A junior doctor contract example – know your facts


Below is one of the proposed templates for the 2016 junior doctors contract – in this case for ITU trainees.

This is what Jeremy Hunt said the BMA was being unreasonable about…

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Neuro Doc Gnanapavan


  • It works out just over 45 hours per week which I don't think is too bad, what study and academic commitments are there?

  • It might average at 45 hours a week, but look at that variance: 26 to 61 hours is a lot on your system.
    You try working efficiently when your rota variance reaches 35 hours difference.
    It's wrong, maybe Jeremy Hunt could do 45 hours of work a week.

    • The critical thing here are not is the average hours worked but the rest periods. Take week 1: 0800-2100 back to back (these trainees are working on ITU, wards picking up people who are peri-arrest and theatres (as some are anaesthetists and anaesthetising patients for operations!)). Week 2: you're then on nights and finish in fact on the friday – but is considered a day off!. Weeks 3 – on Monday you're on a day shift and then back to doing a block of nights. Not to mention weeks 7,8,9 – three weekends in a row. Considering you will have to fit your training, exams, teaching commitments, not to mention your children and spouse around this rota; the priority becomes the rota. For annual leaves if you do a swap with a colleague there's so little flexibility in the rota that you'd end up doing a continuous 48h shift.

  • So you are saying that junior doctors work 46.3h a week on average?

    I am not junior (35), married with a baby on the way…. and I have MS.

    I work 12hours a day, 5 days a week (60 hours that is). Never less, often more.

    I don't have to, but I like my job.

    To the junior doctors, if you are in your 20s and are complaining that 46h a week is much: move on to another career.

    • Junior Drs are not "junior" either. Some are in their 40s until they become "senior" Drs and the term is poorly used. They should be described as trainees rather than "juniors". Most not only work the hours they are rota'd to do but beyond them to ensure the work is done. Those with ambition also work in the evenings to maintain their competence, sit specialty exams so they can become specialists and consultants. In addition they are required to maintain their competence by proving they undertake CPD (continuous professional development) which they mostly fund themselves and undertake in their own time after the daytime work. Ultimately they will attain the "goal" of becoming a Consultant and many assume life will be sweeter then.

      As a Consultant of some years standing, a leader in my field, regionally and nationally recognised, being a mother of 2, still working full time and doing a 1 in 4 on call at my venerable age (early 50s and I am a pwMS) which means being on call for every 4th night and all weekend from Friday morning until Monday 5pm every 4th weekend I have tremendous sympathy for our trainees. I do not get time of in lieu and weeks I am not on call I still have to work 40 hours plus and need to maintain CPD on top of that.They will have a more difficult life as they progress in their careers than they have now. They will be forced to work unsociable hours without compensatory rest, they will be forced to maintain their CPD at their own expense to continue to work and they will see the benefits of working in the NHS whittled away slowly year by year. This is not only in financial terms (my take home pay has dropped by 10% in the last 5 years, not taking into account the rise in the cost of living, due to the many changes that the government has imposed by stealth) but in terms of being able to practice as a professional, being able to support other staff, being able to practice safely and being able to be open and honest with my patients with regard to limits in funding, other resources, time etc.

      I am looking at taking early retirement because I am so disillusioned with the NHS and am struggling to work the hours at my age that I managed easily as a youngster. My own father was a Consultant who worked hours as long as mine if not longer but the pressures were different. He was also an expert in his field nationally and internationally recognised but the difference was that he was not subject to the "targets" we are currently subjected to and other restrictions that making working in the NHS a trial now rather than a pleasure. And no not all specialties lend themselves to a life in private practice, the reserve of the very few in medicine.This brings a different stress in itself.

      Yes I know the general public pay for the NHS via their taxes and we should be grateful for this to fund our "lavish" lifestyles however I pay taxes too, I cannot fiddle those taxes through other routes as I PAYE, I have to bite my tongue when unfairly criticised, and I have to be "grateful" that I still have a job. I am not grateful for the daily abuse I get from a certain group of patients, I am not grateful for the change in my professional status and I am not grateful that I feel so angry that I have resorted to venting my spleen on a blogspot! I cannot be open and honest except anonymously as I do not want to jeopardise my position and I want to encourage my own trainees who will ultimately be looking after me in my decrepitude!

      Ok I will get off my soapbox now but take this message….I have 2 very bright children, both of whom could make a difference to the world, both are caring and compassionate but I am ACTIVELY discouraging them from studying medicine or any other allied health profession. My hope is they will make a difference in a field that they will be appreciated in, not constantly criticised and derided for expecting fair compensation for a hard day's work.

    • I sometimes think the human factor gets lost in these discussions, with appropriation of blame being the main discussion point. We realise that some of our bloggers find our political posts distressing, but it is important that we keep our readers informed of the dramatic changes taking place in our health service. Something I've realised also is that the popular news cannot be trusted to convey the facts.

    • Dear Anon (Thursday, February 25, 2016 8:04:00 pm)

      I am in full agreement with your post and support your position entirely. Your comment is well-written and to the point. Thank you.

      With the deprofessionalisation of medicine it is simply a race to the bottom. I suspect Jeremy Hunt and the NHS will eventually gets their way with the introduction and increased usage of healthcare assistants (foot doctors with minimal training), nurse specialists and eventually their beloved junior consultant grade. This does not even take into account the impact technological innovation will have on our jobs (uberization of healthcare). Yes, why would our brightest and most motivated children want to choose medicine as a career when its future is so uncertain. Just the the size of the student loan should be enough to put them off.

      But let's not get too negative; I still love my job and consider it a privilege to be able to get up in the morning and to have a vocation I love. This is what Jeremy Hunt doesn't understand; medicine is not a job, but a vocation, a calling. Almost all of my peers walk the extra mile and work way and above 60+ hours a week with no complaints. All Jeremy Hunt is doing is destroying morale and the goodwill there is in our profession. It is a pity Jeremy Hunt never learnt anything from his father who was a military man; a Commander in the Royal Navy. Military people know that moral wins wars; it is the glue that makes individual soldiers work together, fight and die for their fellow countrymen, stand up for principles and do extraordinary things. If Jeremy Hunt wants to reform the NHS he needs his soldiers working together, not fighting against him. This is why our junior doctors have my unconditional support.

    • I had cancer and I did not see a doctor who was my surgeon until four months after my scan went to MDT. I saw an interventional radiologist who did my biopsy. I saw a nurse specialist before and after my op. I was treated better when I had a veruka. I see more nurse specialists all the time, some are good and some believe they are doctors and provide poor care.



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