Junior doctors: the future of the fiasco
From Mmc
Junior doctors: the future of the fiasco
Last Updated: 12:01am BST 06/08/2007
On August 1, junior doctors across the country took up the posts they had been allocated by the controversial Medical Training Application System (MTAS), which left up to 13,000 without jobs.
Mei Nortley is one of the 'lucky ones'. Here, she explains why the crisis isn't over yet and how it could threaten the future of British healthcare
When we, as doctors, ask patients to give their consent for an operation, we understand the importance of helping them to make an informed decision about how their future care will be managed. The patient has every right to be made fully aware of the advantages, disadvantages, risks and benefits of the treatment, and to be told about all other options available to them so they can then make an educated choice. As the junior doctors' recruitment crisis has unfolded over the passing months, it has struck me that those of us treating these patients are being denied these rights. We no longer have the opportunity to make an informed decision about our own futures. When offered a job, most people would think it reasonable to know a few basic facts before deciding whether or not to accept it. Perhaps, for instance, the salary - central in assessing your ability to maintain your mortgage repayments - and the hours expected of you - crucial for those with childcare issues.
You might also deem it useful to know whether you have the skill set for that post - what special knowledge it might require. And, of course, it would be important to establish whether you have an interest in that particular area and whether the experience you gain will benefit you or a future employer. You might also expect to be told the geographical location of your prospective workplace, so that you can know whether you will have to move house, commute long distances or be separated from your spouse and children. Last but not least, in the field of healthcare, conscientious doctors want to know whether a job will provide the best training in the area in which they will ultimately provide specialised care for their patients. If you are a physician, for example, it is unlikely to be of benefit to you or your future patients that you have spent precious training time completing a surgical job. Unfortunately, the answers to such questions are luxuries that have not been afforded to junior doctors. They have no choice but to abide by the rules of their monopoly employer - the NHS. They aren't actually "junior" doctors as people might imagine them - they're not new medical school graduates who have yet to prove themselves or put down roots, they are established professionals, many of whom are married with young families and mortgages.
And yet this week has seen thousands of them forced into jobs about which they know nothing. Physicians are working as surgeons, psychiatrists have taken up posts as physicians, while some are having to repeat training jobs for no good reason. Doctors who are passionate about a particular speciality have been left pining after the job of their choice, which has been awarded to someone who has no interest in it. We have been herded - disillusioned, disoriented and without spirit - after months of uncertainty, into jobs from which we will not gain the vital skills required for the specialist areas we hope ultimately to work in. With 33,000 junior doctors applying for 18,500 places, training jobs are a scarce resource to be treated with respect. They need to be distributed thoughtfully and with vision - getting it right is crucial for Britain's healthcare system.
We may not begin to feel the effects of this fiasco tomorrow, or even within the lifespan of the present government. It will become clear only when existing consultants retire and we find that the new cohort of doctors don't have the skills they need - when patients start dying, then it will be too late.
