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To be or not to be a doctor?

325 replies

MrsDThaskala · 07/04/2025 18:36

DD said today that she’s been in thinking about becoming a doctor. Not sure what area, not sure what kind, just said it out of the blue today. I mean she’s doing well in her sciences. But quite honestly, the doctors I know, GP and hospital doctors, and a surgeon always say how stressed they are, how much pressure hospitals are under, how hard medical school is….etc. not necessarily for my DD but what do you think? With all that we know about the NHS right now, what’s your take on becoming a doctor?

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GingerPaste · 28/05/2025 07:34

It used to be a good job - now it’s not.

My niece wanted to be a doctor and I told her that it’s really mostly an awful job now. She didn’t get the grades to do the training so now is training to be a teacher. Another job that used to be great and something to aspire to. But now is also mostly shit.

mumsneedwine · 28/05/2025 07:54

CCT and flee seems to be the plan for lots. None of them want to go but unemployment is currently the alternative. How sad we have got here. That medicine (& teaching) are now seen as such awful options. 2 professions we will always need (if you think AI can teach a class of 30 slightly hormonal and uninterested teens then you’ve never set foot at the front of a classroom 😂).

Anyone not supporting doctors in getting better conditions must be prepared to not be able to see one when they are elderly. Private won’t help you as the doctors are all the same people. No NHS, no private.

TuesdaysAreBest · 28/05/2025 08:14

mumsneedwine · 27/05/2025 08:12

It’s big just the pay, it’s the way you are treated for that £17 an hour (F1 pay). Made to move every 6-12 months, with no say in where that will be. No say in your rota, you just have to live with missing many important events as no say in that either.

Cant think if any other job that has one possible employer. No option to leave and move elsewhere.

Despite this, doctors love their jobs. Because they get to save lives and make people better. Not a bad way to spend your day.

So much misinformation on here. They are not "made to move" every 6 months. That will be entirely dependent on the Deanery you are in. Many work through their 2 year foundation placement in one location but will rotate specialities.

ispecialiseinthis · 28/05/2025 08:58

TizerorFizz · 28/05/2025 02:50

@Welshwhales the minimum pay appears to be £105,000 for consultants. What does he expect to do for that? He probably earns more. In the uk most people would work long hours for that. The self employed would do, and they don’t get 28% pension contribution either. It’s amazing to ordinary people how much doctors complain. They are not unique in working long hours or finding their work changes at the behest of others.

It’s not really comparable to most jobs in terms of qualifications needed, training and the risks involved in the job.
Schools/sixth forms still often list how many pupils were offered places for medicine as part of the selling point. There is a reason for that.
£100k really isn’t a lot for the qualifications, time, training and responsibility that is required of the job.

Auchencar · 28/05/2025 09:29

TuesdaysAreBest · 28/05/2025 08:14

So much misinformation on here. They are not "made to move" every 6 months. That will be entirely dependent on the Deanery you are in. Many work through their 2 year foundation placement in one location but will rotate specialities.

Strongly agree. This has been the case for far too long on MN threads.

And now the completely ill informed notion that doctors will be left with no financial support if they take maternity leave.

For anyone interested in the reality, most of my own DCs' friends (DC plural, friends multiple - tens and tens) have not had to move house involuntarily for their entire training (most now on the last two to four years of the consultant training pathway, including one currently on.... paid maternity leave). The rental market/ greedy landlords are far more of a problem in terms of stability than the NHS as employer.

That said, the NHS is in a dire state for sure.

Needmoresleep · 28/05/2025 10:09

TuesdaysAreBest · 10/04/2025 15:22

Well said. There’s always a pile on with these threads saying medicine is not a good choice. Thank goodness bright keen youngsters (and mature students) do choose it.

One of my DC is in specialist training. They have a passion for it and nothing else would tick that box for them. Yes, it's hard.

You are right that medicine is a wonderful career. However things have changed dramatically in the last year or so as the impact of Boris' lifting of the Resident Market Labour Test starts to impact.

Medicine is no longer a secure career. Newly qualified doctors now facing enormous competition for even basic entry level jobs, let alone training. Unless your DC knows what they want to do, and is very organised and driven, or if you are able to fund a later Masters (gap year) to prepare for the exams and gather together the super-curricular CV enhancements now needed, they may struggle. 20,000 of this year's group leaving F2 will be without training, whilst 100's if not thousands are competing for F3/house jobs.

The playing field is not level. I have a friend who is a very senior doctor in Asia with a lucrative private practice, and with a son at about the same stage as DD. He graduated elsewhere in Europe but she wants him to train in the UK, as she did, before returning home. UK speciality training still carries a good level of prestige and we are the only comparable country to give equal consideration to doctors from overseas. My friend's DC will have plenty of time to study for exams, with support and tutoring. He will be able to join his mother in some pretty impressive research. He will be able to enter competitions in his own country, which may not be as competitive as ones in the UK. He will have support writing his application. If he were in India he could take PLAB, which has a higher pass rate than the MLA that UK based doctors have to sit.

DD in contrast is working long and chaotic hours in a Deanery which still uses the old (2005) F1/F2 contract and where there is little scope for engagement in research. The current rotation is really tough. She expected this so before she started, she used her days off to batch cook. The NHS is a very different place to when others on this thread started their careers. The demands are huge and pastoral care is limited. Her rotation should have six F2s but the drop out rate is such that they only have three. Medicine is a lot less rewarding when, rather than treating people, you have to tell someone who has been waiting eight years for relatively straightforward, but life changing, surgery that they are still nowhere near the top of the list.

My friend comes from a culture where you put family first. She has no qualms in getting to know the system, and ensuring that her son does well. The British set the rules, and she follows them. If they are daft enough to have a system that disadvantages their own in favour of those who want their UK training in order to guarantee a lucrative career in private medicine elsewhere, so be it. (And yes, next time I visit I may well combine the trip with a thorough heath check, now being offered to visiting Brits by a commercial firm set up by someone else I know.)

The debate about prioritising UK graduates for UK training is live. https://www.pulsetoday.co.uk/news/education-and-training/bma-leaders-to-debate-prioritising-uk-medical-graduates-for-foundation-programmes/

I am not sure I really understand the argument about the debt we owe to overseas doctors. Yes we do owe a historic debt to doctors from overseas who came here and stayed. However their children are likely to have gone to UK medical schools. Things are different today. Overseas doctors who have beaten the huge competition to gain training places may now be more interested in moving onto private health hubs, like Dubai and Singapore than to dedicate their careers to the NHS. I also don't get the "racism" argument. Other countries put their own residents first. Why can't we? And if we choose not to, we need to think carefully about whether we want to have so many graduating from UK medical schools. It is not fair to either the taxpayer or the young person to spend so much when the career path is so uncertain.

MY DD did not apply for training during F2. After two rotations, the speciality she thought she wanted to go into, is now her least favourite, and she has a far better idea of where she does want to work. She also realises that she is a work hard-play hard sort of person. After a 60 hour week she needs to get out onto a sports pitch, not least to build local connections. Those that are able then to hit the books are impressive, but it is normal that others do better by maintaining balance. She is only aware of a couple of her peers who have training. Sadly the brilliant locum, who was a huge support to both F1s/F2s and to newly arrived overseas doctors, did not get through and is now having to try again, effectively blocking the job that someone from DDs year might take.

Instead it looks like zero hours work with NHS Bank. Bank hourly rates where she lives are low, probably because of the over supply of young doctors. They are higher in a more rural trust about an hour's drive away. She then needs to pay her own insurance and mortgage (she really did want to build her career in a hard to recruit area) which she can do it she prioritises shifts with anti-social hours. If not she uses her intercalation (strong advice is to choose a course that allows for useful intercalations - DD studied medical engineering at Imperial) to switch career. Or Australia. The problem with Australia is that you are behind Australians in the queue for more sought after jobs and training and that, unless things change, it is very difficult to return to the UK.

The madness is that there are loads of vacancies. In a previous rotation a couple of DDs consultants went out of their way to tell her they thought she would make a very good clinician with good diagnostic and communication skills. Training selection is done nationally and the jobs in that Trust are relatively unpopular. The Doctor who has spent £30,000+ on a training academy in India to increase their chances of landing a training slot in the UK, or the Oxbridge/London high flyer who has burnt the candle both ends to put together the perfect CV, will wait for something better to come up. Why spend eight years in the back of beyond, with little research opportunity, no international recognition, and in one of the more failing parts of the NHS. As a result eight out of the sixteen training positions are vacant. Consultants are on call one night in four. They have a Physician's Associate but the training and the restrictive contract hours mean they are very limited in what they can contribute. As a result patients have to wait two years for an appointment even with an urgent referral. And frustratingly though consultants do what they can to encourage good F2s, especially those who want to stay in the area, they can't hire them.

BMA leaders to debate 'prioritising' UK medical graduates for foundation programmes

Doctor leaders will vote on whether UK medical school graduates should be 'prioritised' for foundation programme posts.

https://www.pulsetoday.co.uk/news/education-and-training/bma-leaders-to-debate-prioritising-uk-medical-graduates-for-foundation-programmes/

Needmoresleep · 28/05/2025 10:28

TizerorFizz · 27/05/2025 21:55

@Destiny123One poster says everyone is going abroad. Take redundancy and go. More money no doubt.

Tizer, I assume that facing open and worldwide competition was not a problem for either of your Dds when trying to build their careers. How would you feel if either of your DC were facing a reality where the only chance of employment after eight years study and training was to work on the other side of the world, with virtually no chance of returning.

Largely because the monopsonistic employer does not give any priority to those already resident in the UK.

Australia is a very long way. Forcing hard working and bright young people to emigrate seems a odd way to secure the future of either the country or the NHS.

And very cruel. I spent a decade supporting my elderly parents, with the in-laws now starting to look doddery. Family is important to us, and the idea that children, and potentially grandchildren, might be a huge and expensive journey away makes me both sad and angry. BAPIO, who are heavily engaged in training and recruiting of overseas doctors to the UK are now running a campaign to allow elderly parents to join their doctor children in the UK. Fair enough. But why doesn't anyone care about separating UK resident families.

Destiny123 · 28/05/2025 17:46

TuesdaysAreBest · 28/05/2025 08:14

So much misinformation on here. They are not "made to move" every 6 months. That will be entirely dependent on the Deanery you are in. Many work through their 2 year foundation placement in one location but will rotate specialities.

I don't know a single person who's done f1/f2 in the same place and I've worked in hull/york/Scarborough/scunthorpe/grimsby/boston/Nottingham/torquay/Salisbury/Southampton/winchester/guildford/redhill/Kings/evelina/gstt

Wow that just sums up how disjointed and buggered my life has been trying to get within an hour of my parents in kent

TuesdaysAreBest · 28/05/2025 17:50

It was in Scotland. Deanery of choice but perhaps not everyone’s choice….

Destiny123 · 28/05/2025 17:51

AgeingDoc · 27/05/2025 13:31

You’d think they’d be employed by the NHS so would get continuous service. But nope, they are employed by individual trusts, so each time they HAVE to move their employment status resets to zero. Maternity pay is a dream for most resident doctors as getting 2 years at one hospital is unheard of.
It would be such a simple fix. Run through training at one trust for every speciality, no need to rotate 100s of miles every 6 months.
Are you sure about that @mumneedswine ? Admittedly it is a long time since I was in training but whilst I was paid by the Trust I was working for at any point, my contract was with the Deanery whilst on rotation. Continuous NHS service absolutely did count for things like sick and maternity pay. We've definitely had rotational staff get maternity leave in our Trust in recent years. I'm retired now and haven't really taken much notice of medical politics for a while but I'd be shocked if the BMA hadn't put up very vocal resistance to such long standing and basic employment rights being removed.
In fact the BMA website currently states
If you have 12 months continuous service with one or more NHS employers at the beginning of the 11th week before the expected week of childbirth, and you have notified your intention to return to work with the NHS, you are entitled to:

  • 8 weeks' full pay, less any Statutory Maternity Pay (SMP) or Maternity Allowance (MA)
  • 18 weeks' half pay plus any SMP or MA (providing the total does not exceed full pay)
  • 13 weeks' SMP or MA
  • 13 weeks’ unpaid leave.

And the same page specifically mentions that resident doctors are eligible for the NHS maternity scheme. There's even some protection for those who have had approved time out of their programme.
If someone is trying to prevent your DC or any of their friends accessing those entitlements I suggest they contact the BMA ASAP.

And I am afraid that rotation is a necessary evil, always has been, probably always will be. There are very few Trusts in the country that could provide the training in every subspecialty that most specialties require, and those that could are all tertiary centres in major cities. That isn't where most consultants end up spending the majority of their working lives. If everyone did all their training in one of a few large Trusts, not only would there not be enough work for them all to gain adequate experience, service delivery in general hospitals would be hit even harder than it already is and you'd have lots of doctors having to apply for DGH posts with absolutely no experience of working in one.
I don't doubt that rotations could be better organised - we used to think there was someone planning our allocations who looked at our home addresses and deliberately sent us to hospitals that were as far away and on the most difficult routes as possible, and I don't suppose it has improved - but getting experience of working in different places, as well as in different subspecialties is really important, both for the service and the individual doctor. My views on what I wanted to do and the kind of place I wanted to work changed radically from the beginning of my rotation to the end - you have to see it to be it. Yes, the travel etc was a pain in the backside, especially once I had a child, but I wouldn't have swapped it for years in the same hospital as I would not have been as well trained for my eventual job.

Edited

Deanery contracts are incredibly rare unfortunately as it would mean far less admin/elearning/payroll screwups. Predominantly Scotland Wales Yorkshire and another northern deanery. Everywhere else you're paid by trust, I've had 4 employers in the last yr it's a pain in the neck for hmrc, I'm on my.9th tax code since April

But you're 100% right on tbe continuous employment for sick pay/maternity etc etc moving still counts

mumsneedwine · 28/05/2025 17:59

People who actually work in medicine - you will rotate every 6-12 months (a v few foundation tracks are at same hospital but after that it’s moving a lot).

People who don’t work in medicine - my friends uncles dogs aunties rabbit never had to move so you are wrong.

And I’m happy to report that DDs friend will now be getting maternity thanks to the BMA. Idiot HR dept have backed down (took a legal email !). Thanks for the advice here too.

Every time you rotate to a new trust (pretty much h every time) you get a P45 and they much up your tax code. Bonkers inefficient system.

mumsneedwine · 28/05/2025 18:00

And I love the idea of redundancy 😂😂.

mumsneedwine · 28/05/2025 18:07

@Auchencaryour DS and friends must all be in London at v v small deaneries ! Or have had long commutes. Maybe Trent as that’s probably just about drivable. Because you will never be in the same hospital for all your training and will have to spend at least some of the time at a regional
DGH. Lots stay in the same house and suck up the 1-2 hour journeys. But for big deaneries this isn’t possible. Not sure anyone would fancy commuting to Truro from Exeter.

Auchencar · 28/05/2025 18:10

All in London yes mumsneedwine, although two (a married couple) have chosen Bristol for the latest stage of their training.

mumsneedwine · 28/05/2025 18:12

Here is a fantastic article by a v senior doctor

https://www.bmj.com/content/384/bmj.q79

mumsneedwine · 28/05/2025 18:13

@Auchencar they haven’t chosen Bristol. They’ve chosen Severn. So they’ll be spending some time in Taunton, Gloucester, Bath and/or Swindon. Some nice commutes !

Auchencar · 28/05/2025 18:38

London deaneries aren’t small; simply that transport links are good, obviously. Doctors rotate just as they do elsewhere but it’s not the huge deal that it appears to be for your DD. Exeter to Truro would be a pain. The trainline beyond Exeter is not in the least resilient. Exeter to Plymouth dead easy though.

mumsneedwine · 28/05/2025 19:01

No it wouldn’t. It’s 1.5 hours by car on a good day. It’s 50 minutes to Torbay. No idea why you always bring my DD into it - not talking about her. She’s fine thanks. But many many doctors aren’t. Even London deaneries can be have hard to reach hospitals - and you don’t get any say in which one you get.

South London - some nasty commutes if you live near one of them. Not impossible but makes for V long days !

To be or not to be a doctor?
mumsneedwine · 28/05/2025 19:03

So Exeter to Plymouth is an hour by train. But Derriford is no where near the station so another 20 minute bus ride. So with waiting times that’s a good 1 hr 40 each way (if you live next to Exeter station). So not great after a 13 hour night shift. No idea of the cost !

mumsneedwine · 28/05/2025 19:05

These would be interesting journeys every day 😂

To be or not to be a doctor?
mumsneedwine · 28/05/2025 19:09

And then there’s N West Deanery. You move hospital every 6-24 months. Maybe people own helicopters

To be or not to be a doctor?
mumsneedwine · 28/05/2025 19:11

Exeter to Plymouth annual season ticket - £4,430 !!! Ouch

Auchencar · 28/05/2025 19:16

Yes obviously that’s what I meant mumsneedwine, Severn. Nope, so far only Bristol tbh. They’ve been there a couple of years and are settled. Of course with one friend being on (paid) mat leave her commute isn’t currently relevant but so far neither have had any problems with commuting.

mumsneedwine · 28/05/2025 19:19

Severn is one of the smallest deaneries so they are commutable (except maybe Gloucester). Lucky to only have got Bristol and no DGH, that’s v unusual. Parking is a nightmare at Bristol hospitals but like London, v good public transport. I love Bristol 😊

Bluechoc · 28/05/2025 20:20

I’m now a medical consultant . In one of the very few specialties where family life / pressures are slightly less than the more acute ones. However I did my time during training!

i love my job. Being a doctor is a vocation. I can’t think of any job I would rather do. It’s satisfying, I feel like I’m helping others , I feel intellectually stimulated never bored and love the actual work.

the gov have essentially *ucked up an incredibly satisfying job. The sacrifice , the pay, the changes, the pressure, the expectations I’m glad my kids have no desire to do it.

I wish it was different and if either of my kids were very keen I would encourage practicing elsewhere post degree.

the nhs is an absolute mess and I’ve no idea how it’s going to get better. On the shop floor everyone is feeling it morale is low and doctors pay is NOT accurately portrayed by the media.