Why I...wish my medical school tutors had prepared me for hospital medicine

June 25, 1999

I work as a senior house officer in a busy district general hospital in London. It is nearly two years since I qualified as a hospital doctor. Educated at a northern comprehensive, I got my A levels and read medicine at King's College, London. It took me eight years to become a junior doctor, but, having enjoyed medicine during university, I am now faced with the grim reality of a future in hospital medicine. I feel unhappy, dejected, frustrated and, above all, undervalued.

The basic hours are 40 a week - looking after patients on the ward. Overtime is part of the job and involves caring for patients out of hours and admitting new patients from casualty. Once a week I expect to work 32 hours straight through and on one out of six weekends I work a 56-hour stretch with an average of three to four hours' sleep a night. My maximum week is 105 hours, but in many hospitals, this can exceed 120 hours.

The work is hard, emotionally demanding and physically draining. Every decision carries potential legal repercussions and, more importantly, may be a matter of life or death for the patient.

How can junior doctors feel valued when our reward is to be the lowest-paid members of hospital staff for out of hours work? Much of our time is spent taking blood, administering drugs and setting up drips. Such tasks could all be carried out by appropriate specialists - only it is cheaper to have junior doctors do it. It is scarcely surprising that there is talk of doctors taking industrial action. I wish I had known when I was a medical student what being a hospital doctor would be like and then I might have made some different choices.

Until the working conditions of junior doctors are improved, the sense of satisfaction and excitement in doing such a demanding job will continue to be overshadowed by the spectre of exploitation. Is it any wonder that doctors like myself are leaving the United Kingdom in droves in search of better treatment?

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