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10 Reasons Not To Be a Doctor (Or Work For the NHS)

Why Doctors should strike


Being a doctor is one of the most glamorised jobs and simply saying you are a doctor earns you a respectable nod from most people. The NHS employs over 1.5 million people across the UK and provides for varying roles in the medical sector, from cleaners, cooks, doctors, nurses and pharmacists. Most qualified medical professionals usually either work full-time for the NHS or part-time. Most qualified doctors have an employment rate of 99.30% the highest in any subject across the globe because they are needed and classed as "essential workers" (thank you COVID for that one).


The NHS currently is facing a record demand for both urgent and emergency care services (Again - Thank you COVID). So far we have had nurses and paramedics across the UK striking for better pay and with the ever-increasing cost of living it is vital that people get paid for the work that they are putting in.


Now, there are some benefits to working for the NHS such as flexible working hours, a final salary pension scheme, some professionals getting their tuition paid in full or partially and a flexible career path within the system.


reasons you should not be a doctor in the UK

Junior doctors strike:


From the 13th to the 15th of March junior doctors, a planning a 72-hour walkout following the increasing cost of living and the complete disrespect of pay. Doctors demand a 26% pay rise whilst the government states this is simply not "affordable".


This is quite scary because in the last strike held 7 years ago a total of 300 000 appointments were cancelled.


1. Poor pay


During foundation training, doctors earn a basic salary of between £29,384 and £34,012 per year. A doctor beginning their specialist training will earn between £40,257 to £53,398 a year. This can be slightly more if you do on-calls, longer work days, work nights and or unsociable hours you do. This document gives you a general idea of how pay has gradually declined as the cost of living and inflation have risen. Imagine applying to work for a company and being informed you will be earning less than what your predecessors earned 10 years ago. The NHS salary for junior doctors is an actual, literal joke, especially considering the working conditions that are the NHS.


Recently 97% of junior doctors voted to strike as they are unhappy with the above pay. The junior doctors have held the NHS together amid the spiralling staffing and patient overload crisis and it's safe to say they are exhausted. the HCSA president, Dr Naru Narayanan, said, "In return for this huge emotional, mental and physical toll, they’ve been subjected to a decade of real-term pay cuts totalling over 26 per cent. Enough is enough."


According to the BMA, Junior doctors have had a 26% pay cut since 2008 if inflation is taken into account. Many of my colleagues have decided to strike for various reasons, and Dr Jatinder Hayre summed it up perfectly by stating, "Yes, I will be striking, for my colleagues, my patients and to save a wounded NHS. We ask not for resolution but for resolution."


With the cost of living most junior doctors, wake up, head to work, get home and redo the entire day again.


2. Horrible shifts


A lot of junior doctors work long and unsociable hours. Typical hours range from 8 -16 and sometimes with no break. Yes, this comes with the territory of working as a doctor and most doctors are fully aware of this before starting clinical practice. However, understanding something in theory and living it are two very different things. But coupling the long hours and a lack of support, poor eating and sleeping facilities, poor supervision and entitled patients can make a regular 12-and-a-half-hour shift feel like you have been carrying around a tonne of bricks.


Dr Jatinder Hayre stated that during the first two weeks of his training, he was doused in urine, sent to request scrotal support (LOL) and was barely able to get to finish work on time. Dr Ruqaya Idreess stated, "During my first year as a junior doctor I just felt like I was getting up, going to work, coming back, having some food, going to bed, getting up, going to work, coming back, having some food, going to bed. And this was just my routine. It left me more irritable, and more anxious. So, even before Covid, I felt burnt out." Currently, the overall summary is that there are too few doctors, too many patients and no solution in sight.


3. Lack of support

I was working as a junior doctor in my first week and a foundation year 1 and I was bleeped during an on-call shift to review a patient with an early warning score of 10 (Only senior registrars are supposed to review any patients with an EWS of above 8) because the registrars were not answering their bleeps. On arrival, I did a full assessment and diagnosed the patient as having sepsis secondary to hospital-acquired pneumonia, and bleeped the registrar for assistance. I completed sepsis 6 and waited for the registrar to arrive. By the time I had finished treating the patient, they were now only scoring a 3. I went to the junior doctor's mess and found the two registrars on my on-call having a "chat". I asked if she had seen my bleep and she stated, 'Yeah but I was on my break." I asked if I could discuss the patient and was replied with, 'after my 1-hour break." Whilst I respect that we all need breaks this was something I should not have dealt with alone, let alone not being given the opportunity to discuss the situation. I was deflated and I cried for a good 30 minutes before my bleep went off and I had to insert a cannula - Dr LB (Foundation Year 1)

A lot of the time during shifts there is simply a lack of support and occasionally you get unhelpful senior doctors. Rota gaps and workers falling sick with COVID have all led to very horrible working conditions.


Younger junior doctors also feel questioned and disrespected by a lot of consultants who are simply judgmental and unhelpful. Workplace bullying is rampant within the NHS. A study carried out in an NHS community trust found that 1 in 3 staff reported being bullied in the previous year, while a report by the King's Fund, an independent health think tank, found that bullying, racial harassment, and discrimination were daily experiences for black and Asian doctors.

We need more doctors, well trained doctors.

4. The lack of mental health services for doctors


Most junior doctors report that they don't know what health services are available for their mental health within the NHS. Furthermore, they do not even know who to contact. A growing plethora of evidence shows that some doctors end up self-medicating with drinks and alcohol.


At a time when mental health seems like a priority for NHS patients, why is there nothing in place for doctors that provide these services?

At a time when mental health seems like a priority for NHS patients, why is there nothing in place for doctors who provide this service? Doctors are not only affected by the cases they see: severe illness, death (including watching someone die), child abuse (sexual, physical, neglect), sexual abuse, domestic violence, elderly neglect, breaking bad news and poor care. Doctors also face abuse from patients, bullying from colleagues, poor working hours, difficulty booking annual leave, poor training programmes and just a generally poor working environment. Additionally, they have their own personal health issues, mothers, fathers, brothers and friends who also get sick, a lack of sleep, depression, anxiety, weight loss, weight gain, pain, negative thoughts, and poor work-life balance. Most people on these issues are ignored with consultants stating, "Back in my day we pushed through," another form of bullying. This leads to burnout and severe illness that takes people out of work. There need to be more mental health options for doctors and these need to be highlighted for easy access.

During my two years of being a foundation Doctor I only had two one hour sessions on wellbeing. During my first day as an FY1 I was informed that any personal issues are to be forgotten as soon as I entered the hospital and I had to build "RESILIANCE". I tried to and I failed. I ended taking six months off the foundation programme and I plan on taking an F3 year - ANON (Foundation Year 2 doctor).

5. Horrible supervision

I had my educational supervisor change mid-placement and never developed a personal relationship with him because he seemed focused on medicine. At the end of my second year, I informed my educational supervisor that my mother had died from cancer. He expressed how sorry he was, and told me to reflect on this. And then we never spoke about it again, despite my asking for some form of support - Anon (FY2).

The foundation programme is focused on the NHS recruiting as many doctors as possible. In truth, the NHS cares about the NHS. If it cared about patient care, it would carefully recruit appropriate supervisors and ensure that we are getting appropriate supervision. Colleagues of mine have stated they have emailed their supervisor at the end of the block and were asked who they were (LOL 🤣). Meaning the supervisor did not even remember to check in on them or see their performance during the placement.

During my surgical block I met my supervisor at the beginning of the placement and then saw him again at the end of the placement. Luckily, he was a chilled dude and passed me but that was strange. Luke (Foundation Year 1 Doctor)

6. The toll on your health


Poor sleeping patterns, poor diet, lack of exercise, stress, poor supervision, inadequate financial reward and programme demands will often play a huge tool in the health of most doctors.


TRIGGER WARNING:

Recently the number of suicides and doctors dying while driving home is scary. Five doctors died by suicide whilst under GMC investigation between 2018 and 2020. There have also been steps to assist doctors and improve mental health due to the sudden death of doctors in training. There have also been several doctors who have died after working a night shift and falling asleep at the wheel, to name a few: Dr Ronak Patel, Dr Lauren Connelly and Jyothis Manalayil.


With the lack of coping strategies, a lot of juniors turn to recreational drugs as a way to simply alleviate the stress that they feel because they don't have the time or energy to do anything else.


I lot of my collegues including myself take night nurse following a set of nights. Better to feel groggy that sleepy - (ST4 in General medicine).

7. More benefits of working as a Locum


Working as a locum doctor for the NHS is simply better. To name a few: time flexibility, location flexibility, financial flexibility, higher rates of pay, and a lot more stimulation. With the current state of the NHS, it is often better to have some autonomy over how many hours you can take on and how many to take off.


However, there are some negatives to working like this including uncertainty and not feeling like you are part of the team. Considering more and more doctors including consultants are choosing to locum, this is becoming a healthier career choice for most.


It is also laughable how the NHS is prepared to pay more than double or triple to locum doctors and not the same amount to trust grade or doctors in training. If the training posts were more desirable and beneficial, more doctors would apply.


8. Poor work-life balance


Looking at the hours, the stress involved, the unsociable hours and sometimes working longer than the contracted hours with no compensation at times. There is very little time to rest and take part in other activities such as working out, reading, hobbies, relationships, family and friends. At times there aren't even enough hours to have a full 8 hours of sleep (see highlighted below)

I often have to work 12 and a half hour shifts 8am to 8:30pm, the bus usually come at 9om, which i often miss because handover almost always runs over due to some doctor coming in late. The next bus is usually at 10pm, its a 2 hour commute home, and i am in bed at arounds 12:30am and I have to wake up at 5:30 the latest to make the 8am morning round. My hospital does not offer rest rooms otherwise I would happily stay in hospital during these shifts - Dr Ansu Abrahim (GPST)

This lack of balance also deters female doctors because this means they don't have time for a family or they don't have time to be with their families for weeks on end.


9. Lack of posts for the desired speciality


The NHS training programme is now longer (a way to get more doctors into training no doubt) and most people end up settling for a speciality they don't want because of a lack of training posts. The posts that most people want are highly sought after and people have to sacrifice a lot (more degrees, more qualifications, having a family, changing locations, attaining more publications, gruelling exams, gruelling interviews and not to mention the impact on their mental health. Furthermore, these speciality roles are mainly filled with upper-middle-class men, making a lot of these posts uncomfortable.


Summary:

There is currently very little benefit to working for the NHS. With 97% of doctors voting to strike and the strike going ahead in a few days, this is simply not Gen Z complaining, this is a crisis that is in dire need of being sorted.


Either the NHS changes or the doctors change
lexick.com

A lot of doctors did not want to have their names shown in this blog so most names are anonymous.


References:

- Recreational drug use in doctors: https://www.bmj.com/content/350/bmj.h2481






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A NOTE FROM LEXICK

This Blog focuses on the life of a junior doctor working for the NHS as well some interesting topics on organisation, books and christianity.

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