Junior doctors are today in the third day of a 4-day planned strike for better pay, which started on 11 April and will continue until 6:59 am Saturday 15 April. The BMA has argued that junior doctors' salaries have deteriorated by 26% over the past 15 years due to inflation and low annual rises.
There seems to be a misapprehension in the public that junior doctors are all young medical graduates in their 20s or perhaps early 30s, therefore, it's ok if they're paid lower wages. However, this isn't always the case. As shown by this recent Twitter exchange, it's not just recent graduates that are facing low wages.
Not Just Recent Graduates
Seth, a young doctor on the picket line who only wanted to give his first name, quickly dispels this myth. He said: "The category of junior doctors covers a huge range; the youngest age is 23 and then there is no set point when you stop being a junior doctor. You have got to pass a set of exams along the way. For some people, it takes 15 years or more to become a consultant."
Seth started working as a junior doctor in August 2021 and he currently works in the A&E department in the Royal Wolverhampton NHS Trust. He comes from the south of England, but his grandparents are from the Midlands, so he moved to Wolverhampton. He discussed how difficult he found it working as a junior doctor.
"I can't say exactly what I expected when I did my course," he said, "but this isn't it".
"There are ill patients and I expected to work long hours, there is all of that, but there are other pressures. I often find I have not got enough time to give the care I want to patients – for a variety of reasons. Sometimes there are no available facilities; you are told, this is the UK, the NHS, we have facilities to help people, but there are no facilities available."
The Reluctant Protester
Hibah, who started working in August 2022, had recently graduated from medical school and was very excited to start working. On the picket line, she shared that she has at times been disappointed by her experiences so far: "I have had two busy rotations and I have seen the ins and outs of the NHS that I didn't see as a medical student. It is disappointing that just after 8 months, I am feeling this way about the NHS.
"My first job was in general surgery. Quite a busy department as you can imagine, lots of acute surgical emergencies that come through the door. A non-stop job. My second job was on AMU [Acute Medical Unit]. It is a pit stop for patients to come through after they have been stabilised in A&E, but they are some of the sickest patients in hospital."
Once they graduate, foundation year doctors are expected to work 2 years in hospitals under supervision of senior doctors. Although, Hibah said that she has not always had the supervision she should have.
"In my humble opinion, I have had to do some crazy things with only a few months of experience under my belt. Having to be on call and in charge of a whole ward of 50 patients just by myself with very little experience, I don't think is safe for patients," she said.
Despite her concerns, Hibah is still determined to continue in medicine: "This is the long-awaited dream job that I have been working so hard for, for the last few years, ever since I can remember, ever since GCSEs. It is a long thing to work towards to, and I feel like you must have a lot of dedication or passion for the course and then the career to be able to continue.
"I know a lot of my colleagues didn't make it this far, they lost passion or for other reasons gave up, but as for me I was always looking forward to this moment of actually being able to apply my knowledge and actually be a doctor."
She said that she's surprised to find herself joining the strike.
"I am shocked myself, I thought I'd be the last person at the picket line, firstly because I feel morally it doesn't fit with my values and I never thought it would come to this. Also, I felt guilt, I have only been doing this for 8 months compared to my colleagues who have been doing it for more years than I have, it feels wrong to be striking at such an early point of my career.
"Everyone has different goals, what they want out of this strike. I know that for a lot of people this is about patients' safety and working conditions. I think that the public may think it is about the money and of course money is a big thing, but that is not the sole thing. It's about reverting the NHS back to the former glory, how it was 20 years ago, when waiting times weren't as bad and working conditions weren't as bad.
"When you speak to seniors now, they look at you and they tell you, 'I feel so sorry for you, I feel sorry that the NHS you are working in today is not the NHS that it was'."
Low Pay and Student Debt
Niki, who works in anaesthetics and intensive care department, graduated from medical school in 2014 and has worked as a junior doctor for 7 years. She said when she started, junior doctors had less pressures than they do now.
"I am here to stand up for all the junior doctors and NHS. Although we are doctors and we care for our patients and the teams that we work with, I feel that we are underappreciated," she explained on why she had joined the strike. "Over the last few years, we have had to make more and more sacrifices, financially, emotionally, and physically for our job.
"I have missed relative's birthday parties and trips with family because, unfortunately, I can't afford to go due to financial commitments for things like a mortgage or food. I live with my husband and child, and we have been fortunate enough to get a mortgage but that was mainly due to lots of sacrifices, savings, and my husband's pay to be able to afford it.
"I was fortunate that I went to university when the fees were £3000 per year in comparison to £10,000 per year now," she added. "I have managed to pay off a significant proportion [of student debt], but I still have probably around 7 years to pay off, so I am trying to pay back my dues to the government and pay my loans off."
Lack of Staff
Describing the increased pressures, Niki spoke of the toll due to the lack of staff: "I have been on many shifts where there is not enough staff, nursing staff, midwifery staff, when I have done my maternity on call, to be able to provide the patient care that they need. Luckily, the patients don't realise that it is that unsafe because we put on a brave face and we try to give everyone the best care. I have been in A&E resus with very sick patients and, usually, it should be me and a very senior A&E nurse and another staff nurse to take care of these patients, but sometimes it is just me.
"I can give good doctor care but the nursing care and the HCA care that they need can't be given and then the patients suffer."
Despite braving the cold weather conditions to join the strike, there isn't much optimism amongst the strikers for the outcome from the 4-day walkout.
Seth said: "I don't think this strike will achieve what we set out to do. There are no talks from either side now, I think it will keep going until the next election with very little achieved.
"A 35% pay increase will not happen, no one thinks it will," he added. "I think it will be more in line with other health care professionals, 5% to 10%. I would like to say that nurses and healthcare assistants should be paid more but unfortunately, I cannot strike for them."
Niki is even more resigned: "I hope that Steve Barclay comes to the table to have a conversation with us, but he may not. I really think that we are trying to give our all, we want to care for the patients as well as we would like to. It is heart breaking; I have definitely had days where I have cried about how little care patients have had."