Junior doctors

[IamSuperTired]

Before people suggest it, I'm not intending to bash junior doctors. They work incredibly hard in a massively under funded NHS. I was also surprised recently to hear they earn less than I thought.

I am posting to ask if anyone knows how long it takes to go from junior doctor to a more senior level where the pay is better? And what's the career path from medical degree to the grade above junior doc?

I ask because other professions, even in healthcare, also get paid pretty poorly at the lower grades but tolerate it because they will eventually reach v large salaries. Eg. Psychologists do their degree, then usually MSc, then often have to work in band 4 jobs for 3 or 4 years to gain the pre-requisite experience, before moving onto another 3 years doctorate level training (is this equivalent to junior doc?) paid at band 6. So in total it takes them (on average) about 8 years before they reach band 7 NHS wage. Other professions are similar.

I'm asking because I'm trying to work out whether the pay is a little unfair or a lot unfair! Given potential future earnings and when they might be reaped! Just trying to educate myself really. Not sure what the AIBU is :) sorry!

I made this " informed choice " when I was 17. I was living at home with my parents. I didn't have any responsibilities other than my school work.

Twenty years after that decision, I am still a junior doctor. I have kids and a partner to consider. People can't imagine what having kids is like before they do it - medicine is a lot like that.

And yes, they can make informed decisions. People with a very high academic aptitude have a LOT of options. Shouldn't we be encouraging capable students to do medicine?

Bloody hell, some of your teenagers must be so much brighter than mine, or else Mystic Meg to know how shit things can turn out. Just listen to yourself, taking to task teenagers and not politicians.

Thanks all.

This has been a really helpful thread. It sounds like the term "junior" doctor does need an overhaul. I didn't realise you could be a "junior" doctor for 15 yrs!

The pay is less than I thought, and I definitely now don't get why psychiatry speciality docs get paid so much more than say, A&E doctors.

I'm still a little conflicted in all this. On the one hand it feels like for all the qualifications and training and stress of the job etc... the pay should be more. But on the other hand I think, well, people know the pay (or should) and training route before starting out, so if they didn't fancy it, they should have studied something else.

I guess the main issue is whether docs are leaving to go private, which I expect many are. Thus the NHS needs to find a level of pay that will retain docs and help them feel supported enough not to be tempted out of the NHS by the private sector.

This is a thread about doctors.

Agree about changing the term.

Mostly because they are using the "junior" bit to justify low pay.

Jealousy and pettiness

@Purplewind yes I know.

My point was that their pay goes up quickly.

In all other jobs, total package is considered. Do salary + benefits (private medical, pension, car allowance etc).

Junior doctors only want to talk about their take home pay now.

If private sector workers deducted the equivalent contribution needed to make up a final salary pension then they would easily be halving their take home pay.

If public sector workers want more pay now, they could opt out of the final salary pension scheme into a defined contribution one.

35% payrise is only going to fuel inflation. It wouldn't stop at "junior" doctor, the increase will go all the way up the ranks. Maybe not at 35% but at a chunk of that

Not really and their debt is far more. Plus they do a different job to nurses.

I tend to think it doesn't really matter whether I think they are getting too little, the right amount, or too much - or if they are paid too much later on. What matters is that they are leaving in droves, so they need to be paid more, as a practical measure to stop that. We need to keep the doctors we have, both to have a current workforce, but also to allow an increase in the number of doctors being trained for the future - shortages in more experienced doctors now will mean that medical students wont' have decent training, which will mean the problem continues. So if doctors don't feel they are being paid enough for their current responsibilities, to the point that they are leaving, then that is what matters to me, and so I support them striking to resolve that. I am not sure that they are likely to get the increase they are asking for, but I suppose they have to start high in order to get something in a compromise.

It worries me when they are out for this long, and I wish there were some other way, but it doesn't mean I don't support the principle of the strike.

You said yourself you elected to stay in a band 5 role because you didn’t like being a band 6. It’s not like junior doctor’s pay goes up automatically just because they are doctors. They are continually applying for the next step up the ladder. Most training posts are 2-3 years at a time before they have to apply for the next phase. There will be lots of doctors stuck on a specific pay grade because of problems progressing.

Yep it took me 15 years, and that is by no means unusual in my specialty - essential PhD, maternity leave, and you very quickly get up past ten years.

In the current system:
FY1
FY2
IMT1
IMT2
IMT3
ST4
ST5
PhD for 3 years
ST6
ST7

So there is no way it can be done in under 12 years. Most people will also do a clinical fellow post between IMT3 and ST4 as they are unlikely to be competitive otherwise, and many people do an extra year as a research fellow before their PhD (because if you don’t have any data you are’t competitive for PhD funding).

So 14 years for a man working full time and no parental leave. Female doctors often take longer.

And before people jump in and say “oh none of that is compulsory” - if you want to be appointed as a consultant nephrologist (or cardiologist, or neurologist, anything else competitive), yes it is. I had two masters, a PhD, and had 9 first author papers when I was appointed, and was still seen as a bit of a fluffy candidate compared to some of my peers.

It is competitive all the way through - many many people do not get consultant jobs. I look after our SpRs, and I have a couple who I know are not going to be appointable because all they have on their CV is the bare minimum of compulsory specialty training. Which is not enough. Obviously we tell them, not all of them listen.

This. One of my DC training to be a surgeon and the competition is unbelievable.

Mixed feelings from me.

I am a consultant of many years now. Full time NHS. Never called in sick.

I am exhausted this week having had to spend all my nights in A and E covering striking juniors. I am too old for this. The extra pay doesn’t make up for the tiredness. And goodness knows what it has cost the NHS in terms of agency rates and paying consultants to act down. The strikes need to end now.

Whilst juniors will never have to do the regular 56h shifts I did (some patients died as we were all too exhausted after two consecutive nights not sleeping), their lot is not easy. I am so so relieved and almost proud that none of my three chose to be a doctor. The hoops to get there are ridiculous, and then the conditions are shit.

However much you think you know a job, the reality is only apparent when you start. Whether that’s Medicine, teaching or Law etc. So I am not sure the ‘you knew what you were getting into’ should be held against someone for life.

Being a doctor, the buck stops with you. Even at a junior level. There is nothing like the stress of going home and wondering if something you did/didn’t do could lead to fatality. The responsibility for life is huge and the anxiety can’t be put into words really.

I support a series of one day strikes but not this massive one. I had to cancel all my OP clinics to cover A and E at night. Other people have had operations cancelled. It’s not right.

When they ballot consultants for the strikes, I will have to say no. We get paid enough and the pension issue is sorted. I understand the juniors’ issues but this week has been too long.

But we need to accede to some BMA demands. We cannot lose any more doctors or teachers or other essential workers. We are nothing without them.

Let’s change the name of junior doctors. And create more posts so their hours are better and they are covering fewer wards etc when oncall; that would be an important step for patient care too.

If HCAs can be trained in 2 years to do the practical side of the job alongside AI and a small number of Drs then maybe looking at another career is the way to go.

Half the NHS budget is spent on salaries, so less burden on an ageing population with low tax revenues and high care needs.

I know quite a few Doctors, the ones with money generally come from money

I want to point out here in case it helps anyone that professional exams are tax deductible and you can offset them against your income in your tax return. As are courses that you do to keep abreast of professional updates.

The huge problem is where is the funding to pay more coming from? There is an incredible amount of waste and inefficiency in the NHS, and people abuse the services. It really needs paring back and looking at from scratch and perhaps not everything that is currently funded should be funded. A Tory government can’t actually effectively do this as there will be outrage from the Left over the beloved NHS and how dare the Tories scrap it. I don’t think Labour would do an effective job either (just look at the crippling costs of PFI hospitals). What would be good would be a cross party working group which includes doctors and nurses and managers who know how it works and what doesn’t work.

A vast amount of Doctors give up on the training to become Consultants due to poor pay and then they Locum. You will also find a lot of Consultants are Locums too.

They earn back the low pay at the moment by doing agency work for hourly rates of maybe 55ph - £90ph. They will work fewer hours if on a contract and then pick up the rest through high locum pay. Newly qualified Doctors don't have the experience to do this alongside their training programmes so their salary is low in comparison.

Yes. Some specialities are so so competitive. God forbid anyone go part-time or has babies.

Agree with all of this. I’m not a doctor but I also know a lot of people I work with are stuck beyond ST7 because of lack of consultancy posts as their field is quite niche.

Public sector pensions need to change to defined contribution. Junior doctors (and teachers etc) could then earn about 20% more. Defined contribution pension schemes are completely unaffordable.

Out of curiosity as it’s been mentioned what is the average pension for a doctor to receive? Thanks

It's not a load of shit. Why don't you do the maths. Take home pay for 38k is 2488 per month. A studio flat where he is costs 1300. Then you have council tax and energy bills and broadband. Total cost will come to 60% of his take home pay. Alongside his research he also has to commute to another hospital miles away to complete training requirements. Petrol costs 300 a month. We haven't counted food bills or phone yet either. And you haven't counted the GMC fees, and multiple exam fees costing thousands. You need a reality check.

Plus you can't just go and get a job wherever you want. You have to apply and get a job where you can for your speciality and training level. You go where the job is.