Doctors, would you recommend beginning a career in medicine now?

[tropicalfish]

Hi,
There is alot of negative media attention on the life of junior doctors, junior doctor contracts etc. I dont know any doctors myself really and wondered is it all as bad as is made out in the media? I personally am completely against the new contract.

Would you recommend a career in medicine and if so where would you do it.
I would have thought being a GP might be a good option but I hear there are lots of vacancies so presume this is not considered to be a good choice.
Is working in London much worse than working elsewhere for instance?
My dc was thinking about doing medicine but is reconsidering because of the worries about doing medicine in that you can get sued, people could make a complaint about you, you have to study all through your career, pay alot of money to do exams and then not really get paid enough to afford to live easily particularly considering the many years of study and lifestyle sacrifices that have to be made.
TF

I wouldn't recommend it either - despite training in the time of 'see one, do one, teach one' and being on take for 72 hours, I still believe that the training now isn't as good as it was and the working conditions are awful. I spent a lot of time sleeping on a chair (when I slept) but I had hospital accommodation that doesn't seem to be around now. DS1 wanted to apply for a post in specialist London hospital and couldn't afford to take the job because he couldn't afford to live.

Molio, I was discussing this with one of the older consultants recently. His feelings were that he worked longer hours, but the job was a lot simpler then. There were fewer treatment options available to know about, less was known about physiology, no one had googled it and decided it was some obscure condition before they arrived. There were fewer patients attending a&e and the workload was less intense. He said he didn't envy the juniors now.

I am not old enough to compare the two, those were just the feelings of one person so I cannot generalise.

yes Snuffle - that's my experience (I am old enough!)

I have seen how both the systems worked. When I started my career we had to work 72 hours but we had a team of people doing the job for the same hours. We knew which doctors were in a and e, surgery, medicine and certainly it was less busier. We could monitor our patients over a period of time and can spot if they are getting worse or better.The GP s knew their patients and sent patients in to hospital only when it is needed. We certainly have aging population so the number of patients coming in to the hospital has been increasing steadily but there has been no proportionate increase in the number of doctors working under these stressful conditions. The complaints are again increasing year on year but most of the reason why these complaints occur is due to lack of doctors and resources.i think the managers and the people running the hospital should be responsible if these compaints are due to organisational defect and for putting lives in danger rather than the doctors alone who are trying to do more than one persons work at any given time.

You could easily see 4 different doctors in a 24 hour period if you are admitted - neither the patients benefit from this, nor the doctors learn from this sort of care. But it just ticks the rota box...I have serious doubts about what our govt is telling with the new contract and how they are trying to implement it.

Yes lawyers and other professionals work long hours and are under a lot of stress but it is different to the conditions doctors have to work.

Don't get me wrong I do love my job and intact I was three hours late ( no I don't regret this and it meant doing something to save someone's life)coming home due to an emergency in the hospital and had to rely on my friend to pick up kids today - neither will I be paid for this or my work recognised.

Unfortunately the specialities who are dealing with emergencies like A and E, medicine, paediatrics are the specialities which will get affected by these changes as more and more doctors would opt for specialities which give better work like balance and who could blame them?

Ginslinger - there are no decent hospital accommodation nowadays. That was one thing you don't have to worry about when you changed jobs every 6 months or so.

molio of course many DCs go into medicine because they want to help people but equally many are applying because of the status or because their parents want them to be a doctor or simply that their eyes were never opened to the other possibilities of a career in Science. It is a major issue addressed by the Oxbridge access courses. One very bright girl we know who got three medicine offers doesn't even like getting her hands dirty but it was the only choice she or her parents would consider.

And not all research careers are in underfunded academic departments disquit Some cutting edge research attracts funding in university and private research faculties because as well as benefitting mankind it may have commercial potential. Obviously our friend is an exceptional case but DDs course offered modules in entrepreurship, science policy and ethics and communication / journalism because as Science makes advances in new areas like genetics, synthetic biology etc. all these skills are becoming more relevant and important, and career opportunities open up. It is all very exciting but how many sixth formers know that?

OP someone (was it you?) already pointed out that the people saying it's a good career are not doctors. I'd go further and say they have little idea what they are talking about. Medicine used to be a reasonable choice of career. Life as a junior doctor was hard but it was worth it when you became a consultant. Times have changed.

I wonder if anyone here has looked at the rotas posted by junior doctors on another thread - I'll add one here. I wonder if they have read about the junior doctor refused permission to go on their honeymoon. Do they know about Rose Polge (young junior doctor still missing after walking out mid shift, car left by sea, hope fading that she will be found alive).

Junior doctors have more student debt than in previous years, pay more for their pension, it wont be as good if they ever get it. Add that to the changes already mentioned with extra patients and the like. Of course there have been changes in other areas too but city lawyers and management consultants are still sent home in taxis after their long working hours while junior doctors drive home and sometimes kill themselves from tiredness. Of course lawyers and management are also being paid - not earning - much more for their hours too and having perks like phones provided for them, child care subsidies and the like that they forget to mention. Expect to see changes to consultant contracts too.

It's said you should choose your speciality by what body fluids you can cope with but it's not unusual for a doctor to say they opted for some work/life balance. There are a lot of vacancies in a&e.

Doctors are often required to live near the hospital. In London that is more expensive. There is more private practise in London though.

There is still satisfaction to be gained from helping people but it isn't a career to choose thinking you will have a great life. You need to be mentally and physically strong, after all you'll be exposed to a lot of infection. If undecided about a career encourage them towards finance, management consultancy, engineering, management generally, law if they are very able.

Yes, I am fully aware that not all science research careers are in academic departments. (I work directly with private research facilities and could easily earn a high six or even seven figure annual income myself. And I have connections with biosciences.)

But nevertheless high salaries for scientific research are not the norm and any student who goes into research thinking they are would be misguided. Nor is there great work/life balance in science.

disquit my DD is under no illusions, she even tried an internship in the corporate world but it is not for her. It doesn't have the intellectual challenge or the excitement she feels about her chosen field. And my point is that most sixth formers, and crucially parents, have no clue about the diversity of careers in science.

ron as I said yesterday on the law thread I don't encourage my DC in any particular direction, nor do I discourage them from the paths they're inclined to themselves. DS has wanted to be a doctor since he was in primary school, I've no idea why but I'm not going to put a damper on anything my DC want to do, provided it's not illegal.

Yes alreadytaken, no stress in the financial world then.....

As someone else said (not OP): people do like to moan.

And my point is that most sixth formers, and crucially parents, have no clue about the diversity of careers in science.

I think most people have no clue about the diversity of careers available, not just about the diversity of careers in science.

But I do agree that there is an enormous problem with the low numbers of students taking science from A level onwards in the UK. We massively under-produce engineers and scientists - which is why my research group/companies I work for have so many international staff.

On science, most boys in my sons' school seem to be doing maths and science A levels with their parents very strongly pushing them towards STEM careers so I am not sure in all schools there are science shortages - i think parents know those can be good careers (although I don't accept that you earn the most money in the UK if you are good at science and study that - I have seen far too many scientists on very low pay retraining as intellectual property lawyers and patent attorneys because the money and life is better. Not everyone can be a Dyson or set up a Glaxo)

On the junior doctors and accommodation point I remember my father's funny stories about being one in the 1950s. He had married relatively young but could not live with my mother so they had to sneak her in and out of a window into the room he had to stay in on site I think at the hospital. I cannot remember if they also had to pay for a room off the hospital site for her to rent.

OP
I wonder if it is a strategy to cause a crisis so they can swoop in and privatise it.

That is my feeling too. And also with state education. :(

"If you want a risk free profession that makes loads, then try merchant banking or similar city jobs."

I have met a lot of Drs over my life who when I told them I worked in the City all in a way regretted not earning the kind of money you can in the City with the kind of qualifications they had. I know a surgeon who left medicine to go into the City.

If you want the money go for the City. You have to like money though - a lot more than most people just want money. You have to actively like making it for itself. You do not get fulfilment apart form making more money. The hours and pressure are the same. The risks are high too. You can get sued /or put in prison.

ABetaDad and if I was the type of poster to link to stories of suicide or other tragedies among a particular group, borne of overwork, I'd be spoiled for choice with City workers.

When I was in the City I came across a great many lawyers and stock brokers and merchant bankers (as they were known back then) who regretted not going into medicine or journalism or music or any of the other more people orientated or creative avenues that could have been open to them at an earlier stage. There was a lot of doubt about their chosen career path and of course equally there were many who were quite happy with their choice, just as DeoGratias evidently is. But we shouldn't pretend that any of these jobs are 'risk free' or a promise of happiness - they aren't - but nor are they necessarily a cause of misery either. These threads are more a reflection of personality than anything else.

(And some doctors earn an awful lot like my brother. It is by no means that you go into medicine and don't earn as much as bankers and lawyers)

Tropical, I think we are at the same stage. DD does not have any offers yet and is also having some wobbles.

From what I recall from your supportive PMs, both our daughters are reasonably academic so the normal AAA offer does not pose a problem. But medicine is not just about grades and lots each year won't get offers despite lots of predicted A*s.

DDs slight advantage, if it can be called that, is that she had a serious accident last summer and so was not in a position to take BMAT. This means a number of the more academic choices (Oxbridge, UCL, Imperial etc) were ruled out. She ended up applying to "middle ranking" schools which did not require a sky high UKCAT, and so still has a chance with three. The origional game plan was for her to use this UCAS round and then, depending on results, try again perhaps with a mix which included one/two aspirational BMAT courses and one/two less selective courses. Your DD seems to done what DD might have done had circumstances been different which is to apply to two BMAT and two (a definition used simply for convenience) "middle ranking" schools. If she fails to get an offer, and she is otherwise a good candidate, she should not read anything into it. It happens, quite a lot. She just reapplies, perhaps a bit more tactically.

Inevitably with interviews hanging over her as well as mocks, DD has started to say she does not want to be a Doctor, and she wants to do "something else". Trouble is she does not know what that "something else" is, though possibly something using physics. My guess is that if she gets an offer the wobbles will disappear. If not she needs to focus on her A levels and then have a good think.

Factors which may come into play.

1. Work load. DD is at a London independent. Her friends parents work in a variety of professions, including medicine and academia. By definition they earn plenty but most work very hard. She expects this.

1. Work security. On one level this is a given. Doctors will always be in demand. Whether the NHS will exist in the form we know it in 20 years time, and whether it will be the dominent employer is a different question. A well trained doctor should have far more security than most other professions, a doctor wanting to work simply for the NHS might find themselves subject to the pressures of a system trying to meet ever increasing demand and expectations on a limited budget.

1. Money. The problem with being a doctor, rather than say a lawyer, is you can't delegate in the same way. A Partner might have lots of associates beavering away through the night and he can charge high fees for simply reviewing their work. If you pay for a private surgeon you expect them to do the work. In anycase I don't think DD is very motivated by money, perhaps an advantage of growing up somewhere where being very rich is not unusual.

1. What else to do? Here I have an advantage as DD has sailed through quite a lot of quite unglamerous vounteering without a problem. Teachers and others say they think she would make a good doctor and this is what she has always wanted to do. If she does not get a place, I will encourage her to research alternatives more thoroughly, if need be adding an A level during a gap year. But suspect once away from the pressure of the UCAS round, she will stay with medicine simply because this is what she wants to do most.

One thing that has surprised her is how many applicants she has met on Open Days, UKCAT preparations courses etc, have their career chosen by their parents. She knows others, often second generation or from overseas, who are being steered into other professions, but medicine seems to be the big prize. Some, presumably will be fine. It may be tough for some others.

My surprise has been how might the "getting into medical school" industry is. We have just dipped in, via a UKCAT preparation course and a couple of books, and I would have paid for an interview course but DD is content to take her chances. With the various non academic requirements, the whole thing feels like an arms race. There is clearly no shortage of applicants despite the concerns Doctors have. And no shortage of children of Doctors we know also applying for medicine.

molio - yes lots of City types leave and start a 'new life'.

I wanted to be a vet when I was 16, then I did biochemistry at university and sort of fell into commodity trading in the City afterwards. I then did other jobs being an academic was one of them and I retired at 43.

I was wondering the other day if I could have retrained as a GP instead of doing a PhD and then going into academic life - it certainly pays more. Too late now.

My DS1 wants to be a lawyer. I would be worried if he said he wanted to be a doctor. It does seem a very raw deal financially and bad work life balance too.

alreadytaken, that is really useful information. I wonder if they use an example of a rota in medical school interviews and ask, so what do you think of this then ?
What does your dc think of doing medicine now as I think they are present at medical school? Presumably more aware of the realities of the profession?
I had also thought that living near the hospital would be advantageous and not everyone would want to or could afford it. Things are much harder for young people now with house prices being as they are. Sure we all know a 70 year old GP that has the massive house but they bought their house when it cost 4000 pounds. These DC that choose to become doctors could choose other careers that don't require the physical and mental stamina and stress faced by the challenges in the NHS which is why so many are looking into working overseas currently. One can't really expect them do anything otherwise unfortunately. For them the current conditions of employment and remuneration are unacceptable and I suppose the government will just use doctors from overseas and pay them less. Market forces at work.

tropicalfish does your DC speak any other languages? If so, it may be worth looking into studying medicine in another European country. I studied and work in France (I have dual nationality) and there are no fees here beyond an admistrative charge of a couple of hundred euros and students can claim housing benefit and even income support in some cases! Certain medical schools are over-subscribed, but most take overseas applications and students from the EU are treated exactly the same as local students.

There were quite a few overseas students in my year, not just from Europe, and not all spoke much French when they first started, but were fluent within a few months and in most universities, at least part of the course is tought in English.

The system is different, as anyone can enrol in the first year, but there is a selective exam at the end of that year, which only around 10% pass. You can take it twice (not necessarily consecutively), but there are also other ways to get in. All universities now have 2nd- or 3rd-year graduate entrance (depending on the degree subject) and some are also accepting students transferring from a biology or chemistry degree in the same university into the 2nd year.

Medicine is hard work anywhere, but working in the French system sounds very different from everything I've read about the NHS. As most GPs are in private practice here, it's fairly easy to choose your hours to get the work-life balance that seems so elusive in the UK. In fact once the first few years of internship are out of the way, it's easy enough to practise part-time in a hospital setting, too! There are also lots of other ways to practice (e.g. working for insurance companies, ambulance service, public health etc).

We like to moan about the social security system being slow and bureaucratic, but I have met very few doctors who actively dislike their job. I've only known of two doctors who have left medicine in the past 20 years. One became an editor of a health magazine. The other did an MBA and got a job in the pharmaceutical industry. Both very well paid.

I don't know about the rest of Europe. I think in the Netherlands there may be courses tought entirely in English. Worth looking into what's available, though, as for students who are passionate about medicine, the NHS is not the only option open!

One of the reasons my DDs don't go to private school is that the ones within geographic reach of us see themselves as production lines for getting academic girls into medicine. I cannot see there being a shortage of medical school applicants any time soon.

VitaminC thank you for your interesting post. this information is quite staggering, in that it sounds alot nicer.

Needmoresleep you say the "getting into medical school" industry makes the whole thing feel like an arms race. It doesn't need to. DS avoided it entirely by not doing more than buying the BMAT book suggested at the Oxford Open Day he attended (despite the recommendation being by the bloke who wrote or co-wrote it!), not doing the UKCAT (his choices didn't require it) and generally just forging ahead with A levels, reading and what work placements he could find locally (several but not extensive). The process seemed very painless. He did all his own detective work through the internet on the various courses and had no input from me, nor needed it. I understand that a lot of people apply but I think keeping aloof from the frenzy described on the MN HE threads makes for a much calmer experience.

I don't see any merit whatever in pushing DC towards a particular career. I'm surprised these kids go along with it - mine wouldn't.

Molio as I said DD has only done a UKCAT course but there is an industry out there that must be being fed by someone.

Different Universities lay differing amounts of emphasis on work experience/volunteering. Oxford does not seems as bothered as some. Because of her illness DD was not able to get to Open Days for any of her choices and so research was largely on line. Perhaps why the process seems so daunting.

Only one University does not ask for either UKCAT or BMAT and their applicant to place ratio is in excess of 25:1. Applicants today would have to be supremely confident to avoid UKCAT.

I too don't see merit in pushing a child into a career, not least the risk that they blame you for ever after. But certainly with medicine it seems surprisingly common. Perhaps part of the reason for the current disillusionment. At least if you make your own decisions you go in with you eyes open.