At this time of year around 7,000 newly graduated junior doctors are starting their first full time medical jobs – and thousands of other junior doctors will also be beginning new rotations in new areas of medicine, as their relentless training continues. August is always a milestone for the many thousands of new doctors hitting the wards, but this one is particularly significant because it also marks the date when the new junior doctor’s contract – the subject of such bitter disputes earlier this year – goes “live”.
The new contract will see premium pay for weekend and unsociable working redefined, and replaced by a broader pay rise for “banded” (standard) hours, which junior doctors perceive will result in a reduction in pay for the many working unsociable shifts.
It is no secret that for many junior doctors, the battles of the last few months have caused staff morale to hit an all time low, “with high levels of anxiety, stress and burnout” reported in many of the junior staff. In response to this, health secretary Jeremy Hunt announced an inquiry looking into why there is such a problem with morale on the wards. But junior doctors have refused to cooperate because the inquiry will not be looking into issues of pay and conditions of service.
If you’re a junior doctor about to head onto the wards you might be wondering what you’re about to get yourself into, and what life on the job will actually be like. Well as part of our research looking at the meaningfulness of work, we have been talking to junior doctors to find out first-hand what morale is actually like for them and their colleagues. So with this in mind, here’s what they’ll need to know before hitting the wards over the next few weeks.
You will be overworked
Many junior doctors we spoke to said the volume of work they were expected to do was only just bearable – which is mostly because of understaffing.
One of our interviewees said: “We were constantly understaffed. On one of the jobs I did, there were just three junior doctors, when you knew there should have been five on the rota – so it’s like three people trying to do the job of five people.”
On shifts like this – it’s important to prioritise the most urgent tasks, as well as to delegate. And jobs need to be escalated to senior colleagues if they need to be.
But you will love the job and your colleagues
Morale was highest among junior doctors who had decided what speciality area of medicine they wanted to pursue because they faced lower levels of insecurity regarding their future career paths.
The doctors we spoke to reported strong feelings of vocational attachment to the day-to-day tasks they carried out, as well as a strong sense of community cohesion being part of a unit with like-minded colleagues.
One of the junior doctors we spoke to simply told us how she is now doing a job she loves – and you can’t say fairer than that.
At times, you will be frustrated
Many junior doctors told us about a lack of understanding among non-clinical managers of patient care and medical practice.
One told us about a day spent writing discharge letters: “You’re doing a job you could have done when you were 15-years-old, then you get grief for not doing them fast enough, even though you’re going as fast as possible.”
While days like these are frustrating, it’s important to focus on the fact that each letter gets a patient out of hospital, freeing up space for others.
So it’s important not to neglect your social life
It’s no surprise that a career in medicine involves long and unsociable hours, alongside rigid timetables. One of the registrars we spoke to said: “We have no choice and are given the hours and that is it … it becomes increasingly frustrating that you have no choice.”
But we found that many junior doctors will work together to accommodate and cover each others’ personal and holiday requests.
Also, if a hospital or deanery has a junior doctor’s mess, doctors should take advantage of the socials that are organised – which are usually around payday. They are a great way to blow off steam and catch up with colleagues in a non-clinical setting at the end of a month’s work.
The reasons behind doing the job
One junior doctor we spoke to summed up the advice she’d give to newly-starting foundation trainees – which really encapsulates the toughness and optimism of those on the job – despite facing increasing pressure from both patients, managers and the government.
She said: “Keep positive. The work atmosphere and morale in the NHS is not at its best with the current junior doctor contract issues. Life as a junior doctor is hard but we do it for a reason, to care for our patients who need us to do our best and brighten up their day and make them better, so don’t forget why you are doing this job.”
Nick Jephson, Teaching Fellow in Work and Employment Relations, University of Leeds; Andy Charlwood, Professor in Human Resources Management and Organisational Behaviour, Loughborough University, and Hugh Cook, Lecturer in Employment Relations, University of Leeds