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It cost the NHS £1m to train us. So why can't we find jobs?
By THEA JOURDAN, Daily Mail
09:33am 11th July 2006
Training a young doctor costs the NHS £237,000. It's a huge investment. In return, they will work long hours for low pay.
The payback is job satisfaction — and the hope that, after their 12-year apprenticeship, they will rise to the top of the ladder as senior consultants in their chosen specialties.
But just at the point when these highly-trained junior doctors are meant to start on their specialist training, 11,500 are instead facing unemployment because the Government has abolished their jobs. From August 2007, the rank of senior house officer (SHO) will be ended as part of a radical shake-up of medical training.
There are currently 21,000 SHOs, but the new scheme will provide only 9,500 advanced training posts for them. Would-be surgeons will be the worst affected because surgical training posts have been cut by as much as 80 per cent.
There will be 5,000 surgical SHOs competing for just 600 training posts, according to Bernard Ribeiro, the president of the Royal College of Surgeons. However, the Government says there won't be any job losses.
'The 21,000 doctors mentioned are already in posts in the NHS and will be reorganised into new kinds of posts within the training and career structure,' says Lord Warner of Brockley, the minister of state for reform in the Department of Health.
Doctors' groups take this to mean that those who cannot fit into the new scheme may be offered new jobs in unpopular specialities, with no opportunity for training or career development.
Cynics say the Government wants to create a tier of specialists who have as little as two years of training to do the job of consultants, at a fraction of the price.
Adding to the frustration is the fact that many SHOs have no idea of how many jobs will be available in their chosen field, let alone how to apply for the new positions. Patients have reason to be worried, too. Quite apart from the potential waste of taxpayers' money, the changes are bad news for future care.
Michael Summers of the Patients Association says it is 'extremely worrying that the Government is prepared to sacrifice so many highly-qualified young doctors. 'We are already facing an acute shortage of nurses and doctors. Patients will be affected as the changes have a serious knock-on effect on the standard of care.'
In a recent survey for the British Medical Association (BMA), around half of young doctors said they would consider leaving the country instead of being forced into dead-end jobs. Around a third said that they would leave the profession altogether. Not surprisingly, other countries are ready to take advantage of the bonanza.
New Zealand and Australia are keen to snap up SHOs who have been trained at Britain's expense. Jo Hilborne, chairman of the BMA's Junior Doctors Committee, summed up the feelings of a whole generation of junior doctors.
'We are not panicking. We are incensed at the cavalier way the announcement was made with no discussion with ourselves,' she says. 'We are incensed that the health department thinks this is a perfectly reasonable and proper way to dispose of the careers and aspirations of 11,500 junior doctors. 'And we are incensed that patients and taxpayers will see young doctors choosing other countries in which to continue their training, or are leaving for other professions.'
Here, four young doctors explain what the reforms mean for them — and for patients
JENNIFER HILTON, 28, an SHO at Norfolk and Norwich University Hospital, lives near Norwich with her fiance, Jonathan Dermott, 30, and their 15-month-old daughter, Lily. She would like to specialise in ear, nose and throat medicine. Jennifer says:
When I was little, I used to make tissue paper plasters for my teddies, so it was obvious to everyone that I was a born medic. When I was at school, I volunteered for the St John Ambulance and got all my first aid badges. I enjoyed looking after people and helping them to feel better.
I knew medicine was hard work and not particularly well paid, but the positive side was that it was a secure profession. I would have to give it my all, but I would have a job for life.
When I started as an SHO, some weeks I worked 90 hours, but I loved it. I met Jonathan at the hospital where we work. He is a paramedic in the A&E department. Even though I was studying, we decided to start a family. At eight months pregnant, I was sitting exams and working flat out. I didn't take a day off sick.
Lily was very ill after she was born and I partly blame it on the stress. She had to be taken to Great Ormond Street Hospital for Children and was on a ventilator for two weeks. I could have lost her.
I have sacrificed so much for this job, including the health of my child, and it makes me sick to know I have been sacrificed to cost-cutting and hasty government policy. I am ready to move on, but there is nowhere for me to go. If I don't get a training post, I will probably leave the profession altogether.
RISHI DUGGAL, 27, works at the Lister Hospital in Stevenage, Hertfordshire, and would like to specialise in orthopaedic surgery. He says:
I am a second generation British Indian. My parents, who are teachers, came to live in Britain before I was born and settled in Muswell Hill, North London.
They struggled to make a good life for their family and it wasn't always easy. My brother and I went to a fee-paying grammar school, and it did mean we all had to make sacrifices.
We had what we needed, but we went without luxuries: education was the priority.
I made my parents very proud when I decided to become a doctor and got into medical school.
It meant a lot to them that their son had succeeded in one of the most competitive professions.
I always thought that medicine was a secure profession. I believed that at least I would never be unemployed. How wrong I was.
Now they are saying there are too many SHOs and most of us will have to rethink our future career plans. It seems very late in the day to be telling us, after they let us start our training. Up until now, I have had blind faith in the system.
The consultants at the hospital have told us that we will be phased in somehow, but they haven't told us how they can make this happen. I think they have been misled, too.
I was so confident that all would be well that I haven't applied for any training posts — and now I wouldn't even know how to apply for the new jobs, or what positions are even available because no one has told us anything.
All my colleagues are just waking up to the situation now and it is almost too late. At this rate, we will be jobless before we even know what's hit us.
I feel that my whole family has been betrayed by what has happened. My parents invested a lot of time and money to get me where I am, and it was difficult for them.
I feel as if young doctors are about to be hit by a truck and we can't get out of the road.
VANESSA TUFF, 28, is a SHO at Musgrave Park Hospital in Taunton. She had hoped to train as a vascular surgeon. She says:
'I have little chance of getting into the new system. As far as I understand it, only one in ten SHOs will be able to get on the scheme.
I'm not fooling myself that I will be one of the lucky few. But I have no idea of what I am going to do.
The most likely thing is that I will leave the profession altogether: at least I can choose something that would allow me to work normal hours and where I am valued.
I grew up in Chichester, West Sussex, and my maternal grandmother inspired me to become a doctor. She was one of the first women to qualify as a doctor at the Royal Free Hospital in London, was a pioneer for women in medicine and had four children.
She died when I was young, but her story was part of family tradition.
I loved medical school and in my first year decided that I wanted to be a surgeon, even though it is so competitive and a difficult area for women to succeed because of the inflexible hours. I just enjoyed operating. I was not in it for the money or the kudos, though I hoped I would eventually have both if I did a good job and worked hard.
Now, I have been told I might as well forget surgery because there just aren't the places. I can try obstetrics or psychiatry instead.
The only problem is that I want to be a surgeon, not a baby doctor. I will be desperately disappointed if I can't do what I love.
I got married last year and my husband, William, is just finishing his training to be a GP.
He has got another six months to go, so his situation is much more secure than mine.
I am so relieved he decided to go into that field and left hospital medicine well alone.
The irony is that this government was supposed to be encouraging women to break down the barriers of this male-dominated area of medicine, by setting up the Women in Surgical Training unit and flexible working.
But when it comes to the crunch, women are being told to put down their scalpels.
KATE HATTON, 29, a senior SHO at Frimley Park Hospital, Surrey, wants to be a consultant anaesthetist. She says:
My mum says I used to tell her I wanted to be a doctor when I was six years old. It's been my lifelong goal.
My parents were teachers who decided early on that their children would be their priority.
They saved hard so I could attend a private school. We went on family camping holidays instead of staying in hotels and were careful with what we spent.
All the scrimping and saving paid off, though. I got into the prestigious St George's Medical School and started my career as a doctor.
For the past five years I have been working hard. I want to run an intensive care ward looking after the sickest patients in the hospital.
It is a challenge every single day and a great feeling to be able to help keep patients alive.
I have already taken my medical exams to join the Royal College of Physicians.
NOW, I have just passed N the final exams I need to start my specialist training. I have worked so hard, and I am at the point of moving on, but the door has been slammed in my face.
The best information I have is that they will probably be reducing posts by 65 per cent, but they are refusing to give out exact numbers.
I feel so helpless and angry. Doctors just want to get on with the job and do it well. We are not political animals, but we have been used like pawns by politicians.
I don't want to be stuck in a staff grade job where I am grateful to have a pay cheque every month.
The idea is to create a class of anaesthetic practitioners who will probably include the non-medical people who assist anaesthetists.
They will have a couple of years of training, as opposed to 15 for a consultant anaesthetist, and will cost a lot less.
I wouldn't want my child to be given an anaesthetic by someone with just two years' training and a diploma.
The next time he needs an operation, I bet Tony Blair won't be put under by a new practitioner. He'll have one of the few remaining consultants by his side who has the experience to think outside the box if things start to go wrong.
I am getting married next February, but this whole mess is putting a dampener on my wedding plans. I might be jobless by then. I so wanted to make a difference.
