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!

mumsneedwine- I suggest you re read my posts before spouting more rubbish!

Junior doctors have for the past 30 yrs gone off to NZ, Canada ( less so) and NZ for 1-2 yrs after doing PRHO, F1/2 jobs there is nothing new in this. Of the 8 PRHOS I worked with in one hospital 6/8 of us did exactly that. 5/8 of us returned to the UK, 1 stayed in NZ, 1 left medicine altogether and 1 has died.

The current behaviours are no different to the previous generations - we went for less hours was def no better pay then!

Medics work hard and don't get paid well, they see their fellow other subject students walk into jobs in the City on more monies and better conditions and resent this. What they do not see is that Goldman Sachs expects 100+hrs per week from its juniors but they reward them better and have a nicer environment than an on call room shared with 20 other doctors.

Covid has made us all look at our lives and think is this what we want. Unlike a lot of people, we did not get furloughed, worked hard in appalling conditions and feel like most of the world had a holiday!

mumsneedwine - sad that you and those doctors you know and some on here are so disrespectful and dismissive of an emerging healthcare professional career with minimal knowledge of the role or its potential. But then you think I am a PA, which if I was I would be proud to say I was and the contribution I make to the working of the hospital, doctors working lives and the patients care. It is that arrogance and belief that you are more intelligent and worth more than others in different professions which loses support for the fight not gains support.

Respect your colleagues from all walks of life.

@DenimSkirtLove you sound fabtastic! Wish I’d had you around when I was an F1.

@Purplewind yes I sometimes wish I’d become a PA. Much easier life.

@Forgooodnesssakenow how many brain tumours might you see in a career? 4 or 5? Whereas how many truly life and death decisions does the medical registrar make whilst in ED resus day in and day out? The level of stress is not comparable. We’re not doing any routine check ups like an optometrist, we’re constantly fire fighting incredibly sick patients. You do a fantastic job, you are highly skilled but it is not the same. I’m a bit flabbergasted that you might compare the level of responsibility to be honest.

I’d say clinical psychologists in some sectors definitely take on a high level of risk.

@lookluv ”The current behaviours are no different to the previous generations - we went for less hours was def no better pay then!”

Literally the entire point of the industrial action is that pay was better. In fact we are paid the equivalent of 26% less than our seniors that is why we are striking because the pay is so low we cannot retain staff. And the stats show more doctors are leaving now than ever, 40% are making plans to leave. It’s always been a tough career, but it’s no longer as well rewarded. And getting to consultant has never been harder. I feel lucky I got into core training when I did, the competition ratios are rising every year.

@Medstudent12 completely agree with all of your post.
@Forgooodnesssakenow your comparison to your level of responsibility and that of a junior doctor @Medstudent12 has summed it up.

Why the need to be uniquely seen as the profession with responsibilities noone else could understand?

Your understanding of some fields of medicine are a bit grey by the sounds of it and of what happens in a clinical environment and the role played by very experienced clinical professionals.

I do not work on the community I work in a clinical hospital setting, I have done for most of my career and I'm 40, I am not running routine tests, I'm monitoring and treating conditions alongside consultants.

I'm specifically saying junior doctors should have a payrise, they deserve a real terms rise comparable to pre Tory government.

I'm specifically saying junior doctors should have the time and space to progress in their careers without more responsibility or work hours than would be considered of other professionals.

I'm also saying plenty of healthcare professionals within our NHS understand the responsibility of carrying s a registration, potential for being sued or struck off and responsibility for life and death and quality of life decisions. Are you very newly qualified that your ego struggles so?

I have just seen a junior doctor in Germany earns 4,700 euros Gross per month.This rises every year until the 6th year when they would no longer be junior.I think the junior NHS docs need a pay rise.

My junior doctors are without doubt one of the highlights of my work. I love it when they stay in touch. I had a doctor email me in Jan; she worked with me in 2016. She is now a GP partner and said I was her best clinical supervisor. It made my day.

The juniors I have met have largely been enthusiastic, fun and hardworking. I love seeing them progressing through life, via Instagram if not real life!

I am very sad so many are leaving and we need to look after them better.

Honestly surely you are not comparing your level of responsibility to a med reg or surgeon? You have a consultant in your clinic. I am assuming a consultant ophthalmologist and a radiologist reporting scans.
Also clinic based jobs are different to life on the wards and on-call.

medstudent12 - you are paid 26% less but do in some cases 40-50% of the hours -you are comparing apples and pears allowing for inflation etc etc

My SHO does 48 hrs on average per week, I did 80 hrs on average per week. You are not looking at the same pay per hours ratio.

https://etheses.whiterose.ac.uk/656/1/uk_bl_ethos_250259.pdf

Nothing has changed which is the sad thing - not worse and definitely not better

I totally respect ALL healthcare workers, whilst also acknowledging that some have more responsibility and accountability than others. Nurses now on strike again too. Have my total and full support. Maybe the government will only sit up and listen when everyone goes on strike together.

ALL the junior doctors I know want to stay. They want the NHS to work. They'd have already left otherwise. But working 72 hours a week on shift patterns that are frankly dangerous (nights followed by twilight followed by nights followed by day), while also expected to study for expensive exams and having to constantly move is proving too much for many. All they ask is a wage big enough to pay their ever increasing bills and conditions that make some training possible while maintaining patient safety. And maybe their student loans paid off (some now up yo £150,000 having started at £80,000 - interest is ridiculous).

I was so lucky qualifying before loans came in. I cannot imagine having that level of debt as a young person now.

@DenimSkirtLove it's terrifying, but they try and ignore it. Most reckon they'll have paid over £200,000 by the time their loan is cleared (more likely cancelled after 30 years). But it's another deduction from their pay.

PS. hope my own DD gets to work for as you sound a lovely consultant 😊.

That’s an insane amount.

When I started as a consultant, I was probably too friendly and one trainee said he thought of me as a good friend rather than a consultant (I was only 31). I then adjusted my attitude a bit and tried to be a bit more of a ‘leader’ and think I got it right over the next 20 years. Though now my juniors are more like my kids as I am Very Old!

They work so hard and their CVs are way more impressive than ours had to be at a similar stage. Though I disagree that every good clinician has to be an expert researcher etc. You don’t have to be the best at everything, but that’s another thread!

‘Whereas how many truly life and death decisions does the medical registrar make whilst in ED resus day in and day out?’

Medical registrars are a special breed. Superhuman. They need paying £11 million per shift. The most stressful job on-call in the hospital at night.

I really wanted to do neurology. But I knew I could never handle the med reg part of the training.

@chopc you can't compare the WiFi fixing guy because he is probably self employed and might only see a few customers a day so maybe £150-250 a day. No holiday pay etc . £100 an hour for a locum for 6-8 hours work a day. Well I think that is pretty damn well paid. I think they do need to overhaul the system to stop referring to registrars as junior doctors but I also think doctors are not being genuine with their salaries. Tbey say £45k and then sneak in the word 'base' as they probably actually take home a lot more than that. The annual leave is very generous as well. I would have more respect and may take their side if they said - I get £40k base with approx £10k extras and 32 days holiday plus bank holidays but would like more because of xyz. Pay rises should never be about stamping feet and saying I want more because I do and look how low my wage is - it should be able articulating their contribution and the level they are working at. I don't see that argument, I just see the whining about wanting more money. 🤷‍♀️

@br0kenankle I'd suggest listening a little more carefully. Not to the BBC or Daily Fail, but the doctors themselves. Twitter is a good start.

Doctors want a wage that recognises the pay degradation they've had (are doctors really less valuable than in 2008 ?). But more so that the the state of the NHS is dangerous, understaffed and that doesn't change unless doctors, nurses and everyone else can maintain some kind of life. Because they'll leave. They can v easily as other countries really want them.

I see more nursing staff strikes being announced. I hope there’ll be more solidarity, as they’re not paid quite as much, so the jealousy element doesn’t come into play.

How much do locum drs get paid? My friends cousin was apparently getting £100+ per hour when she had just completed her training. I have zero idea if this was bollocks

Yes, it’s bollocks. FY1s can’t locum, so she certainly wasn’t doing that when she had just finished training.

In our trust, SHOs earn £35ph for a locum shift, SpRs earn £55ph. In the recent strike, consultants earned £150ph, but only for work done in addition to their usual contracted hours (so just cancelling a clinic and carrying the crash bleep wasn’t remunerated - which is fine, I am just clarifying).

It is possible to earn crazy money as a locum. This is probably why the op hasn't been back to share their most recent payslip.

BarbaraofSeville
There are MPs in their 20s who also earn the MP salary of £84k plus expenses

Very few - there were 21 MPs in their 20s elected to parliament in 2019 (out of 650) - the average age was 51. The youngest MP announced she was donating over half of her salary to charity in her first year.

I don't know what any of this has to do with salaries of full time hospital doctors in the first decade or so of their career

Good point - ask the doctors who have posted the comparison with MPs all over Twitter.

and many consultants donated their earnings to the JDfund to help offset some juniors loss of earnings and not to make profit from the situation.

What has been lost over the years is the sense of team work and being part of a team that worked together to get through your 100 hrs per week. and learn. My trainees are in the most a great hard working bunch but there is definitely less team working and this makes the job harder. We are all ignorant and learning - I am every day I go to work, team working makes that ignorance more copable whilst we educate ourselves. I see my juniors think nothing of leaving jobs for the night shift team - when you were the day and night shift you never did this twice.
As a JD if you left your on call colleague all the jobs venflons, re writing the drug charts to do in the evening - you did it once and never again. Revenge was quick and harsh! James you know I mean you - the manual evac, 22 lost/ finished drug charts, 15 bloods that needed doing, ABGs, siggies and your "lost" morning blood tests were sweet revenge! Too often now I see the handover sheet at 1630 which is full of day time stuff just not done.

I would never want anyone to do the hours my colleagues and I did - they were insane. What I did do, is learn v fast , my 6 months as a medical PRHO is now the equivalent of 18 months of clinical exposure. This job is an apprenticeship, the more of something you see the more you get confident in managing that condition.
One week of nights at 72 hours and then the next on 40-48hrs reduces your exposure so much and loses team working and learning. We have lost the balance -reduced continuity, reduced training exposure and less satisfaction. Bring back a 1:6/8 - worklife balance, learning and care for patients is so much better.

Camaderie makes difficult jobs easier as you do not feel isolated and on your own. What has saddened me about this thread is seeing utter arrogance and disrespect for other opinions, experiences, training, skills and disrespect for colleagues - this is not a race to the bottom, this is absolutely about looking after the most vulnerable any human is in their life, when they are ill by a TEAM of highly skilled professionals, who all add to the package of care. As a consultant I can not do my job without the nurses, physios, amin team, management team, security, porters, cleaners, kitchen staff and the junior doctors.
Every single person in that pathway has an essential role as worthy as the rest. I am not superior as some people have implied they are here - my part is equal to all their contributions.
Respect please.

@lookluv you make it sound like the mafia. Maybe the reason they leave things is simply not coping with the work, rather than a huge generational shift in attitude.

What is like the mafia? The day after your boss was on call you was hell on earth dealing with the new pts, pairing with the person who was furthest away from their con on call, meant they had less patients and less jobs to do - so they helped the busy person out. It just happened - what I observe now is a request for help frequently but not always, meets a deafening silence and the ward round finishes with no one willing to help the over whelmed person.

There is a generational shift and there is no point in denying it. I admire our juniors for saying no to certain things that I just got on and did because that was the way but sometimes I think they lose out on that sense of team work and learning. There is a fine balance and no generation has it right.

Patients do not get sick 0900-1700 and night work is a fact of life in the healthcare world. Doesn't mean I like it but it is part of my role and everyone has to take part.

I wish I had the protected teaching time they have now, the ability to end my shift and walk away - I never got a rota of shift times - you were just told WR at 0730 and you left when the job was done. Clinical and educational supervisors keeping an eye on your progress prompting you to catch up. Things have improved but not enough - but I would never want to work the shit shift systems that are now in place. We used to start a job and look at the rota,in the first 24 hours everyone sat down and sorted out their leave and we divide up the on calls, weekends etc - it was our working life and our free time and we bossed it - today I see poeple looking at the rota as the gospel and being dictated to. As long as the duties are covered and fairly so everyone gets a bit of what they want and tkes the shit with the good then life is much easier. I perceive the current crop of juniors as more passive in that respect - you take control of your working conditions accepting certain caveats - someone has to be on site 24/7/365. If you own your working pattern then you start to control your working life rather than being a passive bystander and seeing it all as shit.