The next doctors’ strike

Nope there have been problems in training for a long time, I'm posting a link to a very comprehensive report that identified all of the issues that are still being raised today. The report is from 2007 and it seems very little has changed. However, what has happened is there has been an erosion of doctor's salaries since the 2008 banking crisis, doctor's now leave university with considerable debt and in August 2007 hospital doctors ceased to have access to free hospital accommodation.

image.guardian.co.uk/sys-files/Society/documents/2007/10/08/MMC_InquiryReport.pdf

In my experience in the past doctors had to be able to move anywhere in the country. eg Scotland to Devon then next to Kent. Being a doctor was never easy.

nanna8

My grandson, a young doctor , works 12-14 hour shifts and half the time is totally exhausted. He also owes thousands of dollars fees for his training. It is so wrong how they are treated but he never complains though I worry about him driving home after those ridiculous hours. I don’t think uk trained doctors would find life any better here.

In Australia, young doctors can get help with their loans if they volunteer to work in more remote areas for a period of time, perhaps because fewer young people want to go there and so recruitment is difficult.

nanna8

My grandson, a young doctor , works 12-14 hour shifts and half the time is totally exhausted. He also owes thousands of dollars fees for his training. It is so wrong how they are treated but he never complains though I worry about him driving home after those ridiculous hours. I don’t think uk trained doctors would find life any better here.

DD has friends working in Australia and New Zealand and they all report better salaries, much better working conditions and definitely more respected. The quick research I've done supports those views. On that basis if your grandson finds training in Australia tough, he should know it's much tougher in the UK but I bet he knows that.

I’m glad your daughter is settled Foxie.I hope for the same for my neighbour 🙏🏻

foxie48

Aveline yes I know doctorss have moved round in the past but it was within the same deanery, I have no issue with that. However, now that stage 1 and stage 2 training posts are treated differently, a doctor could be in one deanery for stage 1 and in a completely different country for stage 2. This is really disruptive for doctors who are in relationships, have children at school etc and it makes it very difficult to have a social life. Back in the "old days" doctors worked in firms, there would be a social club and bar attached to the hospital, and support networks would be kept for many years through training. None of this exists now. Resident doctors are no longer part of a team and frequent moves means they can become quite socially isolated which is not good for their mental health.

It’s one of the advantages of Wales, with one Deanery for the country, all the resident doctors we know live in Cardiff and commute to virtually all the sites, except those in North Wales. It’s a small world, which has both pros and cons - one of the pros is that when they move between hospitals it’s very likely there will be other doctors there who they already know.

Susan56 icanhandthemback thanks for posting, unless you have a child going through the system, it is almost pointless trying to explain that "it's just not like it used to be"

My daughter is in Wales and intends to stay as she has put down roots there but she still spent a year travelling to Bristol on a daily basis as her three year stage 1 training post changed part way through to a two year one and left her high and dry! 12 hour shifts on top of a three hour round trip is not much fun. She had to drive as the train times didn't fit her shifts.
She also had a very long term relationship break up as they were both doctors at the same stage of training and they never saw each other. Fortunately she's now happily settled again with a guy who is not a doctor and who is incredibly understanding about her shifts and, prior to her getting her fellowship, the time she needed to spend revising for exams. I hope your neighbour's son finds the same.

My future DIL had to move over 200 miles to do her training. The system changed last year and it is now done by a lottery system rather than anything else. No benefit for undergraduates to put in the extra mileage to get top marks or be close to where their support networks are and nothing to help UK students to gain employment to do their residencies. An absolute travesty and not something a good Human Resources Department would recommend.

Our neighbour is hospital based and much like Foxie’s daughter works very long hours and is permanently exhausted.He won’t be striking as is based in Wales but if he was he said he would be striking for better work conditions.The guidelines to how many patients should be seen in a night shift is often more than doubled and twelve hour shifts are never less than 14 then back for more the next day/night.
His relationship has ended.I feel so sorry for him.A lovely young man who just seems to work and sleep.

Aveline yes I know doctorss have moved round in the past but it was within the same deanery, I have no issue with that. However, now that stage 1 and stage 2 training posts are treated differently, a doctor could be in one deanery for stage 1 and in a completely different country for stage 2. This is really disruptive for doctors who are in relationships, have children at school etc and it makes it very difficult to have a social life. Back in the "old days" doctors worked in firms, there would be a social club and bar attached to the hospital, and support networks would be kept for many years through training. None of this exists now. Resident doctors are no longer part of a team and frequent moves means they can become quite socially isolated which is not good for their mental health.

Doctors get 28 days which increases after 5 years, pretty much like any other employee. This myth that doctors get long holidays is exactly that, a myth!

ronib

But how many weeks of holiday are given to doctors? My gp once told me for some unknown reason that gps had 8 weeks leave a year!
Compare this with working conditions in startups for example where it seems that holidays don’t figure in the business plan.
So perfectly possible to work 2 years with no holiday time…. And redundancy is a very common issue in startups. So not only doctors with employment problems.

In the UK, the minimum paid holiday entitlement is 5.6 weeks (28 days for a 5-day week), which includes bank holidays, calculated pro-rata for part-time or irregular hours, ensuring fair treatment by multiplying working days/hours by 5.6 (or 12.07% for variable hours).

We employed carers part-time and we HAD to pay for holidays and give them a chance to have a pension even though they had very short working hours. Holidays most certainly have to be included in business plans...except for the boss if self-employed!

ronib

But how many weeks of holiday are given to doctors? My gp once told me for some unknown reason that gps had 8 weeks leave a year!
Compare this with working conditions in startups for example where it seems that holidays don’t figure in the business plan.
So perfectly possible to work 2 years with no holiday time…. And redundancy is a very common issue in startups. So not only doctors with employment problems.

The vast majority of GPs are contractors ronib, not NHS employees. They can take as much or as little annual leave as they choose.

My grandson, a young doctor , works 12-14 hour shifts and half the time is totally exhausted. He also owes thousands of dollars fees for his training. It is so wrong how they are treated but he never complains though I worry about him driving home after those ridiculous hours. I don’t think uk trained doctors would find life any better here.

But how many weeks of holiday are given to doctors? My gp once told me for some unknown reason that gps had 8 weeks leave a year!
Compare this with working conditions in startups for example where it seems that holidays don’t figure in the business plan.
So perfectly possible to work 2 years with no holiday time…. And redundancy is a very common issue in startups. So not only doctors with employment problems.

Foxie48. That's the point of my post. How can training places be increased in number. Obviously, prioritising UK doctors would be a practical thing to do. Govt should just get on to that and push their way through the legal morass that would appear. It's doable. Young doctors have always had to move to where a job is offered. It's nothing new.

Mollygo

But you are of course entitled to decide whether you believe driving when shattered after long hours at work and just a few hours sleep is safe.

Doctors on nights are frequently tired but it doesn't stop them from having to make important decisions about patient care and performing operations and highly skilled technical procedures which are far more demanding than driving. In the "good old days" when junior doctors lived on site and worked in firms, they often got some sleep when they were on nights. That rarely happens now as nights are pretty full on for most doctors!

Aveline the training issue has been in the making over a number of years but the first thing that IMO is medical graduates should be guaranteed an F1/F2 job and there should be some weight given to where graduates actually want to live and ATM there isn't.
Specialist training posts should be allocated first to UK trained doctors but this would require a legal change in our employment law, I believe.
Increasing the number of training places is not easy to do without increasing the number of consultants and ATM many specialisms are short of consultants, half of NHS organisations have at least 10% of their consultancy posts unfilled! You can't train doctors unless you have the people with the skills to train them, that's why losing doctors part way through their specialist training is so damaging to the NHS.
Regardless of those who believe Doctors, especially consultants, are well paid, compared to many with similar levels of expertise and training and who are in short supply, they are most definitely not! However, because they can only work for the NHS if they want to be trained, they can't market their skills like lawyers, IT specialists, recruitment people etc which holds their bargaining power down unless of course they go abroad where pay and conditions are much better. fwiw my daughter has friends in these occupations and despite having had far less training, having smaller uni debts they are all paid significantly more than she is at the same age! Fortunately for the NHS she wanted to be a doctor and I think she'll stay in the UK.
Over 4k left in 2024 to work abroad and we need to encourage doctors to continue working, over the past few years there's been a year on year 10% increase in the numbers taking early retirement and this is a serious loss of skills both in terms of patient care but also in training. Retention has to be an important factor is increasing training places

She's hospital based of course, she's also pregnant and although in her second trimester, she's still being sick quite a lot but I didn't think that was relevant to Mollygo's post. She'll come off being on call and nights at some point but ATM she wants to continue although she could request it.
I'm afraid I do bristle when people describe doctors as greedy, selfish and all the other insults that are currently flying around. When I see someone I love navigating the difficulties that young doctors face in the NHS and hear people continually complaining about them, it makes me wonder why any of them stay working in the UK but then I'm biased! I also know a lot more than most about what is actually happening rather than what people read in the media!

But you are of course entitled to decide whether you believe driving when shattered after long hours at work and just a few hours sleep is safe.

Back from personal issues and those around pay, what would it take for training places to be increased? Would it mean slightly reduced capacity to see patients as senior doctors have to be more involved in training larger numbers of more junior staff or could they just be gradually increased? How could the funding be found to pay for these new, extra staff members? I'm interested in the practicalities here.

You need to live near a motorway or roads that are constantly blocked by accidents, many according to reports caused by tiredness, as well as drugs, careless driving etc, before you say anything about mean spirited.

Good for your daughter, foxie. I'm sure she is a good and careful driver.

Mollygo, I read your post as a mean spirited, unnecessarily cold and critical response to foxie . Where did The suggestion this life saving busy doctor was putting others at risk by driving come from

Your point about seeing a doctor probably relates to the difficulties we all face in getting a GP appointment. Foxie’s daughter is I suspect, hospital based

Spirit of goodwill needed

Kind of you to be concerned about my daughter's safety. Nights are part of most resident doctor 's lives and she had slept for a few hours before driving to see us but it's a known fact that it's really not good for people's health. However, someone has to be working through the night, don't they? I didn't say she was overworked either, I was demonstrating the range of skills that she needs to have whilst on-call.
I'm sure your niece gets fed up at times as paramedics are having difficulty finding jobs just like resident doctors. My daughter was on a survival medical course last month ( she spends leisure time volunteering at events such as the marathon des sables) She said another of the participants was a newly trained paramedic, of the 15 who trained with her, only 3 have managed to secure jobs so far. I'm sure your niece will know all about this. It's the same with newly qualified nurses and although there's a shortage of GPs, we have unemployed GPs too. Such a dreadful waste.