To be or not to be a doctor?

[MrsDThaskala]

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?

Yes, medics are currently being squeezed from all angles.
And no one is listening

Because it’s not your experience does not mean it’s no others

Did any of them join the most recent strikes? Most residents in my London Trust did. The ones that didn’t tended to be IMGs.

I really love my interactions with resident doctors. They are usually a really impressive group who humble me regularly. And they are much nicer to me than my own young adult kids ;-)

I feel like a bit of a hypocrite as I interview for my London medical school. I enjoy it and blown away at how prepared and knowledgeable they seem already, even at sixth form. Yet I am relieved that my kids are not now in that position…

Yes they all did. One was front page photo :)

GrowAway striking with colleagues is different from the endless moaning which seems to be the order of the day on MN. These are bright young doctors who are showing plenty of resilience in difficult circumstances. I think they prefer to channel their energies into their job rather than posting endlessly on Reddit.

I’m still astonished that anyone even moderately bright could seriously believe HR were correct when they spouted this nonsense about mat pay. My DC would instantly challenge the HR person. It’s a very flaccid approach just to tell a friend who tells her mum who repeats it on social media. People really do need to apply common sense before posting misinformation - it can do real harm.

Incidentally none of the circle are IMGs - all UK educated.

(Although obviously it was good to see that the misinformation was corrected swiftly in this instance).

Imgs weren't allowed to strike in the 2016 rounds for visa reasons, they now can

What about the 2023/4 ones?

I don’t think moaning on Reddit and ‘constructively’ going on strike are mutually exclusive 🤷🏼‍♀️ If there is one thing residents can do, it’s multi-task!

I would say that moaning is unconstructive, almost by definition. Indeed that’s why I juxtaposed. It’s evidence of a negative mindset which my DC and their medic friends don’t appear to have.

They can strike now the rules were changed so can't lose their visas if strike (just has to be declared to home office, tbh a lot of my mates still didn't as were too worried

We all have to remember that Auchenar’s offspring and friends are a cut above all other medics 😂. They are too good to need to worry about money or jobs. Meanwhile, in the rest of the world, doctors are going to be unemployed. And yes, they will moan about that.

This. It’s why they ‘Moan’.

Anyone wants a clearer idea of the issues

https://thedoctor.bma.org.uk/articles/life-at-work/specialty-training-squeeze/

And this. Moan away young doctors. Because being ‘negative’ it’s just stating facts to most of us

https://www.bbc.co.uk/news/health-68849847.amp

I've never said anything of the sort, about being 'a cut above'. You will be very hard pushed to get any rise out of me, I just don't care at all about imputations made by anonymous posters on MN.

In fact I would point out that I've several times said that I simply don't see doctors as uniquely special in the way that you clearly do. Lots of young people work exceptionally hard and have to manage anti social hours. Also, individual doctors don't 'save lives' on a daily basis any more than nurses do or policemen do or lawyers do (although lawyers arguably tend to save future lives with their work). Some doctors never save any lives and cause harm, because they're just not good at the job (and the same can be said for lawyers too of course). I just don't know why we're expected to treat doctors as uniformly special. Some are actually really unpleasant (ditto some lawyers of course). One local GP bruised her four your old's arm badly right outside my house and then made lame excuses when the child came crying to show me. Basically, not as sure as you are that they should all be canonised.

By a 'cut above' perhaps you simply mean that the young doctors that are friends of my DC (as well as my own DC) have got training with no real difficulty at all (aside from effort). Several are currently doing fully funded PhDs at Oxbridge and in London but they have their training number now so will simply resume the final stages of training once the PHDs are done.

My doctor son left the NHS to work for a big pharma company five years after he qualified. They all start out with such good intentions - to make a difference - but working for the NHS knocks it all out of you.

@Auchencar if your offspring and their 'circle' are in their last couple of years training before reaching consultant level, then they have not had to deal with the issues faced by the current graduating students and current F2s, in terms of how F1 jobs are now allocated, the issues of insane increases in competition ratios and IMG applications for post F2 training, and the impact that PAs is having on training opportunities for F1/F2 doctors.

Unfortunately your posts do come across as 'my kids and their friends didn't have any problems so your kids must be lazy/inferior', but as your kids are a few years down the line, then they just didn't face the same challenges as those coming through now. I am not saying or implying that they didn't have challenges, no one that chooses this road has it easy, but comparing the experiences of your offspring with those coming through now is just not a valid/fair comparison.

My dd has been very lucky. She is due to start her F1 in July in a London deanery. She and her partner are flathunting in the area of her F2 hospital with the plan of travelling 'in' to her F1 hospital for the first year, and to her partners job, which happens to be at the 'right' side of London. The place they're looking to live is under an hour from our family home. She's worked hard, but is very aware that she's been lucky in the random number generator, rather than having got where she wanted because of her efforts and achievements. She feels terrible for those who have worked just as hard and are being sent away from their partners and families, or ended up as placeholders - and for the many F2 doctors that she's got to know who are facing unemployment very soon.

I am one. If she does for the love of how science becomes art and it’s more of a calling than a career, she’ll do well and enjoy it. I am strongly discouraging mine from going into med school because I can see that she doesn’t have a passion for it. Which will make those psychological, physical and mental demands unbearable, especially in the earlier years when you’re not much more than a teenager.

someone once told me medicine was one of the few things you can do that pays relatively well without you having to be particularly good at anything.

although this was said pre 2008.

HostessTrolley I thought 'circle' would do. I'm actually talking about more than a single group of friends since I'm talking about more than one DC. I think you may be seeing rah vibes where none are intended. The groups are relatively interconnected on account of my DC being at the same uni. Most of the young doctors that I'm talking about are in the final stage of training, and so across the specialty registrar hurdle with three or so years to go. Some did additional degrees at an earlier stage or have taken time out for maternity (paid) so are slightly behind. But while you say they didn't have the same challenges, they do all share the same pay structure, the same hours, the same issues with rotations, the same exhaustion after several nights in a row, the same work environment etc etc and above all the same concerns about the NHS. That said, one of my sons is engaged to a current F1 so I'm not as estranged from the newest cohort as you think. I do understand everything going on with numbers and I've read with interest the previous threads where certain statistics have been put into clear context and interpreted by consultants in a different way to the apparent headline version.

I've never said that my DC/ their friends are 'a cut above'. Another poster said that, presumably to discredit anything I say. I have zero interest in that sort of thing so I just bat it away. What I have said that they're all (DC and friends) making their way in a crowded and competitive field and that they don't moan endlessly and do the whole woe is me stuff which pours out from these threads. It's way over the top. One (not my own DC) opted for Australia not because he couldn't get a post following F2 but because he wanted a change. He came back and was top in the country for his chosen specialty so had the pick of places to go to in terms of location. The high emotions on these threads are not helpful for anyone advising young people. The sensible and grounded advice from a good number of seasoned consultants obviously is. I'm not clear that only giving the burn and crash accounts is helpful either, so I'm flicking in a less apocalyptic one for balance. I think that should be ok and be capable of being read without tripping any heated responses.

I am amused by the great faith in HR. Offices have been off-site so little connection to the day to day work of doctors. Presumably a fair amount of wfh. The NHS is also great at the sideways move for the less competent, and it might be that Department heads do not see rostering for F1/F2s as the most critical job.

So a new person who blocked leave because they were short staffed only to discover three months later that all the then F1s had large amounts of leave that needed to be taken within the month. (It was DDs first rotation and a busy one with lots of nights and death. Like a first term in a new school, she was completely exhausted by the end of those three months. A couple of days off in the middle to rest and rewind would have been invaluable for her and possibly for her patients.) Or the more savvy one who allocated F1/F2 leave before the rotation started. Tough if you wanted to go on holiday with friends or had a wedding to attend. You accepted what you were given. Or the near invisible rota organiser who did not give them their rotas till a couple of days before, and did not respond when DD pointed out that she started with nights thus missing her induction. It led to a consultant shouting at her because she was not aware of a basic departmental procedure, but she is resilient and caught on quickly so the underlying problem can continue to be ignored.

DD is able to be assertive. (Plenty of experience after joining a boys public school for sixth form, with a leadership position thrown in for good measure.) Yet she has struggled. Examples:

• two days of arguing with HR over their plan to have her start a long day shift an hour after five busy nights. They did not see that this was unsafe. Resolved when she threatened to go to the Union.
• A month of daily requests to get hold of a recent payslip needed for a mortgage application. Turns out they had not sent anyone a payslip for that period. Finally, with a real risk she would lose the house she was buying, she announced she would call into their offices to pick it up. As a special case they agreed they would print a copy off.

Lots more. The attrition rate amongst good F1/F2s is huge. Things were still allocated on points so DD got her first choice of rotas, and her peers would have had similar. Far too many have gone, indeed they are down three out of six on her current rota. Being on the old contract does not help, but nowadays you don't get to choose. Staff shortages and the recruitment of doctors, all the way up to consultant level, who are new to the NHS does not help, not least because it can mean F2s are having to gatekeep their department from referrals based on over caution from more senior doctors in other departments. One F2 friend had an awful dilemma. One small and understaffed department had decreed they would only take referrals from doctors at a certain level. It was night and his patient needed seeing urgently. The on call consultant was furious at being woken up by an F2. Luckily it was the right call, awful if it had not been. Another F1 friend got dragged through an inquest, effectively by bereaved relatives. It was agreed that she had done things by the book, but an awful few months. The same could have happened to DD. On one handover she spotted that a patient was about to die and beyond treatment, but had time before the day shift ended, to call someone more senior over to reassess. The family, who had been given false hope, were griefstruck and inevitably angry with the F1 who had caused treatment to be withdrawn. Another time she had reason to politely point out to one of her more senior colleagues that something was inappropriate. It happened without fuss, but it seemed sensible to mention it to their boss. Next day the doctor was gone, and DD felt awful. The incident was not that serious, but it turned out that the doctor was on a final warning.

Some consultants and departments have been lovely and very supportive. Others less so. There is stress throughout the system and in places dysfunction is creeping in.

https://www.bbc.co.uk/news/articles/c4g36q8qepeo

They were a department that was still allowed to have F1/F2s. Elsewhere there are departments where the attrition rate is so high that F1/F2s can no longer be placed there.

DD still loves being a doctor, and consistent feedback is that she is very good. But it is not easy. and there does not seem to be anyone actually looking out for them. To suggest that pointing out the problems is moaning is bizarre and unfair. And from August she will be reliant on zero hours bank work. Yes a very very small number got onto training but:

• she had yet to decide her speciality
• she had decided to opt for busy placements deciding that experience was important, and that, like the teaching fellows she had met at University, she would take an F3 with the time to study for exams. I am told that others deliberately chose rotation with relatively light rotations for the first two F2 placements to give them time to study. Current F1s do not have the choice.
• her way of coping with long and stressful hours is sport. For others it might be music or plain chilling. My guess is that those who can then go home and pick up the books are the exception.

So OPs DC should be a doctor if they want to. But they need to go into it fully aware that the system is broken and that no one, employer or Union, seems to be looking out for those at the start of their careers.

I think there is a risk when extrapolating across a group of friends, as friendship groups are self selective. I could easily say that DS and his friends all got firsts and most headed off to prestigious Universities, mainly in the US, because they did.

But that may not be true now (Trump!) nor is it true of all studying economics. And indeed not true of all at the LSE, a good proportion of whom will struggle with the maths content.

Which does not mean that others will not make good economists. They might not be suited to specialised quant jobs, but there is a wide range of jobs that hire those with economic backgrounds. DS has little interest in working in IB, and indeed one of his friends turned down a coveted summer internship with Goldman Sachs. He then did some Teaching Assistant work for a very well know MBA programme, where most were sponsored by their employers and the technical level, certainly compared with his Masters at LSE, was not high. It does not matter. The participants are bring other skills to the table.

It becomes horses for courses. There are lots of jobs in medicine. The boy who came top of his speciality is probably, and rightly, aiming for a top London teaching hospital. However if the Royal Victoria, quoted in the article above, are looking to hire, I would expect they will be looking for management and people skills as much as good surgical competence. They will be less interested in someone with tip-top academic skills if they don't have other things to bring to the table.

There is a problem. The NHS has staff shortages all the way up through to consultancy level. Many at the bottom of the ladder, including on the key BMA committee, are reporting issues with establishing a career path in the UK.

The fact that a small friendship group, probably all Oxbridge and the six year degree, as doing fine is not an argument for saying that everything is fine.

This poster has previously confirmed that they are not a bored golf-playing housewife from the home countie, and instead has hinted that they have some sort of expertise/role in NHS policy making. No surprise then that any suggestion that something is wrong is batted away as moaning. Trouble is that is it not just F1/F2s who are struggling. DD sees Consultants laving to work in other countries. A London consultant friend says that overseas born colleagues (the example she gave was an Australian) finally admit they have had enough and rather than wait till they can collect their pension, are starting to look for work in their home countries.