they are often not viewed/mentored to the same degree as FT trainees and they get rubbish pay for their hours.

There is another issue of resilience though and medical schools very much look for the academically brightest above all else and while it is obvious that they need to be 'clever enough' there also needs to be consideration for aptitude and very many bright A level students start medicine without realising what the job is like and are then demoralised when peers in finance etc progress quickly and make more money.
It is still a good career if your personality fits but it is not necessarily a good career if you are super bright but are not robust unless you pick your speciality very carefully.

I think someone has already mentioned this but what about public health medicine? The specialty training is very competitive to get into but if you have a good handle on maths and stats it could be a good fit. It has its own stresses but having been in a patient facing specialty and then public health I have found PH to have great work life balance and a generally supportive environment. Feel free to PM me if you like.

“Money is still relatively crap by all accounts - BMA salary scale shows you top £100k after 20 years as a consultant.”

Prime example of my point. In what world is £100k not great pay?

That's why I used the word relatively in my statement above.
Salaries after 20 years are generally much higher in other jobs that require comparable levels of education, training, skills and the pressure of role and consequences of mistakes.

I only raise this in response to posts previously about salaries.

Clearly there are other roles that deserve better pay as well and there is a workforce crisis amongst public sector workers in the most stressful roles doctors, nurses, social workers, child protection officers - we have seen massive consequences on lives as a result of poor morale and funding.

I graduated in 1995 (not medicine) Since then, I've never met anyone who walked into a 40k job. Not even 25k. I really do feel for you, op but please don't think that graduates who've done 3 years are walking into anything approaching a well paid job.

“Regardless, yet again, this isn't about the money, but everything else.”

The problems you have are not about the money, I agree. If Drs would stop saying foolish things about what other people earn it would make it easier for the public to get behind you.

A dr came to give a careers talk at my kids school. She spent half the talk on how “little” drs earn backed with charts. As accountants and others above have patiently pointed out, comparing the pay you get to what the top 500 people in a different profession get is not a valid comparison. She was comparing the salaries to people in finance. We are not in London. There will have been no parent in that room who earned as much as that consultant. She made a fool of herself.

And the race to the bottom thing is pretty irritating. The rest of us aren’t at the bottom we’re just in normal life.

I don’t want to talk about drs pay any more than you do. But someone is feeding you lies about how money works upside the City. If you were a criminal defendant lawyer, then we’d be talking about pay, and rightly so.

...outside.....

There are 500 people in my company, and I estimate 10-11 earn over £100k with another 20 earning £75-85k. None of them work overnights, 12 hour days and there is no reason why they shouldn’t have a fine work life balance. I’m in one of these groups and work 9-5 only doing overtime periods of an extra 3-4 hours a day a few times a year.

It’s disingenuous to pretend all highly paid people slog. Some jobs just attract high salaries due to the skill required. The jobs themselves are not necessarily busy.

Being a doctor doesn’t have to be busy, it is due to shortages in qualified doctors, weird rota’ing and presumably budget restrictions which stops the NHS paying for more on call doctors per shift.

I think to be fair tobeforgotten that is because due to the high academic achievement of doctors, if they didn’t go to medical school they’d be looking at city careers and similar. It’s directly comparable.

I know a group of uni mates who have maths degrees from one of the best unis- 4 are earning huge amounts in pensions, hedge funds and banking, and 1 is a doctor. I don’t know what he earns but his friends are pulling in £400k a year with £100k bonuses. If he weren't a doctor he’d be doing the same.

Interesting point cherry.

There is a bottleneck on recruitment.

I don’t know why.

I'm an NHS consultant.

I've had 2 months off sick with occupational induced stress this year.

I used to love my job. I was always person least likely to quit. Not now. As soon as I find something that pays me well enough to stay in my flat I will.

The relentless pressures of public expectation, downwards managerial pressures, under resourcing and under staffing are too much.

Our pay has dropped in real terms over the last decade which has contributed hugely to under staffing especially in central london. The punitive pension tax regime is cutting dramatically anyone willing to work extra exacerbating the situation.

Dinosaurs who say "it was much worse in my day" are part of the problem. The medical workforce is seriously struggling.

There is no "greener grass" in the UK. I've talked to colleagues extensively (I'm a niche subspecialty) to see if moving will help. I don't think it will.

I hear you Cherry but think about life outside London. Drs have the stand-out salary in most parts of the country.

There may be a London-centric problem here. The public whose support drs want are mostly not in London.

I also went to a top uni. The drs are the highest earners (other than someone who paints oils!!!). Many of us are or have been on the typical low professional wage which round here is £30k (enough). £100 000 k is a massive salary to most of the public including those of us just as highly educated as drs.

Freak I am sorry about your illness.

“Our pay has dropped in real terms over the last decade which has contributed hugely to under staffing especially in central london”

Again, comparisons are odious, but everyone’s pay went south this decade. And London again....

I think to be fair tobeforgotten that is because due to the high academic achievement of doctors, if they didn’t go to medical school they’d be looking at city careers and similar. It’s directly comparable

Really? I don't think the City could absorb and pay for that many doctors (or would be ones) and I don't think the type of people who want to be doctors would always enjoy the City. I know people who work in the City, and even they didn't like it that much (same with lawyers, know almost no happy lawyers, perhaps one). People in the City and law are often trapped by money, a few love it but most find it hard to walk away from the high salary (and not all solicitors/lawyers get paid well anyway).

Academics are a bit the same- we earn much much less than doctors at an equivalent stage and are less likely to make professor than a dr is consultant, but you can't delude yourself that you would have been raking in £400,000 otherwise. There are few jobs that would pay out that and it's unclear would-be drs would want to do them anyway.

Being a dr used to be a sweet spot of reasonably good renumeration (in the later stages) and high job satisfaction. Everyone I know in medicine says the job satisfaction is swamped with the stress of working in the current NHS. They are either planning to leave, emigrate (conditions in NZ are supposed to be good) or went part-time as it's possible to get a good enough wage on 3 days a week as a GP so many many women do that to try to preserve some semblance of work/life balance.

I strongly disagree that it’s a London-centric problem. I do not work in London and everything mentioned above is true here too.

All salaries in the public sector have flatlined in the past decade and dropped in real terms.

Sure @almost50 the doctors would just push out the currently employed grads who have achieved less academically then prospective medical school applicants.

I can’t believe people are trying to suggest prospective medical students aren’t the academic cream of the crop!