Are junior docs really only on £14.09 per hour?

[yawningmorning]

That is so low.

I've seen the headline that you can earn more per hour working in pret.

No wonder they are striking.

Ignored pensions and other good benefits too!

It's low but it doesn't stay low for too long. Although the student loan is effectively a pay cut. If I was a junior doctor I would be more concerned about the horrendous hours and like everyone else the horrendous price of housing

You deserve a ride

A rise ! A big rise . So much respect for female trainees particularly

@Carriemac Thank you.

The irony is that this strike isn't actually asking for a rise. It is asking for a restoration to what doctors , the majority of whom are consultants today, got paid as a "junior doctor" in 2008. It would of course make a difference to have our debts taken away , almost feels like a penalty for choosing this career / not being from a well off background. Or had our accommodation covered. We're not talking fancy state of the art city pads - sure some people might live like this but those aren't the ones affected by the pay erosion in the first place as much as those of us providing just as good a service but having to split our families up to continue. In 2008, F1 doctors were given free accommodation. Not many people would take up free on site accomodation even if it was offered today - who wants to live like that in your 30s/40s and beyond? It's easier at F1 when it almost feels like an extension of the 6 years at university.

Something else that many dont talk about but thankfully I have seen a few videos on social media of late, is, fertility. While we're thrown around the country in our prime child-bearing ages our ability/chances to meet a partner and/or progress that relationship with this sort of lifestyle before even considering starting a family.. meanwhile our fertility is obviously declining. We wait for NHS services as a patient just the same as anyone else. Yes we might be delivering urgent care but are on the same several year waiting list as a patient whether that is for fertility services or otherwise. Yet we move around and again start from the bottom.

The issues affecting everyone else affects us too, but possible harder, because of the complex working conditions involved. Pay restoration could go some way in making things better.

so you think they should be paid the same as a leisure attendant or supermarket worker? I wonder if you will feel the same in the event that you need life saving treatment and there aren't any medics to treat you so u sit on a corridor for hours. Oh wait!! Isn't that what is happening now???

DH and I wouldnt have to houseshare (yes we are both 30something and to keep costs as low as possible, share with others in a flat/house close to each of our hospitals). Neither of us imagined this to happen at this age. Our quality of life would be better if we didnt have to do this, even if just 1 of us)

I was talking to a UK trained ED registrar (so still a junior doctor) who now works where I live (hot part of Australia) and he was marvelling about how he could now afford to rent a place by himself so when he finished a night shift he could actually sleep during the day. He was also in his 30s.

He was also delighted about actually having free time to go surfing 😀

Off topic for this thread but I would be interested to see your sources for this. It is certainly mot my experience and I have decades of teaching under my belt.

It's not hard to understand. But it's illogical to say on one hand that vast numbers of NHS doctors are fleeing the UK to fill jobs in Oz when everyone there is working regular 40 hour weeks.

In the private sector, large numbers of jobs open up when organisations require resource to manage an overflow of work i.e. when current staff cannot deliver without working over their contracted hours on a regular basis.

So when it's claimed that an entire health service in Oz works regular hours but is able to absorb the flood of NHS doctors it just sounds odd, especially when you factor in home grown doctors and immigrants from other countries. Oz has a small population, over 50% smaller than the UK.

I wasn't arguing the point but just that the numbers don't make much sense. Although looking it up it's actually relatively low and into the hundreds, which seems more feasible. Obviously it's undesirable for us but is less dramatic than the press and some make out when we have over 70,000 junior doctors in the UK.

I've said previously that the NHS management are rubbish. You absolutely have my sympathies on this as I've no doubt they're pushing the limits of legal working time directives. I personally wouldn't stand for it but thankfully my industry isn't one for flogging it's staff to death. Like you, I need my brain to do my work and whilst I've done it, don't quite understand how it's possible to maintain lucidity and sharpness over 50 hours/week. This absolutely needs to change for the good of the country (and you obviously).

@SamanthaCaine

Just wanted to make a quick note re: influx into Aus. This is obviously anecdotal but in my experience of medical school, early years of junior doctoring and till date.. most people we have known to emigrate to Australia have been white British, perhaps the weather is attractive? similar cultures? /similar healthcare systems.. attractive destination to visit and or work for a short period of time (then they dont return).

But also wanted to say that a lot of the current NHS medical workforce AND medical students are not from the UK. Either they have heritage abroad but raised here or are properly new to the UK for studying/working. A lot of these guys can speak more languages than English and "go home". A close friend went back to the middle east as her parents were getting older (she speaks arabic) and never came back after hearing our accounts of foundation training. Another went to Malaysia (is Malaysian) after foundation, isnt returning and has already bought a flat there.

So we dont all go to Australia, I think that seems the most attractive if you have no links/roots to elsewhere. But people certainly do go back "home" or alternative English speaking (or whichever language they can speak) countries. Some leave the profession altogether. They were sold a lie, "go study in the UK, become a doctor" etc, this is a narrative in many countries abroad, its almost looked up to as what the brightest kids do and have the brightest futures. Most of my colleagues are immensely smart and would thrive in any work environment.

@23jds

Thanks. I guess I also neglected that Australians are travellers too and emigrate to various destinations.

I think the most frustrating and mind boggling thing for us public sector folks is that the solution seems relatively straightforward but that noone has any interest in solving it.

But I wonder if it's because the solution might well take longer than 4 years and no government is willing to start something that they'll never finish.

But more to your point, we have millions of foreign students here in all areas. Huge numbers only come for education because our qualifications are still highly valued and they can improve their English. Irony how this is the case but our public services are falling apart.

Our education system makes billions from foreign students from secondary to PhD and beyond.

Regards to the diverse NHS staff though, I did also wonder what percentage of the thousands leaving were natural leavers i.e. non British going home or traveling, and not necessarily disgruntled. But again, it's down to the management to analyse the attrition rate and address those who are leaving because they're disgruntled.

@SamanthaCaine

I think its probably multifactorial. Firstly as a side note, medical school and the medical workforce is really diverse, including many "white British" doctors with stereotypical British names are commonly have more than solely British heritage. Anyway, to address your point - I think many overseas doctors who emigrated here are predominantly economic migrants (not many Aus/American Drs about, mostly are from developing countries). The UK is not that attractive anymore. I'd be curious to see actual numbers but from speaking to senior colleagues from the Asian subcontinent and Africa - healthcare has evolved elsewhere, why come to the UK where its cold, no family, different culture and the pay and quality of life really isnt great? They're especially surprised at how poor our emergency care is, waiting hours/sometimes over a day for an ambulance to come out to you only to then wait for hours in a corridor in ED (if you've even survived the wait for an ambulance). So, they're not coming as much because 1) we are a lot "worse" then we used to be and 2) their home is "better"/developing or 3) Other developed countries are a lot more appealing. When they do come, they often are recruited at a junior level, come for the experience and don't renew their contract after a year or two because they haven't liked it enough to stay. Of course there is getting used to a new culture and hate to say it but racism exists. Can't help but notice most people in senior positions are White British, it must be harder to progress in this system as an overseas Dr, a lot of these guys (but some UK trained drs too) are forever "junior drs".

Again anecdotal, but recently heard of (and seen photos) a colleague who's close family member has left for work (hospital dr) in a Southeast asian country and as part of the contract they have a lovely house with a swimming pool and funded private education for up to 4 children. I have no idea what the UK was like years ago (I imagine probably provided basic on-site hospital accomodation to Drs and their families. I lived in one of these shared rooms in my 1st year of being a dr - it was an old building, very basic and miserable as felt like I was 24/7 at work.. I kind of was) but obviously I don't think we can offer that now but it's a no brainer that they'd chose those options.

Then theres the UK drs who are just fed up of this system, some go for a change to work abroad (and all that I know of have not come back). I think a lot more of us are leaving - travelling is so much easier now than 20, 50 or 100 years ago. We are now the economic migrants because working conditions in the UK as a dr is really not that great, especially compared to many places abroad. We all know people that have left, as the years go by, I know of more and more. I also know they enjoy it elsewhere, get paid more and have firmly chosen not to come back. I havent visited anyone like this yet (but have friends scattered round Australia). I havent managed the time off! Also, I think where I am in my training, it makes a lot more sense to try to get through it, "CCT" and consider working abroad as a consultant. I should mention, a LOT of people do something called a fellowship prior to taking up a permanent consultant post. These fellowships can be anywhere - I know people that go to London for example but many go abroad. It is seen as a positive thing to do. Often though, when you get a taste of something that's better than the UK, its very tempting not to come back. Particularly if you've no family/social ties.

When I first started in the NHS there was cheap accommodation onsite which was fine for people staying locally when on rotations. I stayed in 3/4 different homes and they had onsite facilities, one place had a great social club, you could get meals from the canteen at a reduced rate and parking was free. Uniform was laundered and returned. I think getting rid of these things has made a difference and having these things lot of people coped better with demands of the job. Sold off for housing now so that is never going to return.

And you used to get some element of choice about where you went to work as well.

I loved my F1 year. I didn’t have a family at that point as loved living and working with the other f1s at a tiny rural hospital. We all lived in halls like accommodation (not free but cheap) and got free parking and subsided meals (and was paid 26% in real terms more than the current lot are paid). I picked a small rural place because I was poor and wanted to live on site for cheap and applied for that place and several like it via the national application system which at that point was a series of set application questions. It wasn’t perfect but you did get the feeling that of you wrote your application well you might get what you wanted.

But apparently reading applications was too time intensive for the totally not important business of employing doctors then they moved to a multiple choice national exam that asks questions about feelings. F1s express a vague regional preference- like “wales” or “London” and as London is more popular than wales the doctors that score higher get London (and get paid more). It’s kind of like a mix of UCAS points and applying for primary schools. It’s hated by doctors as they don’t really get any say in where they go (your poor and don’t have much family and so want to work in a small rural hospital with (not free) accommodation and good social support - nah you’ve got a massive inner city teaching hospital with no accommodation where your gonna be one amongst hundreds but there was some feeling that at least if you did well in an exam you might get near what you want.

It’s also hated by the workforce planners because they end up with too many doctors in London and not enough in wales or Lincolnshire. So it’s being changed…..to a random allocation system - forget the UCAS points it’s going to be just like primary school applications. Yup what F1 doctor you get working in your hospital next august has been sent there by a computer algorithm. Doesn’t matter if that new potentially pregnant doctor currently owns a flat in Bristol with her husband and she might get northern Scotland. You in theory can apply for special circumstances if you have children who can’t move or are a carer for a disabled relative who can’t move or are yourself unwell. But there are many stories of this being ignored and pregnancy doesn’t count the kid has to be here by the time of application - doctors on dialysis being sent far away from an area with a renal unit, being told because the kids aren’t school age yet it’s ok to move them up and down the country every four months. We value f1 doctors lives and person hood so little that they are just numbers to be allocated on a system for £14.09/hr. I may be wrong but what other profession (other than the military- and they do a least provide (substandard) accommodation and provision for trailing families) sends its junior staff to live somewhere entirely new and random that they had no choice in every four months for two years (the only provision made is you can apply for £500 to help with removal costs)

@Qazwsxefv This actually made me feel a bit emotional. Is that true - F1s now have absolutely no choice AT ALL and its all an algorithm?

I experienced something not dissimilar from yourself. Applied to a smallish rural hospital, undersubscribed area and lived with other F1s. The accommodation was a bit crappy and I did feel like I could never get away from work but enjoyed the communal/camaraderie element of living with other F1s. It was an absolute baptism of fire. No friends or family in the area, working 12 hour+ night shifts being the first doctor to arrive at a cardiac arrest etc. It helped being able to talk to other F1s over breakfast, or indeed talk about the patients as often they'd also been involved in their career on the night shifts prior to mine starting.

What this did mean however was that my husband and I were separated by the national application system. He was on the other side of the country working in A&E on a 1 in 2 weekend rota. We went weeks and months without seeing eachother. It was miserable. Work was tough and having your support system removed from you made it so so hard. Many of my colleagues relationships broke down. I'm not surprised. We tried for a transfer on the basis of being married, to no joy. Was even told being pregnant was not enough of a reason for transfer eligibility - you need a live child. Only, I was barely surviving living under these circumstances, I absolutely do not think I would have been able to bring a child into the world and cope with that life.

As it happened, even when our circumstances meant we were "eligible" for a transfer, there was no job available for the other in their speciality. Also, the more senior you level you get to, the harder it is to get a training post. The options seem like: potentially live together or at least closer but possible forever be a "junior doctor" or if you do well enough to secure a training number odds are it is likely to be geographically a nightmare. We chose the latter. It is a nightmare. Who actually wants to live like this? No matter how much you like your job, who actually prefers it to their family life? Nobody.

When kids make the decision to apply for a career in medicine, they often don't think about meeting their spouse/wanting to start a family etc. You can't live like a student in shared accom forever, you cant be thrown around forever, you can't keep moving your children out of schools. The lifestyle element of it alone should surely be reimbursed. Of course being paid better or at the very least restored to 2008 would make life marginally better.

When people compare it to nurses or teachers etc - correct me if I'm wrong but nobody else's life is this chaotic? As patients you might notice, in your local hospital - the nurses are usually local. As are all the other allied healthcare staff. Doctors very rarely are (and if they are, theyre usually permanent consultants or staff grades not drs in training). Imagine the chaos it would cause if nurses, teachers etc were all sent all over the country? ...