Junior doctors are the backbone of the NHS
I am a 45-year-old mother of four – my youngest has cystic fibrosis. I graduated from medical school in 2010 – since then I’ve had two children in my 40s – and am currently an anaesthetics trainee with at least six years of training left. I live in Bristol and commute daily to Abergavenny in Wales, which is 75 minutes each way. Every day sees me getting up at 5.45am to get the children ready. I start work at 7.45am by seeing patients due to have an operation that day. I work supervised by a consultant, putting patients under anaesthetic and managing their airway and vitals while they are asleep. I also provide on-call services, seeing the sickest patients in the hospital. I admit them to the intensive care unit, provide pain relief, attend cardiac arrests and much more.


No one understands the level of responsibility junior doctors have; we are the backbone of doctors, providing care 24/7. Once I was managing five critically unwell patients in resus overnight as an acute medicine doctor. I needed to make quick life or death decisions, stay calm and focused in the middle of the night.

We sacrifice family time and our own welfare to care for others. In addition, we must work in our own time on mandatory exams, courses, publications, audits and much more. Though I work in Wales, which has rejected the junior doctors’ contract, my 43-year-old junior doctor husband works in England. The proposed pay cut means that one or both of us may be forced to find different work to pay the bills. Our family debt exceeds £80,000. The future looks very bleak indeed and I’m worried. Every time I leave my children and go six days without seeing my husband or older daughters, or when I miss school events and find providing care for my child with cystic fibrosis a challenge, I consider leaving the medical profession. I care for patients sometimes at the expense of my family and that saddens me. This is why we cannot be pushed any further, it is not worth the cost. To say we lack vocation, altruism and professionalism is a deep and painful insult.

Sethina Watson, CT2 ACCS anaesthetics trainee, Wales

The NHS depends on junior doctors to save lives
I’m 27 and have just started specialist training in obstetrics and gynaecology. It’s three years since I left medical school. I remember one case at night where the monitor showed the unborn baby’s heart suddenly stopped beating. The mother required an immediate C-section, but was very scared and reluctant to agree to life saving surgery. The registrar was busy with another emergency so, even though I had never done this before myself, I gave the order to prepare theatre, spoke to the woman about her fears, explained the urgent need for treatment, and gained her consent for surgery. The registrar came as soon as he could and, thanks to my preparation, was able to operate within five minutes to deliver the baby. Had I not acted as I did then, that baby would have been born with brain damage from lack of oxygen. It did strike me how important my work is, how dangerous short staffing can be, how much the NHS depends on doctors at my level, and that even at 4am on your fourth nightshift, you still have to be alert and utterly professional.

I feel angry about what politicians are doing to the medical profession and, by extension, the wellbeing of patients. I also feel betrayed by David Cameron – this is not what I expected after he delivered his powerful conference speech emphasising how much the NHS meant to him personally, or pledges to reward hard work. I love my job and the satisfaction of treating patients so would not want an office job, but I would rather move abroad where I will be valued and able to work to the best of my ability. I have started applying to hospitals in Sydney.

Sam Oxley, obstetrics and gynaecology, London

I am the most senior doctor in the hospital at night, looking after the sickest children in the country
I have been qualified for 13 years and have given up so much for my career
I went to medical school in Oxford in 1996 and qualified in 2002, before the European working time directive (EWTD) came into force. I worked in east London, in an underfunded hospital in a deprived area. It was common to work over 100 hours a week. Our weekend shifts began at 7am on Friday and finished at 6pm on Monday. It wasn’t safe for the patients and it wasn’t safe for me. I chose paediatrics as a specialty, and quickly found that, in order to reduce hours in line with EWTD regulations, we moved on to punishing shift systems. For example, as a junior working in the neonatal intensive care unit at King’s College hospital in 2004, I worked seven 15-hour night shifts on the trot. I nearly crashed my car driving home on more than one occasion.


I passed all my professional exams (at a cost of £1,500, not including the necessary courses and books) at first attempt. After specialist training in paediatrics, I decided that I definitely wanted to train as an intensivist. The best training in the world is in the US, and I competed against a large number of highly-qualified American doctors to be offered a three-year fellowship in Harvard. This required me to take my USMLE (the medical licensing exam for the US) at a cost of about £3,000. I took a large pay cut in the US and had to live separately from my husband. At the end of my three years in Boston, I was offered a consultant post at the best children’s hospital in the US. I turned it down. I wanted to come back to the NHS.

I now work as a senior fellow on the cardiac intensive care unit at Great Ormond Street hospital. I look after children who have had major heart surgery, as well as those so sick they have to be on a form of heart-lung bypass or artificial hearts. I am 37 years old. I have been qualified for more than 13 years. I am still “junior”. I postponed having children until I was in my mid-30s in deference to my career. Partially as a consequence of my age, I have now had multiple miscarriages and ectopic pregnancies. I asked to go part-time and my request was refused due to “service requirements”. I work at the maximally antisocial hours that the ETWD allows. I am the most senior doctor in the hospital at night, looking after the sickest children in the country. Jeremy Hunt would like to cut my salary (by an undefined amount, and this will be non-negotiable). He would like to remove the limits on my hours. I have a mortgage. I have a family. How am I supposed to plan for the future?


New junior doctors' contract changes everything I signed up for
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I am far from work-shy. I believe in seven-day emergency care of the highest quality. But here’s the thing: loyalty will not be rewarded. As a mass exodus of juniors occurs to the antipodes and Canada, the remainder will be left to pick up the pieces. We will be paid less, work more, and the care we provide will, by necessity, be of a lower quality. Morale is at the lowest I have seen in it my career across all sectors.


Why on earth shouldn’t I return to the US? My colleagues who graduated below me in my class are all earning a minimum of US$200,000 a year. They work fewer hours, have protected research time and pleasant working conditions. I love my job, but as a highly-trained and competent professional, I won’t accept the terms being imposed by Hunt. And the NHS will lose yet another dedicated staff member.

Charlie Briar, senior fellow, cardiac intensive care unit, Great Ormond Street hospital, London

Junior doctors are not 18-year-olds fresh out of school
Junior doctors are not 18-year-old apprentices fresh out of school. We have at least five years of higher education and up to 20 years of training after this. We are the doctors who you see in A&E, the ones who diagnose you and give you treatment. We perform your operations and control your pain at 3am. We work hard and we have a sense of professionalism and duty that keeps us working harder than we get credit for. We have endured over a decade of cuts to both the services supporting us and our pay. This does not just affect doctors but is merely the beginning of a much bigger plan. Nurses, physiotherapists, operating department practitioners, healthcare assistants, occupational therapists and all healthcare professionals will face the same in the near future if this gets pushed through and the NHS will not be able to cope with the loss of personel.

Last year, my days were either on call (11 13-hour days in two weeks), covering nights or on normal days, which involved working in theatre or clinic. Our on-call days started at 7.30am and involved admitting new patients to the hospital through the particular specialities we covered that day. It hits home how important my work is every time I perform an operation. I am training in orthopaedics so a lot of what I do is treating people with broken bones. A common injury is a broken hip in the elderly population. If an operation is not performed to fix or replace the hip, the patient would most likely never walk again. Whenever I’m a bit low or busy or frustrated I remind myself how much difference what we do can make for that patient.

I have worked in New Zealand for two years before and am very tempted to return. We returned to the UK as our families are here, but with the changes planned we may be forced to move back to a country that values what we do.

Simon Woods, doing a leadership fellowship between core surgical training and registrar training in orthopaedics, Yorkshire

Out of all the emotions I could feel about the junior doctors' contract, I keep returning to disappointment
I hear 10-year-olds talking about why and how they will end their life
Yesterday, I saw youths and their parents who are going through a troublesome time. Hearing the ways in which a 10-year-old will try to kill themself is a harrowing experience. The only way to treat them is to provide a safe environment for them to be able to vent. My role is to ascertain what thoughts are in place, to risk stratify the situation and, most importantly, to provide ample reassurance and support to the individuals in question.

On-calls are variable as there is one doctor who is medically responsible for three adult wards, one intensive care unit, three forensic wards, a learning disability assessment unit, a dementia assessment unit, a rehabilitation unit, support for the intensive home treatment team, and supporting a first response team. Once a patient comes into the hospital, my role is to keep them medically well so that the consultants can correct any psychiatric issue that they may have.

I was confronted with a situation yesterday that is still resonating with me now. A 21-year-old woman was pleading with me, wanting to go home. I met with both her and her mother and a flood of tears followed. I was left feeling like the tyrant stopping the one thing that they both want. This patient had psychotic thoughts about a baby that she needed to care for (and did not exist). I calmed both mother and daughter and continued to talk with the mother after leaving the ward. She thanked me for taking the time to listen to her, and that made me realise how lucky I am to be in a situation to offer that reassurance. I didn’t save a life, I helped a hurting soul when everyone was too busy to give them a chance to vent. I am thankful for that.


Would I be a fool to return to the NHS on the new junior doctor contract?

Men, these docs hv hectic schdules.

azat:
I am the most senior doctor in the hospital at night, looking after the sickest children in the country
I have been qualified for 13 years and have given up so much for my career
I went to medical school in Oxford in 1996 and qualified in 2002, before the European working time directive (EWTD) came into force. I worked in east London, in an underfunded hospital in a deprived area. It was common to work over 100 hours a week. Our weekend shifts began at 7am on Friday and finished at 6pm on Monday. It wasn’t safe for the patients and it wasn’t safe for me. I chose paediatrics as a specialty, and quickly found that, in order to reduce hours in line with EWTD regulations, we moved on to punishing shift systems. For example, as a junior working in the neonatal intensive care unit at King’s College hospital in 2004, I worked seven 15-hour night shifts on the trot. I nearly crashed my car driving home on more than one occasion.


I passed all my professional exams (at a cost of £1,500, not including the necessary courses and books) at first attempt. After specialist training in paediatrics, I decided that I definitely wanted to train as an intensivist. The best training in the world is in the US, and I competed against a large number of highly-qualified American doctors to be offered a three-year fellowship in Harvard. This required me to take my USMLE (the medical licensing exam for the US) at a cost of about £3,000. I took a large pay cut in the US and had to live separately from my husband. At the end of my three years in Boston, I was offered a consultant post at the best children’s hospital in the US. I turned it down. I wanted to come back to the NHS.

I now work as a senior fellow on the cardiac intensive care unit at Great Ormond Street hospital. I look after children who have had major heart surgery, as well as those so sick they have to be on a form of heart-lung bypass or artificial hearts. I am 37 years old. I have been qualified for more than 13 years. I am still “junior”. I postponed having children until I was in my mid-30s in deference to my career. Partially as a consequence of my age, I have now had multiple miscarriages and ectopic pregnancies. I asked to go part-time and my request was refused due to “service requirements”. I work at the maximally antisocial hours that the ETWD allows. I am the most senior doctor in the hospital at night, looking after the sickest children in the country. Jeremy Hunt would like to cut my salary (by an undefined amount, and this will be non-negotiable). He would like to remove the limits on my hours. I have a mortgage. I have a family. How am I supposed to plan for the future?


New junior doctors' contract changes everything I signed up for
Read more
I am far from work-shy. I believe in seven-day emergency care of the highest quality. But here’s the thing: loyalty will not be rewarded. As a mass exodus of juniors occurs to the antipodes and Canada, the remainder will be left to pick up the pieces. We will be paid less, work more, and the care we provide will, by necessity, be of a lower quality. Morale is at the lowest I have seen in it my career across all sectors.


Why on earth shouldn’t I return to the US? My colleagues who graduated below me in my class are all earning a minimum of US$200,000 a year. They work fewer hours, have protected research time and pleasant working conditions. I love my job, but as a highly-trained and competent professional, I won’t accept the terms being imposed by Hunt. And the NHS will lose yet another dedicated staff member.

Charlie Briar, senior fellow, cardiac intensive care unit, Great Ormond Street hospital, London

I understand your hectic schedule. But here in Nigeria, it is hard to get into internship program not to talk of residency program. Everything here depends on who you know.

I just graduated from a medical school here in Nigeria and yet to start my internship program. I've written some exams, passed the written interview and called up for oral interview. I sincerely think I did well in the orals but yet placement for internship has so far eluded me.

I hope to practice in the US, UK or any other country with good medical standards. I just may need your assistance with usmle and stuffs like that.

Can I have yur email address?