How much do you think junior doctors should be paid per hour

[Jill688]

you are being unreasonable - they should be paid £14/hr

you are not being unreasonable - they should be paid more

Yep, and then we despair that we can’t get the care we’d like….

They should change the name and grade their pay. I know one he's thirty, two children. His wife earned more. He's done all the exams for a consultancy position is looking for an opening

You sound rather unprogressive and I suspect you no longer work in the NHS or are past retirement age.

They are not striking for a payrise, they are striking for pay restoration.

Are junior Dr worth less now than they were previously ?

Also….. Consultants are also being balloted for strike action.

amp.theguardian.com/society/2015/nov/13/hundreds-consultants-jeremy-hunt-support-junior-doctors-back-strike

Good that some that have reached the top support the others.

@HoppingPavlova

I’m assuming you’re a senior in a surgical specialty or anaesthetics? Because you talk about practical skills needing to be learnt and so must mean operating or anaesthesia or cath lab or similar. Uk trained F1s should be competent in all day to day ward practical skills like ivs and ecgs as part of graduating medical school and it would be worrying if they are not and something you should be easing higher. (international grads are not always competent in this stuff because it’s not taught in all international curriculums as I am sure you are aware, but we shouldn’t be claiming uk fy1s don’t have practical expertise just because we are so short of doctors we have to import ones from aboard)

with regard to your comments that all juniors have a lot to learn- are you counting the less junior juniors in this? What wonderful hospital do you work in that has consultants in doing appendix operations or c sections at 2am becuase I’d like to apply to work there!

Btw before this strike week i haven’t seen a consultant where I work as a medical junior for three weeks before they and when I did it was because they wanted me to find something on the electronic records system they didn’t understand. I’m a GP trainee so still a junior-ish junior. I accept I have stuff still to learn about being a GP but don’t think I have much left to learn about being an SHO level doctor in this job. When it comes down to my day to day job which is 100% service provision and no training I’m confident to say I’m competent to undertake it independently- which is what I do after all. I am not being trained by anyone and don’t see why I should be paid an apprenticeship wage when no one is supervising or teaching me.

it’s not just this job- as a psychiatry junior doctor working in an inpatient psychiatric hospital I was expected to provide the medical health care for the 25 elderly inpatients on the ward. The psychiatry consultant was present for half a day a week and informed me they would defer to my option on all medical matters as they had trained outside the uk where psychiatrists did not undertake any physical health training past medical school. I did learn some stuff about old age psychiatry from them as they were very good at this but I certainly was not being supervised or trained in medical healthcare.

the job before this I was the Gynaecology SHO. I was the only doctor on the emergency Gynae clinic from 5pm-9am and all weekend. I would see all referrals and make independent decisions on who to admit and discharge. I would order and interpret the ultrasound scans and blood tests and counsel, consent and prescribe the medical management of miscarriage for these poor ladies, I would also examine (with chaperone) and remove foreign bodies or products as needed . I was taught this admittedly on my first day by another more senior junior (Gynae st3) in the old see one- do one - teach one method (and I of course already knew how to do a speculum and internal exam from medical school as it’s a core competency needed for graduation) If a patient needed theatre then and there it was an ST3 trainee I called and we would then operate together and I also was her sole assistant for c sections. I never saw a consultant in the emergency Gynae clinic - they were on the labour ward in hours, undertaking clinics and performing complex surgeries of course. I’m not claiming to know all there is to know about obstetrics and gynaecology in fact I only know a tiny bit but I am/was competent to do my job as a Gynae sho and did not receive any consultant input into learning to do so. I did assist a lovely consultant to undertake the elective c sections list a few times so I suppose i was being “trained” then but as I’m training to be a GP I’m not sure that’s a skill I have any need of knowing!

Maybe back in the old days when doctors worked in teams with consultants and juniors there was some apprenticeship model learning going on but now days the consultants do clinics and fancy surgeries juniors are not permitted to attend because of “service pressures” and juniors run inpatient medical care and emergencies out of hours. The fact that the outpatient clinics and non urgent operations have all been cancelled so that the consultants are able to work on the wards and admissions units during the strikes shows that the juniors are undertaking patient safety critical work. After all If we were all just standing about watching the consultants do everything as we’re “just learning” then there wouldn’t have been any need for the consultants to come and do our roles on strike days. Yes junior doctors do not know how to the fancy stuff yet but they are independently performing safety critical roles, and not receiving any training in the fancy stuff to make up for the fact their not paid a wage that reflects this

(this probably reads as an attack on consultants - it’s not intended to be one. They are highly trained professionals who generally undertake very necessary specialist clinics and perform complex surgeries and other fancy procedures. But in the UK we have ended up with a healthcare model where the consultants do much of the outpatient and elective care and the juniors do the emergency and inpatient care. )

We’d be stuffed without them as extra hands but equally they are frustrating to train as their knowledge is pretty low and it’s really learning in the job with a steep curve.
Let's ignore how offensive this remark is and focus on the substance (or lack thereof). Presumably you're an end-of-career or retired consultant or GP. How much has medical science advanced in your career? Back when the BNF could have been copied out on a few sheets of A4? When cheese and onion covered everything a houseman needed to know and was what, 150 pages? When the treatment for an MI was an aspirin, a cup of tea, and crossing your fingers?

You've presumably specialised in something, and had a career learning it and keeping up to date with the developments in it. But your juniors are feckless because they don't know your specialty in the depth you do because they've spent five years learning yours and everyone else's, and then carry on rotating through various jobs. Seems a bit odd and entirely devoid of insight to me.

Yes, they pull (or should pull, but they are trying to dodge this) enormous hours but this is their only learning opportunity essentially.
Sorry, when have junior doctors tried to dodge the working hours? The new deal (which was negotiated when I was about five years old, I believe) was to bring the profession into compliance with the European working time directive and many of us are expected to opt out regardless. My work schedule states my rostered hourly average is 48 hours. I frequently work 72 hour weeks, and I never leave on time.

I'm sick and tired of old-school GPs bleating on about how bad they had it with their hundred hour weeks as the houseman and we're all so soft, while conveniently forgetting to mention that when they were on-call they were expected to sleep in their rooms and be woken up only by the sister infrequently. Medical science has advanced, the population is older and sicker - and the intensity for juniors has too. Management have decided the nurses can't use their professional initiative any more and must bleep us for everything so we now spend our lives on-call running around desperately trying to firefight.

And if the ward is our only learning, why am I saving for thousands of pounds in fees to start taking the MRCP next year?

Back in the day 6-7 Juniors would have piled into a 3 bed rental on the basis they would only need a bed once every few days for a few hours and would never be ‘at home’, and if so most others would be out so ‘musical beds’.
If this was ever true (giving strong Monty Python's Four Yorkshiremen vibes), it would be a breach of every tenancy agreement now and the landlord would probably be breaking the law around HMOs. And there's one key thing you've forgotten to mention - your generation had free (as a house officer) or subsidised hospital accomodation on-site and free meals provided 24/7. I can't even buy a £5 sandwich out of hours now. You could buy a house as you finished as an SHO - good like finding an SHO who can do that now without help from their parents.

So what was the house you rented with it's 'musical beds' for? A break away from the hospital? But we don't deserve that, according to you.

Now Juniors blather on about having to rent a north facing flat for one as essential to ‘decompress’
Yes, we need to decompress from work. You might have missed it but much of the last three years have been rather focused on something called COVID, and the system is collapsing around us because of underfunding and a demographic bomb as the boomers are becoming increasingly frail and unwell.

You can harken back to the 'good old days' all you like. Some of our consultants bought coffee to the picket line, and they really didn't enjoy being on-call on Monday night as much as they thought you would. What else in our profession's "fine" history would you like to bring back - lobotomies for troublesome housewives? Blood-letting?

Don't worry, we're all back at work tomorrow so you can get back to screaming at your talentless, procedurally weak post-nights FY1 on the post-take ward round for not ordering the serum rhubarb when they clerked the twelfth patient of their fourth night shift in.

What "dues" do you think are owed by us to the public exactly? What value do we owe you, and how have you calculated the cost? What interest is payable? What rate is it paid off at? What happens if someone can't work as a doctor any more due to their health? What happens if they leave the country? What happens if they go and volunteer for a charity? Do we commit to paying the same to the countries who we poach junior doctors from?

What about nurses who go on to train to be doctors? Do they owe you twice? Are they to work into their 90s to pay this back, or do you propose just taking it from their children instead?

I accept medicine likely costs the taxpayer more than the £36k my tuition fees were, but how much more? Lets not forget, I owe over £80k for my education, which is looking like it will grow to somewhere in the region of £250k before it's written off as I won't pay it off with my salary as it is in the next 30 years. If you're wondering why I don't feel I owe you anything perhaps start there.

There's a reason the only Tory talking rubbish like this is 30p Lee. In short, it is because you're proposing 16 year olds sign up for some form of regressive indentured servitude.

@juniordoctor you've misunderstood the phrase I fear. 'Paying your dues' doesn't meant you owe the public, it means doing the grunt work and working your way up the ladder within an internal system, as opposed to walking in on day one thinking you can run the place. I'm not speaking as a member of the public, I'm speaking as a fellow HCP. This is not all FY1s, but I see it in most juniors in my own profession. We've had medical students rocking up to meet the consultant prior to their placement in trackies. There just seems to be a lack of professionalism and respect among some young trainees.

We’re talking about junior doctors here not med students. I don’t think that junior doctors should be paid a low wage because some unrelated undergraduate teen once turned up PRIOR to starting placement in a tracksuit.

With regards to the lack of deference I think your putting effect before cause - have you considered that the fact that juniors don’t want to do the grunt work because there no longer being paid a decent wage to do it. Back in the day junior doctors earnt 26% more than they do now per hour so maybe they were more happy to get on with the job as they were being paid more to do it.

Add in that the justification for the low wages juniors get is because we’re apparently being trained but no training ever materialises - yes if a senior tells me I once more can’t have my study leave to actually go to the teaching I’m supposed to go to because of “service needs” I’m probably going to be less than impressed. The low wage is justified because apparently we’re being trained - except we’re not being trained so the wage isn’t justified.

Finally juniors know they have to because there are just too many well publicised cases of seniors throwing juniors under the bus if something goes wrong and the fact that all of the evidence shows that flattened hierarchies have better patient safety outcomes. I know if I see something not being done right I’m supposed to speak up not get on with it because a more senior person told me to. As a HCP I’m sure you’re aware that the evidence all shows that encouraging juniors of all healthcare professions to speak up leads to less adverse patient outcomes. I’ve been a student and junior through an awful lots of healthcare scandals from mid staffs to okendon. When you know the department you work in is currently being investigated for multiple cases of negligence you tend not to value the integrity and knowledge of the people running that department.

(with regards to the undergrad student I would suggest that if not in a patient facing role they (teen with no money) can turn up in any clothing they like as long as it’s clean and decent. I assume when they actually started the placement they were in office clothes or scrubs? Other HCP students get uniforms provided - medical students have to buy their own work approved clothing which when you are in debt and unwaged and not from a background where you have a load of suits your parents bought you it’s a bit expensive to have to buy a suit when your not even going to see a patient)

@Qazwsxefv you're proving my point beautifully. No it is not okay to turn up to a professional meeting with your soon-to-be boss in trackies, this is basic! And they stoated onto the ward like this, so yes patients saw them. Also other HCP students do NOT all get uniforms provided, I have always had to buy my own work clothes (student or qualified) as we're not uniformed. Even when covid hit I had to buy my own scrubs as it was suggested we wear those for infection control. And come on, a pair of black trousers and a shirt can cost £20 from Asda, nobody's insisting on suits. And you don't have to be 'unwaged', what's wrong with having a part time job? I know plenty of med students who were at uni the same time as me who could work a Saturday job so don't be giving it 'we're too busy studying'.

True for some specialities. But try being a consultant in paediatrics in a small DGH. It's not unusual at all to be in most of the night, having been working the day before, and still be expected to work the day after. And it isn't just being called in because of the acuity of the patients: it isn't that unusual to be called in for a cannula! Some specialities are still relatively consultant led, if not consultant delivered. Which is very clearly part of our job, and how our "juniors" learn.

For the record, I support the strike, and have donated to the strike fund. We have to improve pay and conditions to stem the exodus to other countries of much needed and valuable medical professionals. Though I can't help but think that drastically reducing the crappy portfolio requirements would be one way to improve morale that wouldn't cost much!

Wow essentially unskilled labour hey. Gee that's so weird - I must have hallucinated the fact that junior doctors are the ones who look after hundreds of patients overnight in a hospital and make medical decisions autonomously. I also must have hallucinated all the surgical lists performed by junior doctors on their own, without a consultant physically present. Not to mention all the clinic patients that junior doctors see, assess, and make clinical decisions regarding.

Terrifying that all of this is being done by "unskilled labor". It's almost as if this is literal lies made up by someone who has no idea what they are talking about.

Will the medical profession be happy that the £1000,000 limiting pension pots has been removed? I am sure the public are sympathetic with this dilemma? The limit certainly makes nurses, HCAs and porters relieved about their regiment plans.......(little.hint of sarcasm)

Medics moving to other countries so a 120K ultimate salary can be replaced by 200K and the public are meant to sympathise with the 'brain drain'?.Does anyone have an idea of average earnings in the UK? Why are medics moving if not for what would it in a lot of people's opinions be astronomical salries?

So one student turned up in unprofessional clothing, therefore all medics are unprofessional?

Medical students can struggle with part time jobs, particularly later in the course. Most part time employers don't really appreciate people disappearing for weeks or months at time for rotations in different towns.

I voted yanbu but I do think it's unreasonable for junior doctors to talk about an hourly wage as if they were paid per hour. they are in the early stages of a very important profession, they should be putting in plenty of hours, but they should be getting better support in that, with the extra hours being spent genuinely learning from more experienced professionals, not the reality of being left flying virtually solo (with an F2 somewhere in the building theoretically "supervising" but not actually) - extra hours ought to be spent building the experience needed to become experts in their field, and there's loads of professions where the early-years juniors have to put in 60+ hour weeks if they want to be the best and be raking in the 6 figure salaries 10 years later. instead, the extra hours are being spent propping up seriously understaffed and underfunded hospitals, it doesn't give an F1 any useful career-enhancing experience to just do more and more hours without real support.

An F1 starting salary should certainly be over £30kpa though.

"Junior Doctor" makes me think of child doctors like Doogie Howser MD. They should be asking for a job title change if they want people to take them seriously.

I literally said in my previous post 'This is not all FY1s, but I see it in most juniors in my own profession'. It is a bigger issue now than it used to be though.

Socrates, 4th century BCE: "The children now love luxury; they have bad manners, contempt for authority; they show disrespect for elders and love chatter in place of exercise. Children are now tyrants, not the servants of their households. They no longer rise when elders enter the room. They contradict their parents, chatter before company, gobble up dainties at the table, cross their legs, and tyrannize their teachers."

What is considered "good manners" changes with each generation.

Erm no, a pret manager earns slightly more and that is the limit of their earnings. Its complete bollocks to compare that to someone just starting out in their career after university whose earning potential will just go up and up and up.

Nobody uses that term who I work amongst junior doctor what is that? Amongst my colleagues they are know as the on call doctor if we need to bleep them or the SHO. Perhaps some don't realise it doesn't matter how junior they are or not they are the doctor making the decisions. The nurses go to then to escalate NOT the other way round!

I doubt you ve been anywhere near a Hospital as a HCP.

Just spouting the normal anti nurse/ahp and now junior Doctor crap to denigrate, insult, to promote the Governments pov that these essential workers aren't worth a penny extra & are actually a drain on the NHS, as Coffey put it "dont like it leave, we'll get some overseas workers"

Or as one NHS manager once told me "This place (Hospital) would run just fine if we didn't have all these troublesome staff"

Medics have gotten used to the sort of work life very few people would accept.

You work hard for 6 years, pass your exams and then are randomly allocated a job ANYWHERE in the uk. It doesn’t matter where your family are, it doesn’t matter if you have young children and need family support. These factors are not even considered.

You are given a 2 year job absolutely anywhere in the uk and you take it or you don’t work as a doctor. You are then given 6 jobs in 2 years with little or no induction to any. You are expected to learn multiple new computer systems, job plans with little or no support. While you do this you are paid poorly, working 80 hours per week. You work bank holidays, weekends, night shift. You miss family weddings. If you’re REALLY lucky you may even get rota’d to work YOUR OWN WEDDING day. Because “it’s a night shift… surely you get married earlier in the day?”

You work 13 hour shifts with no toilet breaks. I once gave myself pyelonephritis from not urinating. I was septic and needed intravenous antibiotics, I took 3 days off work and was hassled the entire time when I would be back as the oncall rota was so short.

You get almost no training. Most of the work is pure service provision to prop up the nhs which under staffed and under resourced. You are supposed to get teaching, this is cancelled due to “busy wards”. You have to pay £1000s for your own exams, without which you cannot progress. In order to specialty train you must move around the country.

You handover sat on broken bins, have no food available out of hours and nowhere to rest.

in 2016 junior doctors striked for better working conditions.
what happened? Nothing good. Conditions worsened as did our pay
what have we learnt? Conditions WILL not be improved

why do people go abroad?

you’re paid for EXTRA work you do
you have training
you have somewhere to sit
you’re treated like a human being
you’re paid fairly
people respect you

it isn’t all about pay. But when you leave your children 80 hours a week to work like this, and have paid your £1500 per month childcare bill (or maybe £3000 for 2 children) as you live nowhere near family for help, it’s nice to be able to afford somewhere to live