To tell you that a newly qualified doctor only earns £29k?

[Drstrike]

Doctors now leave medical school after 5/6 gruelling years of study - with £85k of student debt.

First year post-qualification is £29k, rising to £33k the following year. Then things stagnate around £40k whilst in specialty training.

The first year post-qualification is more supervised. But you are still the first doctor to be bleeped if one of your ward patients starts bleeding post-op, falls and hits their head, has chest pain etc. and you are the one to initiate management then contact your consultant to let them know. You are still covering wards overnight with seniors at a distance. You are still prescribing medications, ordering scans involving radiation, explaining plans to patients and families. You are still a fully qualified doctor - just not with full registration.

This salary is based on a 40-48 hour full time week depending on rota. That means you can be "part time" working 40hrs a week in a job like surgery.

It takes 5/6 years of medical school, 2 years of foundation training, 3 years of core training and 3 years of higher specialty training to become a consultant. That's a commitment of 13 years, generally from the age of 18.

During this time doctors have to pay for their own progression exams (£500-£1000 each).

There are out of hours premia for nights/weekends on top, but in specialties like psychiatry and GP only basic is earnt.

Does this shock you?

I think where the message is getting lost is that junior doctors are asking for better wages as it will make the shit working conditions seem more bearable. I don't think it'll work. I don't know how any doctors tolerate what's expected of them - it's beyond ridiculous.

A 22 year old with very little experience can be the only doctor on call in a large hospital, expected to deal with literally every medical need across every ward. It's insane. Most people wouldn't even be able to contemplate facing such responsibility.

Their training costs THEM a fortune- financially, emotionally, personally in time and effort.

and the horrible suggestion that because it unsurprisingly costs a lot to train doctors to be of the standard needed in such a complex and responsible job they who are performing that job should somehow be grateful to you sat at home for funding them.

I think people actually have no idea what the job entails.

Because in the 5 years they've trained we had a poorly managed pandemic, pay cuts, hundreds of doctors leaving the profession, worse patient attitudes.

"The job" is not some static entity where conditions don't change over the course of the half a decade it takes to do the degree.

If their clients are stupid enough to pay them obscene amounts of commission, so be it, but both companies and employees should be paying the full whack of tax and NI so that public spending on essential services and infrastructure can be properly funded. The financial services sector needs these and should be contributing a fair amount to keeping things going, including the NHS.

I think doctors pay is fine, considering the career as a whole and the alternatives for bright and motivated people with an interest in science and a prosocial outlook. The alternative would be a scientist (much lower pay), teacher (same), or other HCP. They're not generally the cohort to go on to become big business owners or venture capitalists. If you work hard in a low risk career you could do much worse than a doctor's salary in the UK IMO. And my doctor friends privately agree. But pay as a whole across the economy is shite and that's because of lack of investment and low productivity over the last 15 years. But relatively speaking, doctor's pay is about right - overall, salaries need to go up as a whole.

Apart from the huge responsibility, I think one of the cruellest and most difficult aspects of medical training is how impossible it is to build a normal life. Most trainees have to move regularly, sometimes multiple times a year. It's so disruptive and expensive and damaging to relationships.

I also read a story recently - I must dig it out - where two trainees quit training posts because they wanted to get married (to each other) but it was so entirely impossible to find a day that they were both off that they had no choice but to quit. Working conditions are pointlessly bad - that sort of shit has nothing to do with demand and everything to do with a system that just treats staff as resources to be squeezed of every drop.

Now, for a PGCE qualification, students do need to show evidence of time spent in schools before applying. I think maybe something like this should exist for medics (if it doesn't ) as it's waste of tax payers money if they just leave so soon after qualifying.

No they don't, not anymore, the vast majority if not all no longer require the 2 weeks experience.

Issue is a) a lot changes in 5 years, just look at covid and inflation etc; b) getting onto medicine is highly competitive, applicants do realistically need some sort of relevant work experience as well as a lot of knowledge about being a doctor. Doing that when you apply is worlds away from 5 plus years down the line actually doing it.

I think its awful. They deserve more money and better conditions. Loads worked 72 hours during covid etc. If they had better conditions there wouldn't be the shortage. In n.ireland gp surgeries are closing down and it's near impossible to get an appointment. I know a few people har went to the private gp at £125 ad they can't get seen in the NHS

It’s the terrible conditions and work-life balance that causes people to leave medicine and teaching.

Those things have got worse due to a lack of funding.

It’s not a lack of resilience. People can be very resilient….but everyone has a limit and rightly so. The question is how unpleasant can doing your job be due to lack of resources for the service, before you decide you just can’t do it and don’t want to carry on?

Thinking about teachers, with a moderate salary which isn’t the key issue, how many years can people be expected to work 60+ hour weeks and struggle through days in a classroom beset with bad behaviour and consequences of significant learning difficulties without TA support, and fewer and fewer resources, plus abusive parents? Is it a lack of resilience to say after 5 years if it worsening, that you’ve had enough?

Everyone has a breaking point. As conditions get worse in these occupations, more people reach it. They knew it would be hard in these jobs….but they have got harder. People don’t seem to realise the consequences of funding cuts for the experience of doing the job. More people leave and those remaining have it even harder.

MRI scans, lifelong diabetes treatment, cancer treatment, maternity services, operations, occupational therapy equipment and physio, ambulance trips, inpatient admissions, free prescriptions. All for free. Yet people quibble over paying staff a fair wage.

Free? Get a grip. We pay TAX! We have paid 40% tax for years, equalling more than many people earn in a year.

The NHS ought to be investing in more IT services to be more efficient, cut red tape, cut middle -level execs, stop wasting money on supplies (pens, rubber gloves, etc) that are bought by each trust, instead of a national supply chain ( to get better deals), and so on.

They spend £millions on snail mail, when the private medical sector uses email and texts. The whole system is still in the 1950s.

There was a report in the press yesterday on how the NHS is not using technology. An algorithm by Lantrum is being trialled at Guys. It schedules appointments and staff. As a result , they have reduced agency staff from 16 to 11. Rolled out across the NHS it's estimated this could save £200M alone.

If you are a dr @Drstrike you ought to attack the NHS for its wastage, money spent on 'diversity schemes' and lack of drive to improve the service. That would release £billions to pay drs more.

I'm a B7 nurse fwiw

FY doctors do tend to be carried by the clinical team, which is fair enough - they are just starting their career and they develop quickly. They probably should make the same as a B6 but B6s are horrendously underpaid for the work they do, so it very quickly becomes a race to the bottom. It's hard to compare AFC pay with medical pay now because the pay freezes have made everything quite warped.

On the surface I'm not hugely worried about doctors pay because most of the consultants I know make incredible money with locum/private practice.. but then if we did pay doctors properly and had a more consistent and resilient health service the demand for private medicine would reduce, we'd have less medic vacancies and the NHS would save enormous amounts on locum fees.

We pay so much for locum doctors and agency nurses a decent payrise would pay for itself in a few years and mean we'd be able to run a decent service, but the government just isn't interested in a few years ahead.

I'm not jealous. I know her through DH who knows her from way back. There's been times when he's been there for her because she's got so stressed about money and given her lots of emotional (and financial support) on occasion. I'm kind of sick of being the 'bad guy' in saying sensible shit to her. I could really live without her in my life but she's a friend because she's important to DH.

Just this week he was sounding off about how tough she was finding it and how worried he was about her. As if it wasn't affecting everyone. I was half expecting DH to offer to help her out again (which we can't afford right now as our mortgage is about to go up). When she bought her current house it was beyond what we could afford at that point (has since changed), it's massive and needs a huge amount of work she can't cope with managing. But she wanted to live the lifestyle she dreamed of, so despite trying to gently say to her 'have you thought about the cost and practicalities of running the house' she did it anyway. She firmly in cloud cuckoo land - partly due to her upbringing. She just not remotely realistic not practical. And that's exhausting to deal with.

Then the postcard came through the door which has thoroughly pissed me off.

She is inept with financial decision making and her expectations are way off reality. She genuinely sees herself as poor. Thats the issue for me. She's not. She wants a lifestyle beyond her means and that's categorically different. It's living in a bubble where people who pay tax are 'other people' who should pay more - yet she's a higher rate tax payer.

DHs brother is also a doctor. So is SIL. The amount of 'keeping up with the Jones' type lifestyle expectations they come out with winds me up. It's the 'we only shop at Waitrose' mentality.

I couldn't give a fuck. It's the condescending attitude to lesser mortals whilst claiming poverty. I'm happy with what I have - it's the godlike doctor complex attitude I don't like.

Financially we are secure and I've no need to be jealous. It's the emotional labour involved in pointing out how actually doctors are not on the breadline or anywhere close to it but have certain lifestyle expectations.

I'd rather save my financial sympathies for carers thanks. The career progression doesn't really work out.

It's all about lifetime earnings v take home pay for me when talking about what doctors earn. Looking at annual figures early in a career in isolation really doesn't give a true reflection .

Why shouldn't doctors want to have a comfortable lifestyle? For a job like that seems reasonable to me. The fact so many are so resentful of NHS staff daring to ask for fair pay is perhaps indication time to wrap it up and people pay for what they use. I'm sure the NI they save a month will erm- well yeah cover a few apps at most.

That's not about pay though.

It's the conditions that should be worked on more than the salary imho.

THAT I have sympathy for, with regards to doctors

I certainly think that a newly qualified doctor should earn more than the starting salary you describe. I think that a newly qualified teacher should earn more than the starting salary and that it’s very unlikely that a teacher would earn the sums of money that, I’m told, consultants do. There’s a similarity in the working conditions in the sense that few teachers have time to eat a sandwich or go to the toilet during the day.

Like many things that are inequitable, I think MAT CEOs should be paid less and that a proportion of managers in the NHS are on salaries that would be better paid to clinicians. Many teachers will tell you that it’s the working conditions they struggle with and it seems to be the same for health care professionals.

In an ideal world, those we need for our health and well being and our education would be paid far more than someone who is a city banker or has a talent for kicking a football, or is an excellent actor.

But we don’t live in an ideal world and I think you do yourself no favours OP, by denigrating those who choose to earn a living by doing manual work or a job with less status. All these things are needed to hold the fabric of society together.

When you retire early with over a million pounds in your pension,paid for by the taxpayer,you may understand why folk find it reprehensible that drs consider striking. Those in the private sector,even high earners,are being forced to work until they are nearly 70 and even then can only dream of the sort of pension you will receive.

There is a reason you are called “ junior” doctors,qualified but not experienced,you are still learning which is why the death rate goes up at weekends when you cannot find a consultant for love nor money ( that I do sympathise with junior drs on)

As you go up the ladder your salary will skyrocket, there are many professions where skills must be perfected until they are lucrative,and yours will be.

My late father was a lifelong nhs doctor, he was and still would be ,absolutely disgusted at the idea of drs striking. He managed to support a wife and two children,though in poverty, as a junior doctor. My two older brothers were born whilst he was still in medical school, he raised four kids ,money was always tight and he was a consultant psychiatrist who did not work privately . His pension was nothing like that which drs get today,nor was his income, but he considered himself well off .

To cap it off, my father was disabled through polio at the age of ten, he walked with a limp very much like Ian Dury and he managed to complete the gruelling task of getting through the “ junior “ years.

So you want sympathy,try earning peoples respect by doing as your predecessors did, who did not get the same rewards you are inline for.

How is it "denigrating" to say a doctor should earn more than a binman?

Honestly the UK is fucked.

There will be money for front line staff is the NHS was willing to change and there is no sign of that.

They need to focus on more preventative strategies.
Obesity is an epidemic costing billions. It's not being tackled radically enough.

The ethos of the NHS is make sick people better, not prevent illness in the first place.

There is a complete lack of efficiency, they don't use IT in the way that companies like Tesco do.

They don't manage buying properly and waste millions.. It's not that long ago patients were being given free paracetamol FGS!

Really, it's shambles, presided over by too many execs who are useless.

Mature med student. I haven't read the full discussion but whilst I 100% agree with the junior drs' strikes, I don't think this OP sets out the main arguments well by leading with FY salary and student loans. As a graduate salary in the public sector I think FY pay is not shockingly low at all (although of course i would like more!). As a PP says- who is it roughly in line with in the NHS and what's their level of responsibility, experience and clinical expertise? Band 6 nurses, paramedics, physios for instance.

The FYs I work with in my part time NHS job, whilst being enormously capable and highly educated people, are quite a burden on seniors at least at the start in terms of needing supervision and support (understandable and important that they don't try and work above their level of experience) because they haven't worked independently much and are just really starting to piece their learning together.

Student loan, well, what is the OP positing as an alternative? Free training for doctors? It's a lot, yes, but what's the average student loan in other subjects if one takes the full maintenance and fees amounts? It's a huge investment for the NHS to train a doctor and a prestigious and well paid career eventually. Also there is over representation from students from well off backgrounds rather than there genuinely being equal opportunities for every background to access medicine. A lot on my course are open about wanting to emigrate to Canada or Aus as soon as humanly possible so the NHS won't get any return on that investment in a lot of cases. So I'm not sure why doctors' student loans shouldn't reflect their full course.

Another point in terms of pay is how much private work doctors often pick up should they wish later in their careers. Many other professions don't have this option and I suppose it isn't factored into NHS salary reporting but it does really add up to a well paid job.

The main points as I see it are more to do with conditions, hours including study time and some being pushed to work outside their capability leading to mistakes and near misses. Staffing issues elsewhere adds to this, work life balance, burnout, and honestly, bullying in the form of being treated like shit by consultants when making a good faith attempt to learn the trade.

Please stop the melodrama- a 22 yr old is not the only doctor on call in the hospital making decisions - that is blatant lies.

It has been a hard few years and everyone in the nhs is demoralised. Working nights is part of the job like many jobs but overall working conditions are no horrendous. What is the worst part is everyone moaning about how hard it is and feeling hard done by.
an 18k pay rise will see juniors earning the same as consultants - so we then do not value experience and responsibility. Might as well stay as a junior doctor then.

But if you look at lifetime earnings, you assume someone makes it to the later stages of the career.

People are dropping out because pay and conditions matter in the early stages too. People have to live in their 20s and 30s. They need to build relationships then, but increasingly feel they have zero life work balance. There is always an element of deferred reward, but that can’t be to the extent that life now is totally totally miserable and unsustainable.

People are so grudging. I don’t know why that is when we all need doctors and teachers and other public sector services which seem to be held in contempt.

@Drstrike I notice you are picking away at various points, but not engaging that the business model of the NHS is fucked.

More money for doctors is there is so much wasn't wasted on so many other aspects of the NHS.

Blame the TRUSTS for not adopting more efficient working practices and getting rid of execs being paid £200K and not getting improved results each year.

It doesn't shock me no

Im well aware if their basic starting salary for their 2 trainee years.

I think it should be more.

But many do earn more with locum shifts, enhanced hours etc and their earning potential is huge.

Their workload is horrendous though.

But of all the concerns I have about the NHS doctors pay isn't anywhere near the top of the list

Most doctors come from privileged backgrounds; so zero sympathy here.