Busy. One simple word which describes the lifestyle of a typical junior doctor. Five years of gruelling undergraduate education, as well as the cost of the training courses and exams, make the profession one of the most demanding in the United Kingdom. The taxing nature of the process has not been made any easier by government policies and systems implemented throughout recent years.
Trainee doctors in the UK follow the current postgraduate training structure created by the Department of Health – the Modernising Medical Careers (MMC), which is a means of deciding which speciality to follow after a certain number of years of training. The MMC’s introduction in 2005 led to what could be seen as one of the first of many criti- cisms the Department of Health has received about the treatment of junior doctors. In particular, this affected the number of training posts available, which could have resulted in many doctors leaving the UK to train abroad.
Currently a similar situation is occurring as a result of a insufficient funding going directly into medical resources, as well as over- stretched doctors struggling to deal with an influx of patients due to a shortage in staff. In 2016, around 12.7 per cent were either train- ing abroad, taking a job abroad, or applying for one, making it a four year high.
The stability of the NHS and the livelihood of a junior doctor is not what it once was, although they still have the highest paid starting contracts after they have left university. The instability created by Jeremy Hunt (the Secretary of State for Health) over the junior doctor contract disputes, and the recent disagreement between the politician and Stephen Hawking over the misinterpretation of research behind Hunt’s ideal of a seven-day NHS, leaves a lot for current junior doctors to think about.
I’m trying to find my own feet…those who have worked for a lot longer may feel differently
Needing to understand the current condition of junior doctors in the North, and more specifically the York area, I first speak to 23 year old junior doctor of two months, Ofuchi Egbuji, who studied for her medical degree at the Hull York Medical School. I ask her to define the role of a junior doctor. She begins by saying that “junior doctors vary in grades, so for example, the lowest point is a first year foundation doctor, who normally runs the wards. For example, in the administration ward you are the person who makes a list of all the jobs that need doing regarding new ad- missions. It goes all the way up to Registrar.”
As a junior doctor with only two months of experience, Ofuchi highlights that the hours of her job differ from “the standard junior doctor job”, which the media often portrays. “My hours are okay,” she says. “I work four days a week in a Psychiatric Hospital in Tamworth and one day a week in Queens Hospital, Burton. When I am in the psychiatric ward I am not that trained or experienced in psychiatry, so my job is mainly the physical health jobs: to be more like the patients’ GP.”
Building on this, I ask Ofuchi about her average patient: “I see a lot of elderly people that have falls and have become unwell because of that. One that struck me the most was an alcoholic that was vomiting a lot of blood.” I ask Ofuchi if she’s concerned about her hours getting longer once she does get more training in the future. She says longer hours are “inevitable with the job unless more doctors are filling in the rota gaps and it will inevitably become worse”. While this is the case, Ofuchi believes her colleagues who are not doing nine to five shifts like her are being overworked. She gives an example of the acute assessments unit where the staffing can be low, which raises stress levels among the staff. She says that she can tell it can be difficult to “keep it together”. In her particular case, her work is going smoothly so far, and it is only when someone goes on leave that she begins feeling a little overstretched.
I ask Ofuchi whether there is anything doctors do when they are feeling emotional pressure caused by seeing seriously ill pa- tients or working longer hours than neces- sary. “What I try to do,” she tells me, “is fall back on the framework that we are taught. When you go through medical school, when you go through training, you are taught specific ways of doing certain things.” Most importantly, she encourages everyone to talk about what they’ve seen and what causes them distress.
I ask Ofuchi if this has caused her to worry about the future for junior doctors such as herself. She tells me it has. “It doesn’t seem like it’s changing positively quickly. Despite what’s going on, they are trying to make changes, such as exception reporting. If you are going over your shift too many times in a row, or if people feel like there is some kind of problem, then you can report it. I feel like they are trying, but at the same time people still aren’t satisfied with their work environment.”
When I ask her what she believes the government can do to help ease the pressure off junior doctors, she finds it difficult to answer directly. After some thought, Ofuchi tells me she believes that putting more money in the system would help, and that actually talking to junior doctors would assist in implement change. She tells me later that she isn’t sure if she can comment to an efficient enough standard as she describes herself as trying to “find her own feet”, but “people who have worked here for a lot longer may feel dif- ferently because of their experience.”
Ofuchi tells me that based on her experiences, the reason she wanted to study medicine was because of how people oriented the profession is. She adds to this by expressing how her religion has affected this decision making process, and her role as a doctor as a whole. “I am a Christian,” she begins, “and I like the fact that medicine is reinforcing certain virtues. By putting the patient first, you are caring for them.”
No matter how tiring it can be, the next morning I am all ready and excited to start the new day
Ofuchi’s views are not dissimilar to Arpan Doshi, just 21 years old, working at York Teaching Hospital. He explains that he has “always been fascinated with the human body” and wanted to be a part of a rewarding profession while helping others.
Having entered university at just 17, he is thought to be the UK’s youngest doctor. Arpan was accepted into the University of Sheffield as a medical student after passing his International Baccalaureate exams in France, which ensured him a £13 000 scholarship towards his medical studies. When asked how it felt to be the country’s youngest doctor and whether it was a title that he wanted to achieve he said, “When I started studying medicine, I knew I was one of the youngest in my year but did not know that I was the youngest doctor in the UK. My parents have really supported me throughout my studies and I feel like having achieved this title, I have made them feel proud more than anything. It does feel good to have this title, but it was never my intention.”
I ask Arpan what made him move from Sheffield to York for his medical training, to which he highlights York’s beautiful culture and history. But when delving into the depths of the NHS’s funding and staff shortage, Arpan admits that “sometimes it does feel like they are stretching a bit to make it work”.
He explains that his from 8am to 5pm, but he does have long night shifts and on-call weekends. At the time of the interview, he mentioned to me that he just came back from his first 12 hour on-call weekend shift. Despite this, Arpan takes it all in his stride, highlighting to me that despite the challenges which junior doctors face on a daily basis, he is planning on finishing his training in the UK rather than moving abroad. He says, “I “have always seen it as a challenge and that has made me even more motivated to become a doctor. Yes, it is a hard job and sometimes you just want to come home and sleep, but still it is a really satisfying job. No matter how tired I am after coming back from a shift, the next morning I am all ready and excited to start my new day.”
It is clear that both Ofuchi’s and Arpan’s experiences, while not entirely dissimilar, differ from the media’s coverage of junior doctors in the country, but also represent a similarity with medical students and recent graduates who cannot fully comprehend the situations more experienced junior doctors are in. It is easy to understand why this may be the case for them; while they are aware that their situation may change in the near future, this anxiety is too far ahead, and may only be felt by more experienced colleagues. M