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.

GrapefruitsAreNotTheOnlyFruit I agree with you, it's the same in academia, the long hours culture was well-suited when there was one main breadwinner and a wife at home. It doesn't work at all with a two career structure with two parents exhausting themselves to do silly hours. I think similar people go into academia as medicine and probably struggle for similar reasons- the structure now is very harsh and unforgiving, there's little support, being a mother within this is almost impossible (as targets set very high and hard to achieve when also doing the bulk of the caring). The people I know where this works work part-time in the NHS as GPs and if academics have either no kids or have a husband at home a lot. I don't know any medics who work f/t hours because they prefer to take the pay cut and find this the only manageable way to cope with the very long days and horrendous stress of working in a creaking and collapsing system.

I would look to moving out of hospital medicine OP because you don't enjoy it. I find the work structure of my job (academia) difficult, lots of sexism and ridiculous targets, but I do love the day to day work and get a lot of pleasure out of teaching and writing. If you get almost no pleasure from the day to day work, and find the working conditions intolerable, I'd be looking for a sideways move.

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Name changed back to an old one for this as probably quite outing

I do wonder if you would be better moving out of London, my experiences further north are more positive, although I do recognise what you are saying. General medicine and surgery are rife with poor working hours and bullying I have found, smaller specialties seem to be friendlier.
I've just finished training and started my ED consultant job, and am enjoying it. Our department has multiple people doing clinical fellow/CESR posts in varying percentages of full time that have come out of training for various reasons that have a much better work life balance. We do care about our juniors and want them to be happy in their lives outside the hospital.

I have found, in previous times, that large hospitals seem to be much worse at looking after juniors than smaller hospitals. Training seems endless currently, but you need to find a specialty where there is a light at the end of the tunnel...

Change jobs as soon as possible. It's not being a doctor that's crap, it's your employer. Report them. Whistle blow. Don't accept this appalling behaviour.

Apologies, because my previous post probably wasn’t particularly helpful to the OP, so attempting to make amends.

If you aren’t happy then you should absolutely look into changes. I think ppl can sometimes feel trapped in medicine because of the high (sunk) costs of training and the prestige of the occupation (why would you leave?). But it might be the best thing. You only get one life OP. No point in being miserable.

If I were you I’d make a list of all my options, both inside/outside medicine and consider a move too (either outside of London or outside of the UK).

Have a look into the feasibility of each and then pros and cons. You have more options than you might think you do.

@GrapefruitsAreNotTheOnlyFruit

Whilst I agree to an extent it’s important not to cloud general poor management/failings with feminist issues. Yes women should be treated better but men should too.

My DH has been told he can put in an application for shared parental leave but its really not guaranteed. NHS HAVE to maintain staffing levels in his speciality and women get priority for maternity leave. Males are expected to cover the loss and his legal rights to shared parental leave apparently aren’t important.

I see this from both sides. Feminists will ofc claim women should be given priority as they carry the child but my DH not being allowed parental leave because ‘too many women are on maternity’ actually forces my hand staying home longer than I would want to (disadvantaging my own non NHS career).

There’s a reason that the MAJORITY of Dr’s wives (especially those in certain demanding specialties) end up SAHP’s!
Yes women should be treated well in the workplace by focusing on ‘feminist issues’ rather than just general poor management/treatment women can actively disadvantage other women (the female partners of Male Dr’s!)

Female Dr’s saying ‘we should be allowed XYZ’ whilst allowing the NHS to force men to pick up the slack are just contributing to other women’s problems!

Well I think the profession needs to change to become more family friendly. An advantage to both men and women though women will benefit more. In this I include the current female spouses of male doctors.

But also we need to recognise that in certain professions people will need to work odd hours or unexpected overtime. So flexible child care options should be better supported and less harshly taxed.

And perhaps junior doctors need to earn more so they can afford the childcare they need.

Another pretty fundamental difference between men and women is that men are better able to postpone having children until they are a little older so may have been able to move further up the ranks before starting a family.

It's so sad that couples need two wages to live ( even in higher paid careers) or the hire of nannies or au pairs which adds to the costs and creates a vicious circle.
I know I'll be flamed and I am old, but things did work better when it was more of a choice and not a necessity to have two incomes or things are so bad that more flexible working arrangements can't be made in this profession where it can in others ( hard to do of course)
I feel for the young doing these much tougher careers.

Interestingly 20 years ago a relative of mind who is a doctor was attending a BMA conference.

The subject being discussed was how to prevent the medical profession becoming lower status and lower paid once more women started working in it.

At the time as a naive 20 something I thought this was a preposterous idea. But now I am not so sure.

Grapefruit, it's another ' mans world' being stamped over by women and the men not liking it that much i suppose.
There's always old dinosaurs about who loath the change of the status quo.
Women have to fight for everything so much more.

It's extremely challenging, OP and people in medical professions are extremely vulnerable to burnout. I've just been through this with DH, who ended up in hospital through been ground down physically and mentally from his medical job.

He starts at a new place in a few weeks and we are hoping that finding a better organisation to work for will make the difference. However it still doesn't seem like this is a sustainable career path in the long term, just from the nature of working for the NHS and always having to do more with fewer resources.

Several of his former colleagues have set up their own companies and work for OOH and various services flexibly, giving them more control and autonomy. Have you considered this?

@moseshrute...you hit on one of the biggest problems. There is so much more to surviving and thriving in medicine than being a very high achieving a level student.

I work across a wide range of the profession and hear this over and over again from seniors.

With the likes of the gmc talking about building resilience in our doctors we need to be looking at who and how students are selected

I don’t really understand those who go into medicine in the uk now if it’s not something you really really really etc want to do.

There are other highly paid options out there for good grads but really you can’t go into medicine just for the money can you.

My dh and I work in finance but most likely like a lot of others we had to start at the bottom work ridiculous hours and be down trodden to the point of despair until we finally came out with the end result of 6 figure salaries in our late 20’s. I imagine most careers you have to build up from something. Sure some grads might go onto ok paid jobs but most do actually have to work for the higher roles and salaries. We have to continuously stay on top of qualifications and updates in regulatory areas as well.

If you are handing in your training number then have a “gap year” locuming when convenient for you or go the SAS/staff grade route to ensure one hospital location? Get some headspace and rethink.

Good luck with it. I lasted 25 years and bailed. Not in the UK but we have the same problems and I did spend several years in my younger days over there working for the NHS. Funnily your conditions were a hell of a lot better than our conditions at the time. Now I would say ours are but not by much.

Lots of options available for qualified and experienced medics but not sure how that benefits you at this point. I’m not even registered anymore, no need, plenty of work without that and my next step will be retirement but I don’t plan that any time in the foreseeable future.

Admittedly, in my area I probably saw the worst that people have to offer but all ex-colleagues, friends and family in hospital based roles (think A&E, ICU, tertiary specialists with no private work) are all bailing. The only people willing to stay are those in majority private with rights as opposed to on staff. The next gen are not ready to fill these gaps as yet so it’s interesting and really sad as to how it has come to this. Also sad that no ones kids (incl. mine) wanted to go into medicine as they saw it for what it is in the practical sense nowadays. Miles apart from those with ‘it’s always been my dream’ and stars in their eyes trying to get in.

The other thing that perplexed me these days is when women in medicine choose to have kids. I’m not having a dig at all but there seems to be a huge difference between now and my day. Around late 30’s/40 was standard for us after we had done everything we needed to and got to the point where we had some stability and flexibility. Age is not great admittedly and I’m probably the only person I’m aware of that didn’t end going through IVF but at that point you do have a bit of bargaining power. Now it seems as though women are having kids at the beginning and then throwing their hands up as to how it fits in when it doesn’t really at that point. Unfair biologically but that’s the reality.

I qualified 24 years ago and trained as a GP. I do think we were more willing to do nothing but work for a few years - a lot of us lived in and we worked really long hours but went out every chance we had
I then did GP for many years but became totally fed up with the paper work and targets. I drifted into palliative care and now do this full time, and I absolutely love my job! I am a specialty doctor, and have no intention of becoming a consultant.
What I'm saying is, don't just give up. Have a look at different specialties and options.
I do think there is something in the idea of having help from your spouse.DH works 4 days a week, flexi time, and he helps out massively so that the children can do their hobbies while I'm at work!

Grapefruits

Wow so well put. I am a consultant in a 9-5 specialty, but it is still hard graft. I was chatting to my clinical director the other day, nice bloke, but early 60s, close to retirement, no kids and a wife who has a part time job. I had bought my lunch from the coffee shop downstairs and he was ranting about how expensive it is etc.

His wife makes his lunch for him!

I made a comment about how much easier my life would be if I had a wife at home.

The look on his face told me he had never had considered just what I did alongside my job (which is basically the same as his!).

We are having to employ a nanny as my eldest special needs have tipped him out of childminder territory. The amount of faff and risk associated (SS for 28 weeks) with that is eyewatering. And yet childcare is not a tax deductible expense. Unlike employing a chauffeur which is .

I am honestly surprised any of our trainees want to carry on. They look broken and I say this as someone who worked a 1:4 with prospective cover shift pattern for years. I don't think I ever felt so defeated.

The pharmaceutical industry recruits medics. It might be worth considering.

Jads, doesn't surprise me.
Most men in their 50s or 60s have 'the wife' sorting it out back home I bet!
The younger ones are struggling.

@hoppingpavolva I think if by early 30s you could get to a point where it would be ok to have kids then it would make a massive difference to women in the profession.

My medic relative took time out for a child in her mid thirties because she had seen too many colleagues wait too long and either not be able to have children or have children with disabilities.

Maybe young medics reckon their chance of having the family they want if they wait until they make consultant is pretty low so they just get on with it.

I want to say thank you to you for being a doctor.
We really need people like you !

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

That’s pretty shitty.

Look, the pay is one thing. The bigger thing is the way we are treated by our employers, the NHS.

It is made abundantly clear to us during training that we are numbers on a Rota spreadsheet. There to fill a gap, a body in place to keep the machine ticking over.

In training for instabce, we have no say where we work within a given area (and in some cases that is a large one) and change every so often (frequency depending on specialty). We don’t get rota’s Far in advance. Where we get placed gets changed at short notice at times. If there are rota gals, no-one really cares what we have to do to cover them- they might make the right noises but that’s it. It can mean juniors covering more wards/units than they should (i.e. was deemed safe when doing medical workforce planning). But we all knew that if mistakes were made due to workload, the NHS would hang us out to dry rather than admit that shortages and staffing issues were at least partly to blame. Add to that that trying to attend some of the mandatory training sessions we were supposed to do as trainees was made almost impossible at times due to workload (not enough of us to cover) but that was mostly ignored/excuses made. That environment is not conducive to satisfactory working conditions. It’s also not good news for patients either.

The NHS is also rubbish as an employer in lots of other ways. For example, I have had colleagues rota’d to work on their own wedding days despite having placed a request months before with frequent reminders. When mistake is pointed out the response is usually “oh, sorry we’ll if you want it off you’ll need to get a colleague to swap”. I’m not talking a one off, or only in one place- this sort of thing happens all the time.

One colleague was admitted to hospital with significant bleeding at 23 weeks pregnant-admitted about 7:00 am, we were due on at 8. She left a message on the ward with sister, on her supervisor’s office answer machine and emailed him, plus left message with his secretary and the admin team who do the rota. As well letting me know (as I would be working with her). Because she did not then call in by 8:30 to confirm she wouldn’t be in personally, they tried to discipline her as she had not “followed procedure”. BMA and deanery involved and they backed down- but again this sort of thing is not an isolated incident only heard of in one place.

Another example is monitoring- the process by which the amount of additional pay on top of basic salary (known as the banding) is calculated. This is based on number of on-calls/evenings/nights and weekends worked. This is decided by the employers and checked on every so often- by getting juniors to record hours actually worked. If the department “fails”- I.e. juniors working longer than the department has claimed (and paid their juniors) then the banding is changed and there are fines to be paid by the department. The idea being that this incentivises HR and the departments into making sure they fill rota’s/manage workload to avoid having to pay junior doctors more and/or pay the fine. Except, many departments put a huge amount of pressure on their juniors to lie or doctor their working hours to avoid the monitoring being “failed”. They aren’t supposed to, but we still hear of it happening. The monitoring sheets where we recorded our hours would often go missing (solved by keeping copies), but strangely only ever in posts where it was obvious it would fail or it was borderline. One post I did as a junior even tried to discredit the whole cohort by saying we had been recording hours incorrectly. We had to go to ridiculous lengths such as getting bleep logs and getting timings from patients t records etc. Left a very bad taste, and even when they were proved wrong there was no apology forthcoming. Again, not an isolated incident.

I recognise medicine is not the only profession where working conditions aren’t great. Nor the NHS the only employer who is a poor one. But it is one where poor decisions made due to exhaustion/burn out/ too heavy a workload can lead to harm to others.

Rota gals = rota gaps.

jacks yes yes to all of that. It sounds familiar. I know two doctors who were told they wouldn't be given leave for their own wedding day, and to just swap if they happened to be that rota slot.

I know someone who was treated appallingly, having been diagnosed with cancer.

I know people who have been told to make up the time they had off on sick leave or compassionate leave. In fact the sick leave happened to me too (I was told I would need to swap my on calls, to do them when I was better).

Rotas are often non compliant, but I have never personally been time carded.

I also know colleagues who were sexually harassed by consultants.

It's all completely inexcusable, and I can't imagine any other employer treating their employees with such utter contempt.