Resident doctor (United Kingdom)

Last updated

Within the National Health Service, resident doctors (previously known as junior doctors) are qualified medical practitioners working whilst engaged in postgraduate training. The period of being a resident doctor starts when they qualify as a medical practitioner following graduation with a Bachelor of Medicine, Bachelor of Surgery degree and start the UK Foundation Programme. It culminates in a post as a consultant, a general practitioner (GP), or becoming a SAS Doctor, such as a specialty doctor or Specialist post.

Contents

The term resident doctor currently incorporates the grades of Foundation doctor, Core Trainee (in some specialties, such as surgery, medicine, and psychiatry), and Specialty registrar. Before 2007, it included the grades of Pre-registration house officer, Senior house officer and Specialist registrar. During this time, resident doctors will do postgraduate examinations to become members of a Medical royal college relevant to the specialty in which they are training, for example Membership of the Royal College of Physicians for doctors specialising in Internal medicine, Membership of the Royal College of Surgeons for doctors specialising in surgery or Membership of the Royal College of General Practitioners for doctors specialising in family medicine. Doctors typically may be resident doctors for 8–20 years, and this may be extended by doing research towards a higher degree, for example towards a Doctor of Philosophy or Doctor of Medicine degree. In England there are around 71,000 resident doctors. [1]

Replacement of the term "Junior Doctor"

There had been controversy about the historical term "junior doctor", with many organisations and individuals voicing concern that it created misconceptions about their work and does not do justice to the skills and experience acquired by these doctors, many of whom have been working for several years. [2]

The British Medical Association (BMA) voted to discontinue the term “junior doctor” from all forms of communication at their 2023 Annual Representative Meeting (ARM). [3] The motion was presented to the BMA Representative Body by Dr Sai Pillarisetti, a Foundation Year Doctor. After a debate and vote of members, it was passed in full and made BMA policy. [3] [4] [5] References to junior doctors in BMA policies and communications are due to change to 'resident doctors' from September 2024. [6]

An independent report for Health Education England (HEE) authored by Prof Scarlett McNally found more than 75% of those surveyed found the term "junior doctor" inappropriate, and almost half thought "trainee" should be avoided. The report recommended a shift towards "Postgraduate Doctors" instead. [3] [2] [7]

In December 2023, then Health Secretary Victoria Atkins faced criticism for using the term "doctors in training" as an alternative to "junior doctor" in a TV interview on BBC Breakfast. [8] [9] [10] This was followed by a spokesperson for the Department of Health & Social Care stating they respected the profession's decision to move away from the term "junior doctor". [11] [12]

In September 2024, as part of the settling of a long-running pay dispute, it was announced that the term "junior doctor" would be changed to "resident doctor" within the NHS [13] from Wednesday 18th September 2024 onwards. [14]

Working hours

In Europe and the US, there has been some reduction of the working hours of doctors who are in postgraduate training, in line with recommendations and legislation aimed at improving patient safety and doctors’ working conditions. [15] In 1991, the government, the NHS and the British Medical Association (BMA) agreed a package of measures on working hours, pay and conditions which was called the New Deal for Junior Doctors. The Doctors' duty hours, which were felt to be excessive, were reduced to a maximum average of 56 hours actual work and 72 hours on call duty per week, although the change was not enforced until 1 December 2000. [16] The European Working Time Directive (EWTD) sets out minimum health and safety requirements for the organisation of working time. The EWTD required the average working week to fall to 48 hours or less by 2009. [17]

The shortening of resident doctors' working hours had implications for how training programmes are organised, especially for specialties such as surgery, where there was a tradition of maximising the hours of experience. [17] Most studies that have looked at a reduction of resident doctors working hours have found either a beneficial or neutral impact in terms of measures of patient safety, clinical outcomes and postgraduate training. [15]

The reduction in number of hours worked by resident doctors is one of the factors leading to blurring distinctions between them and other clinical professions such as nurse practitioners who also perform complex tasks. [18]

Migration

An Organisation for Economic Co-operation and Development survey in December 2015 showed that 35.4% of NHS doctors, 34,000, were born abroad compared with 5% in Italy, 10.7% in Germany and 19.5% in France. The UK was the second highest exporter of doctors, second only to Germany, with 17,000 British doctors working in other OECD countries. These figures are for all doctors in the NHS, not just resident doctors. [19]

According to the Career Destination Report published by the UK Foundation Programme Office in 2019, an increasing number of UK resident doctors are seeking to take up work abroad. [20] [21] A report by the General Medical Council described a number of "push" and "pull" factors, including seeking a better work-life balance and wanting to take advantage of other opportunities abroad. [22] Most doctors who complete foundation training do eventually return to specialty training in the UK within three years. [23]

Modernising medical careers

In 2005, postgraduate medical training was significantly changed in the Modernising Medical Careers programme. A two-year Foundation Programme was introduced for newly qualified doctors, the number of years of postgraduate training changed in some specialties, and doctors needed to decide which specialty to follow sooner after graduation. [24]

There were later initiatives to engage resident doctors in NHS leadership; resident doctors are seen as essential to the drives to achieve efficiency savings in the NHS since 2010. [25]

NHS  Medical Career Grades
Old SystemNew System (Modernising Medical Careers)
Year 1: Pre-registration House Officer (PRHO)

1 year

 Foundation Programme: 2 years
Year 2: Senior House Officer (SHO) a minimum of 2 years, although often more.
Year 3: Specialty Registrar (StR) in a hospital specialty: 6–8 years Specialty Registrar (StR) in general practice: 3 years
Year 4: Specialist Registrar: 4–6 years GP Registrar: 1 year
Year 5: General Practitioner

total time in training: 4 years

Years 6-8: General Practitioner

total time in training: 5 years

Year 9: Consultant

total time in training: minimum 7—9 years

 Consultant

total time in training: 8—10 years*

OptionalTraining may be extended by pursuing medical research (usually two-three years), usually with clinical duties as wellTraining may be extended by obtaining an Academic Clinical Fellowship for research, or a Clinical Fellowship for sub-specialisation. *due to competition for consultant posts, it may take longer than 8 years to gain Consultant status .

Pay and conditions

The NHS Careers web site stated in 2023: [26]

As a doctor in training you’ll earn a basic salary, plus pay for any hours over 40 per week, a 37 per cent enhancement for working nights, a weekend allowance for any work at the weekend, an availability allowance if you are required to be available on-call, and other potential pay premia.

In Foundation training, you will earn a basic salary of £32,398 to £37,303 (from 1 April 2023).

If you’re a doctor starting your specialist training in 2023, your basic salary will be £43,923 to £63,152.

The basic salaries outlined are defined for a contract of 40 hours per week. Salaries are increased proportionally for any extra hours worked on average per week. Any hours outside "social" hours, namely 9pm and 7am, are supplemented by a 37% enhanced rate. Weekend duty is paid as a percentage bonus, up to 10% of the basic salary for working alternate (1 in 2) weekends. Other bonuses are also available for being non-resident on-call (being not physically on site, but available to answer calls or come in to hospital if necessary), for recruitment into academia and undersubscribed specialties, and for doctors living and working in London. [27] [28] [29] In 2015, NHS Employers reported the total annual earnings for foundation doctors in England averaged just over £36,000. While the basic starting salary for doctors in specialty training was £30,002, NHS Employers were reporting that average earnings in this group of doctors was nearly £53,000. [30]

In 2013, graduates who had studied medicine or dentistry were the most likely to be employed and had the highest average gross annual pay when compared to graduates who studied other subjects. [31] In 2015, the average starting salary of resident doctors was the third-highest of all graduate starting salaries, after dentistry and chemical engineering. [32] In 2016, it was reported that after 10 years of employment, medicine graduates had the highest salary of all degrees. [33] Research conducted in December 2014 showed that across a range of other jobs, almost a third of graduate programmes at Britain's best known and leading employers paid starting salaries of more than £35,000; however, 83% of these leading employers reported that they were recruiting for jobs in London where salaries are higher, [34] [35] whereas NHS salaries are set on a nationwide basis, with doctors in London given an additional payment (£2,162 as of 2013) known as London weighting to compensate for increased cost of living. [36]

Since 2007, resident doctors have been receiving below inflation salary rises. [37] The independent Review Body on Doctors' and Dentists' Remuneration (DDRB) takes evidence from a range of sources and makes recommendations around pay; in 2015, they recommended a 1% pay increase. [38] In 2005, the average starting earnings (salary plus bonuses) for a medical graduate was £32,086. [39] In an inflationary environment, all wage-earners, including doctors, may find the buying power of their income becomes less; some describe this as a real-terms cut in pay of 15% between 2007 and 2014. [38] In 2019, the British Medical Association came to an agreement with NHS England to settle for a guaranteed 2% annual pay rise until 2023. [40]

In 2023, resident doctors in England initiated their longest-ever strike, protesting against pay disparities within the National Health Service (NHS). The strike, which began on 13 July 2023, continued for five days and led to the postponement of appointments and disruptions in healthcare services. While emergency care remained accessible, patients were advised to seek alternative options for minor health concerns. The ongoing dispute revolved around the demand for a 35% pay increase to address below-inflation salary increments over the past 15 years. The impact on patient care, NHS costs, and waiting list reduction was a matter of significant concern. [41]

Expenses

Doctors pay professional annual fees to maintain registration with the General Medical Council and medical indemnity cover. Resident doctors also incur costs associated with training courses, preparing for and sitting exams and college membership; training can be associated with £420-£3,000 of professional fees annually, depending on stage of training and level of income. [42] English students embarking on a medical degree could in 2015 expect to pay £40,000 on university tuition fees alone. [43] Student loans are available to meet these costs, with repayment starting as soon as individuals begin working as a resident doctor. [43] University tuition in Scotland is free for students ordinarily resident in Scotland, and grants and loans are available to help with living costs. [44]

Changes to working patterns of doctors meant there was no longer a requirement for first year resident doctors to be resident, and from 2008 free accommodation was no longer provided by employers. [45] The British Medical Association said that this amounted to a £4,800 annual pay cut for those who might have previously lived at the hospital rather than independently, but the numbers of doctors involved was not clear. [45] Ann Keen, Labour Parliamentary Under-Secretary for Health Services, stated, "The provision of free accommodation for foundation year 1 doctors who are on call at night, is dependent on the contract of employment of the resident doctor, which is for agreement locally. The Junior Doctors Terms and Conditions of Service continue to provide that if a doctor is contractually required to live in hospital accommodation no charges should be made for the accommodation provided." [46]

Prospects

The NHS Careers web site states: [26]

Specialty doctors and specialist payscale

If you’re working as a specialty doctor you’ll earn a basic salary of £52,530 to £82,400. If you are a specialist grade doctor you'll earn a basic salary of £83,945 to £92,275.

Consultants

As a consultant from 1 April 2023, you'll earn a basic salary of £93,666 to £126,281 per year, depending on the length of your service. You may apply for local Clinical Excellence Awards and national Clinical Impact Awards (previously known as Clinical Excellence Awards). This is a competitive process which takes into account work that you do over and above delivering your basic job requirements. In addition, if you take on extra responsibilities, for example in management or education, you may expect to be paid more.

Consultants can also supplement their salary by working in private practice if they wish. The opportunities available will depend on their specialty areas and the time they wish to spend on this outside of their NHS contracted hours.

General practitioners

There are two contractual options for GPs. They can be:

1) independent contractors who are in charge of running their own practices as business either alone or in partnerships. They have autonomy in how services are delivered according to their contract with NHS England. In England, these GPs have increasing responsibility for the commissioning of hospital services for the community

2) salaried GPs who are employees of independent contractor practices or directly employed by primary care organisations. From 1 April 2023, the pay range for salaried GPs is £68,975 to £104,085.

Pension scheme

Resident doctors may pay into the NHS Pension Scheme, which from April 2015 has been a Career Average Revalued Earnings (CARE) scheme. The 2015 scheme involves paying towards a pension which will be based on the average of a member's pensionable earnings throughout their whole career, with a revaluation of active members benefits in line with the Consumer price index plus 1.5 per cent per annum. [47] [48] The 1995/2008 scheme is closed to new entrants.

Contract dispute in England

Since 2012, NHS Employers and the BMA had been in negotiation towards a new contract for resident doctors. These talks ran into serious problems when the Secretary of State for Health, Jeremy Hunt, appeared willing to impose items from the Conservative 2015 election manifesto upon resident doctors in England. [49]

On 12 January 2016, resident doctors in England took part in the first general strike across the NHS, the first such industrial action in 40 years. Emergency care was still provided. [50] There have been claims that the Medical Director of NHS England, Professor Sir Bruce Keogh, has used performance target levels to justify and encourage NHS Trusts to declare an emergency situation, forcing resident doctors to work despite the strike, a move which the BMA has condemned. [51]

In September 2015, Hunt proposed new contracts for resident doctors which would scrap overtime rates for work between 7am and 10pm on every day except Sunday while increasing their basic pay in a move that Hunt said would be cost neutral, a claim the BMA say NHS Employers have been unable to support with robust data. [52] [53] In response, the doctor's union, the BMA, called for a strike, the first since the 1970s. [54] The strike vote started on 5 November. [55] In November 2015, the BMA balloted over 37,700 of their members in response to Hunt's contract proposals; 76% of eligible doctors voted, with 99.6% of doctors voting for action short of strike and 98% voting for all out strike. [56] In November 2015, Hunt said he would offer a basic pay increase of 11% but still remove compensation for longer hours. [57] [58] [59] On 19 November 2015, the result of the BMA strike ballot was announced, with more than 99% in favour of industrial action short of a strike, and 98% voting for full strike action. Hunt said the strike was "very disappointing", but declined the appeal for arbitration. [60] He was criticized for failing to answer MP's questions about the strike, with his deputy claiming he was too busy preparing for the strike. [61] Hunt eventually agreed to discussions overseen by Acas. After five days of talks between the government and BMA, Hunt withdrew his threat to impose a new contract without agreement, and the strike action that had been planned for December was suspended. [62] The first day of strike action was called off hours before it was due to start (too late to avoid some disruption), with later days suspended. [63] [64] [65]

On 24 December 2015, Dr Johann Malawana, leader of the BMA's junior doctors committee (JDC), gave a 4 January deadline for the talks to yield an acceptable outcome, or industrial action would be announced. [66] An agreement was not reached by this deadline, and so the BMA announced that a strike would go ahead, blaming "the government's continued failure to address resident doctors’ concerns about the need for robust contractual safeguards on safe working, and proper recognition for those working unsocial hours". [67] [68] The first day of the strike went ahead on 12 January. [69] [70] Resident doctors again withdrew their labour for routine care on 10 February 2016, leading to the cancellation of around 3,000 elective operations. [71]

Rest breaks

In a case involving University Hospitals of Derby and Burton NHS Foundation Trust in July 2019, the Court of Appeal decided that the trust had breached the 2002 contract for resident doctors because their hours and rest periods had been underestimated by commercial software over some years. The case will affect other NHS employers and substantial arrears will be due. [72]

Risks to patients

The period in August where there was a large changeover of hospital staff has sometimes been dubbed the "killing season" (due to a perception that there is an associated rise in the number of patient deaths). [73] In 2009, research looking at emergency admissions to hospitals in England established that a small but statistically significant increase in patient mortality occurred during August. [74] The limited data was collected retrospectively over an 8-year period, comparing two week-long blocks (one week prior to commencement, one week post commencement). The methodology meant that drawing firm conclusions was unwise with correlation not implying causation. [73] In the month when resident doctors start working, when other factors are adjusted for, patients had a 6% increase in mortality. [73] For patients admitted as an emergency who were not requiring surgery or suffering from cancer, the mortality rate increased by 7.86%. [73]

Other concerns have been raised regarding mortality following admission to hospital at a weekend. A research paper published in 2012 looked retrospectively at data from 2009; the study observed an increase in 30-day mortality for people admitted to hospital on Saturday and Sunday, compared to mid-week days. [75] The risk of dying in a hospital on Saturday or Sunday was actually less than on a weekday. [75] The data in the study did not enable the authors to describe the cause of this so-called weekend effect. Subsequently, there has been considerable speculation around whether the availability of consultants was a factor. [76] The authors of the paper have also openly criticised the conclusions drawn by the government and popular media on the paper, saying that to draw such conclusions as to associated decreased weekend staffing levels to increased mortality at 30 days post-admission would be "rash and misleading". [77]

Health Education England produces reports on NHS trusts under “enhanced monitoring” by the General Medical Council, because of concerns from trainees. 20 of these were analysed by the Health Service Journal in 2020. Bolton NHS Foundation Trust and Barking, Havering and Redbridge University Hospitals NHS Trust featured prominently. Reports included consultants leaving resident doctors with insufficient support, bullying, reluctance to report concerns and IT problems. It has the power to withdraw trainees from trusts but this was only used once since the start of 2019. [78]

See also

Related Research Articles

<span class="mw-page-title-main">General practitioner</span> Generalist medical doctor working in primary care

A general practitioner (GP) or family physician is a doctor who is a consultant in general practice.

The British Medical Association (BMA) is a registered trade union and professional body for doctors in the United Kingdom. It does not regulate or certify doctors, a responsibility which lies with the General Medical Council. The BMA has a range of representative and scientific committees and is recognised by National Health Service (NHS) employers alongside the Hospital Consultants and Specialists Association as one of two national contract negotiators for doctors.

<span class="mw-page-title-main">Hospital Consultants and Specialists Association</span> British trade union

HCSA - the hospital doctors' union is a nationally recognised professional association and trade union in the UK dedicated solely to hospital consultants, specialty doctors and core/specialty hospital doctors in training and Foundation grades, originally established in 1948 as the Regional Hospital Consultants and Specialists Association.

<span class="mw-page-title-main">Residency (medicine)</span> Postgraduate medical training

Residency or postgraduate training is a stage of graduate medical education. It refers to a qualified physician, veterinarian, dentist, podiatrist (DPM) or pharmacist (PharmD) who practices medicine or surgery, veterinary medicine, dentistry, podiatry, or clinical pharmacy, respectively, usually in a hospital or clinic, under the direct or indirect supervision of a senior medical clinician registered in that specialty such as an attending physician or consultant.

<span class="mw-page-title-main">Family medicine</span> Medical specialty

Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primary care physician, is named a family physician. It is often referred to as general practice and a practitioner as a general practitioner. Historically, their role was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s, family medicine / general practice has become a specialty in its own right, with specific training requirements tailored to each country. The names of the specialty emphasize its holistic nature and/or its roots in the family. It is based on knowledge of the patient in the context of the family and the community, focusing on disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is "promoting personal, comprehensive and continuing care for the individual in the context of the family and the community". The issues of values underlying this practice are usually known as primary care ethics.

Modernising Medical Careers (MMC) is a programme for postgraduate medical training introduced in the United Kingdom in 2005. The programme replaced the traditional grades of medical career before the level of Consultant. The different stages of the programme contribute towards a "Certificate of Completion of Training" (CCT). It has been dogged by criticism within and outside the medical profession, and an independent review of MMC led by Professor Sir John Tooke criticised many aspects of it.

In the United Kingdom, Ireland, and parts of the Commonwealth, consultant is the title of a senior hospital-based physician or surgeon who has completed all of their specialist training and been placed on the specialist register in their chosen speciality.

An NHS deanery is a regional organisation responsible for postgraduate medical and dental training, within the structure of the National Health Service (NHS) in Scotland, Wales and Northern Ireland. In 2013, restructuring of the NHS in England led to its deaneries being incorporated into new bodies, known as Local Education and Training Boards (LETBs), that have taken over these functions.

<span class="mw-page-title-main">History of the National Health Service</span>

The name National Health Service (NHS) is used to refer to the publicly funded health care services of England, Scotland and Wales, individually or collectively. Northern Ireland's services are known as 'Health and Social Care' to promote its dual integration of health and social services.

<span class="mw-page-title-main">National Health Service (England)</span> Publicly-funded healthcare system in England

The National Health Service (NHS) is the publicly funded healthcare system in England, and one of the four National Health Service systems in the United Kingdom. It is the second largest single-payer healthcare system in the world after the Brazilian Sistema Único de Saúde. Primarily funded by the government from general taxation, and overseen by the Department of Health and Social Care, the NHS provides healthcare to all legal English residents and residents from other regions of the UK, with most services free at the point of use for most people. The NHS also conducts research through the National Institute for Health and Care Research (NIHR).

Healthcare in England is mainly provided by the National Health Service (NHS), a public body that provides healthcare to all permanent residents in England, that is free at the point of use. The body is one of four forming the UK National Health Service, as health is a devolved matter; there are differences with the provisions for healthcare elsewhere in the United Kingdom, and in England it is overseen by NHS England. Though the public system dominates healthcare provision in England, private health care and a wide variety of alternative and complementary treatments are available for those willing and able to pay.

<span class="mw-page-title-main">National Health Service</span> Publicly-funded healthcare systems in the United Kingdom

The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom, comprising the NHS in England, NHS Scotland and NHS Wales. Health and Social Care in Northern Ireland was created separately and is often locally referred to as "the NHS". The original three systems were established in 1948 as part of major social reforms following the Second World War. The founding principles were that services should be comprehensive, universal and free at the point of delivery—a health service based on clinical need, not ability to pay. Each service provides a comprehensive range of health services, provided without charge for residents of the United Kingdom apart from dental treatment and optical care. In England, NHS patients have to pay prescription charges; some, such as those aged over 60, or those on certain state benefits, are exempt.

Doctors in Unite is a trade union for doctors in the United Kingdom. It was formerly known as the Medical Practitioners' Union (MPU) before its affiliation with Unite.

<span class="mw-page-title-main">Johann Malawana</span> British entrepreneur and former physician

Johann Niranjan Lyle Malawana is a British entrepreneur and former obstetrics doctor. Malawana was the Chair of the British Medical Association's Junior Doctors Committee from September 2015 to July 2016. His tenure included the 2015 junior doctors contract dispute in England where he was the lead negotiator on the new contract. Malawana founded technology company Medics.Academy and The Healthcare Leadership Academy in 2016.

<span class="mw-page-title-main">2015 junior doctors contract dispute in England</span>

A junior doctors contract dispute in England led to industrial action being taken in 2015 and 2016. A negotiation between NHS Employers and the main UK doctor's union, the British Medical Association (BMA), had been overshadowed by the Secretary of State for Health, Jeremy Hunt, threatening to impose certain aspects. The BMA balloted members in November 2015 and industrial action was scheduled for the following month. The initial action was suspended, although further talks broke down. Junior doctors took part in a general strike across the NHS in England on 12 January 2016, the first such industrial action in 40 years. Junior doctors again withdrew their labour for routine care on 10 February. On 26 April 2016, junior doctors withdrew from emergency and routine care, the first time this had happened.

<span class="mw-page-title-main">Hadiza Bawa-Garba case</span> Medical controversy in Leicester, England

Jack Adcock, a 6-year-old child, was admitted to Leicester Royal Infirmary (LRI) on 18 February 2011. He died later that day, in part because of failings in his treatment.

<span class="mw-page-title-main">Jeremy Hunt as Health Secretary</span> UK Government appointment from 2012 to 2018

Jeremy Hunt served as Secretary of State for Health, later Secretary of State for Health and Social Care, from 2012 to 2018. Appointed by David Cameron, Hunt served in the Cameron–Clegg coalition and Cameron majority government. He was reappointed by Theresa May and served in the majority and minority May governments. In January 2018, Hunt gained additional responsibility for social care in England and, in June, became the longest-serving Health Secretary in British political history. He left the role when he was promoted to Foreign Secretary following the resignation of Boris Johnson, and was succeeded by Matt Hancock.

<span class="mw-page-title-main">2022–present National Health Service strikes</span> Healthcare strike

The 2022–present National Health Service (NHS) strikes are several ongoing industrial disputes in the publicly funded health services of the United Kingdom.

Emma Runswick is an English medical doctor and trade unionist specialising in mental health. She has served as the deputy chair of the British Medical Association council since 2022.

References

  1. ↑ "How many junior doctors are there in England?". Nuffield Trust . 31 March 2022.
  2. 1 2 McNally, Prof Scarlett (April 2022). "What should we call 'Junior Doctors'?" (PDF). Medical Schools Council UK.
  3. 1 2 3 Patterson, Chris (2023-07-06). "Call to revise term 'junior doctor'". The British Medical Association is the trade union and professional body for doctors in the UK. Retrieved 2023-08-31.
  4. ↑ Looi, Mun-Keat (2023-09-20). "What do different countries call junior doctors?". BMJ. 382: 2130. doi:10.1136/bmj.p2130. ISSN   1756-1833. PMID   37730378.
  5. ↑ Today, Telangana (2023-07-06). "Term 'Junior Doctor' discontinued in UK thanks to Hyderabad doc". Telangana Today. Retrieved 2023-08-31.
  6. ↑ "Junior doctors to be called 'resident doctors'". The British Medical Association is the trade union and professional body for doctors in the UK. 2024-03-19. Retrieved 2024-07-07.
  7. ↑ Pillarisetti, Sai Ram; Kanneganti, Chandra; Majeed, Azeem; Asanati, Kaveh (1 December 2023). "Rethinking the terminology: transitioning from 'junior doctors' to 'postgraduate doctors' for enhanced representation in modern medical practice". BJGP Open. 7 (4). doi: 10.3399/BJGPO.2023.0178 . ISSN   2398-3795. PMC   11176672 .
  8. ↑ "Health Secretary Leaves People In Disbelief After Bizarre Description Of Junior Doctors". HuffPost UK. 21 December 2023.
  9. ↑ "Health secretary Victoria Atkins sparks outrage with 'doctors in training' remark". The Independent. 21 December 2023.
  10. ↑ "Health secretary accused of deliberate slight over 'doctors in training' remark | Doctors | The Guardian". amp.theguardian.com.
  11. ↑ Dugan, Emily (21 December 2023). "Health secretary accused of deliberate slight over 'doctors in training' remark". The Guardian.
  12. ↑ "Yousaf reiterates offer of help to mediate junior doctors strikes". The Independent. 22 December 2023.
  13. ↑ Campbell, Denis (2024-09-16). "Junior doctors bring dispute to end by voting to accept Streeting's pay offer". The Guardian. ISSN   0261-3077 . Retrieved 2024-09-16.
  14. ↑ "Junior doctors want more despite backing pay deal". BBC News. 2024-09-16. Retrieved 2024-09-17.
  15. 1 2 Moonesinghe, S R (22 March 2011). "Impact of reduction in working hours for doctors in training on postgraduate medical education and patients' outcomes: systematic review". BMJ . 342: d1580. doi: 10.1136/bmj.d1580 . PMID   21427046.
  16. ↑ Brown, Steve (1 February 2001). "Q & A: Junior doctors' pay deal explained". The Guardian. Retrieved 22 November 2015.
  17. 1 2 Fitzgerald JE, Caesar B (2012). "The European working time directive: A practical review for surgical trainees". International Journal of Surgery. 10 (8): 399–403. doi: 10.1016/j.ijsu.2012.08.007 . PMID   22925631.
  18. ↑ Lomas, Clare (29 September 2009). "Trespassers on medical ground?". Nursing Times . Retrieved 22 November 2015.
  19. ↑ "One in three UK doctors born abroad, international research shows". Daily Telegraph. 28 December 2015. Archived from the original on 28 December 2015. Retrieved 28 December 2015.
  20. ↑ "Archived copy" (PDF). Archived from the original (PDF) on 2019-07-10. Retrieved 2020-01-09.{{cite web}}: CS1 maint: archived copy as title (link)
  21. ↑ "F2 Career Destinations Report 2018 released".
  22. ↑ "Why doctors take breaks from their training - a GMC report".
  23. ↑ "Training pathways report" (PDF). gmc-uk.org. Retrieved 15 July 2023.
  24. ↑ Hays, Richard (3 September 2005). "Foundation programme for newly qualified doctors". BMJ. 331 (7515): 465–466. doi:10.1136/bmj.331.7515.465. PMC   1199009 . PMID   16141134.
  25. ↑ Brown, Benjamin; Ahmed-Little, Yasmin; Stanton, Emma (March 2012). "Why we cannot afford not to engage junior doctors in NHS leadership". Journal of the Royal Society of Medicine . 105 (3): 105–110. doi:10.1258/jrsm.2012.110202. PMC   3308637 . PMID   22434809.
  26. 1 2 "Pay for doctors". Health Careers. 2017. Retrieved 9 October 2018.
  27. ↑ "BMA - Pay scales for junior doctors in England". www.bma.org.uk. Retrieved 2019-11-19.
  28. ↑ "Pay and Conditions Circular (M&D) 2/2019" (PDF).
  29. ↑ "Pay calculator". Personal Finance for Junior Doctors. Retrieved 2019-11-19.
  30. ↑ Nick Triggle (2016-01-04). "Junior doctors row: What you need to know". BBC News.
  31. ↑ "Graduates in the UK Labour Market: 2013". Office for National Statistics. In 2013 those graduates that had an undergraduate degree in medicine or dentistry were the most likely to be employed and had the highest average gross annual pay
  32. ↑ "Top 10 degree subjects for graduate starting salaries". Which?. Medical degrees have, and will no doubt continue to have, some of the best employment outcomes of any degree in terms of salary expectations and long-term prospects.
  33. ↑ Brian Milligan (12 April 2016). "To earn more, study medicine or economics, says IFS". BBC News. If you want to earn a big salary, you would be advised to study medicine or economics, says a report by the Institute for Fiscal Studies (IFS). Just ten years after graduation, male medical students earned a median wage of £55,000, the research found. Female medical students also became the highest earners, typically making £45,000 a year.
  34. ↑ "The Graduate Market in 2015" (PDF). High Fliers Research. Retrieved 22 November 2015.
  35. ↑ "How does your salary compare with the rest of the country?". Metro. 2015-11-18.
  36. ↑ "F1 Pay Scale". South Thames Foundation School. 2014-03-31.
  37. ↑ Jaques, Helen (10 June 2011). "How inflation has downsized your pay". Careers. BMJ. 342: d3473. doi:10.1136/bmj.d3473. S2CID   80299254.
  38. 1 2 DDRB. "Review Body on Doctors' and Dentists' Remuneration Forty-Third Report 2015: Figure 2.3" (PDF).
  39. ↑ "Memorandum of evidence to the Review Body on Doctors' and Dentists' Remuneration. Annex 1 - A comparison of graduate earnings". British Medical Association. 2005-10-01. Archived from the original on June 8, 2007. Retrieved 2007-08-02. Table 3 - Expected earnings for a medical graduate in the first five years post graduation - Year 1 - Weighted average -£32,086{{cite web}}: CS1 maint: unfit URL (link)
  40. ↑ "BMA - Agreed new contract deal for junior doctors in England". www.bma.org.uk. Retrieved 2019-11-19.
  41. ↑ Roberts, Michelle (2023-07-13). "Junior doctors in England start five-day strike". BBC. Retrieved 2023-07-13.
  42. ↑ Ahmed, Usman; Malik, Shahbaz; Akram, Yasmin (12 September 2012). "Dealing with the costs of being a junior doctor". Careers. BMJ. 345: e5939. doi:10.1136/bmj.e5939.
  43. 1 2 Ercolani, Marco G; Vohra, Ravinder S; Carmichael, Fiona; Mangat, Karanjit; Alderson, Derek (21 April 2015). "The lifetime cost to English students of borrowing to invest in a medical degree: a gender comparison using data from the Office for National Statistics". BMJ Open . 5 (4): e007335. doi:10.1136/bmjopen-2014-007335. PMC   4420932 . PMID   25900463. Open Access logo PLoS transparent.svg
  44. ↑ "Financial help for students". Scottish Government. Eligible Scottish domiciled students studying full-time in Scotland are not required to pay tuition fees if studying for a first degree or equivalent. Students may also be eligible to apply for an income assessed bursay and student loan to help with living costs from the Student Awards Agency for Scotland (SAAS)
  45. 1 2 "Doctors in accommodation protest". BBC News. 22 May 2008.
  46. ↑ "Written answers: Junior Doctors: Accommodation". They Work For You. 3 June 2008.
  47. ↑ "2015 NHS Pension Scheme". NHS Employers. 1 April 2015.
  48. ↑ "Changes to the NHS (Scotland) Pension Scheme from April 2015". Scottish Public Pensions Agency. Retrieved 22 November 2015.
  49. ↑ Wintour, Patrick (4 November 2015). "Jeremy Hunt: I cannot negotiate on manifesto promise of 24-hour NHS". The Guardian. Retrieved 3 January 2016.
  50. ↑ Triggle, Nick (1970-01-01). "Junior doctors' strike: Treatments postponed amid walkout - BBC News". Bbc.co.uk. Retrieved 2016-01-12.
  51. ↑ "Striking doctors could be ordered back in, in move which sparks fury". Telegraph. Retrieved 2016-01-12.
  52. ↑ "FAQs on junior doctor contract proposals". BMJ. Retrieved 31 October 2015.
  53. ↑ Denis Campbell (17 October 2015). "Leader of NHS junior doctors urges Jeremy Hunt to reopen negotiations". The Guardian.
  54. ↑ "Junior doctors to be balloted for strike action, says British Medical Association". The Guardian. Press Association. 26 September 2015. Retrieved 10 October 2015.
  55. ↑ "Junior doctors to vote on strike action - British Medical Association". BBC News. 21 October 2015.
  56. ↑ Campbell, Denis (19 November 2015). "Junior doctors overwhelmingly vote for NHS strikes". The Guardian. Retrieved 3 January 2016.
  57. ↑ "Jeremy Hunt offers junior doctors 11% pay rise in bid to end dispute".
  58. ↑ "Payrise Offer A PR Stunt, Say Junior Doctors".
  59. ↑ "Junior doctors claim Jeremy Hunt's 11% pay rise will be a 'pay cut' of 26%".
  60. ↑ "Junior doctors: Jeremy Hunt says strike vote 'very disappointing'".
  61. ↑ "Jeremy Hunt an 'absolute disgrace' for refusing to face MPs' questions on junior doctors strike".
  62. ↑ Cooper, Charlie (1 December 2015). "Junior doctors strike called off to grant more time for talks". The Independent. Retrieved 3 January 2016.
  63. ↑ "Disruption expected as junior doctors' strike called off".
  64. ↑ "Doctors' strike called off after Hunt lifts threat to impose new contract".
  65. ↑ "Junior doctors strike called off to grant more time for talks".
  66. ↑ "Junior doctors likely to strike as government talks falter".
  67. ↑ "Junior doctors in England to strike next week after talks break down".
  68. ↑ "Junior doctors announce they will strike next week".
  69. ↑ "Junior doctors' strike live: Jeremy Hunt brands strike 'unnecessary' as poll shows high public support for stoppage".
  70. ↑ "Junior doctors' strike: Get back to negotiating table - Hunt".
  71. ↑ "'Operations hit as doctors strike again". BBC News . 10 February 2016.
  72. ↑ "Junior doctors win landmark case over rest breaks". Health Service Journal. 31 July 2019. Retrieved 3 September 2019.
  73. 1 2 3 4 "'Deaths rise' with junior doctors". BBC News . 22 September 2009.
  74. ↑ Jen, Min Hua; Bottle, Alex; Majeed, Azeem; Bell, Derek; Aylin, Paul (23 September 2009). "Early In-Hospital Mortality following Trainee Doctors' First Day at Work". PLoS ONE . 4 (9): e7103. Bibcode:2009PLoSO...4.7103J. doi: 10.1371/journal.pone.0007103 . PMC   2743809 . PMID   19774078.
  75. 1 2 Freemantle, N; Richardson, M; Wood, J; Ray, D; Khosla, S; Shahian, D; Roche, WR; Stephens, I; Keogh, B; Pagano, D (February 2012). "Weekend hospitalization and additional risk of death: An analysis of inpatient data". Journal of the Royal Society of Medicine. 105 (2): 74–84. doi:10.1258/jrsm.2012.120009. PMC   3284293 . PMID   22307037.
  76. ↑ Kirkland, Faye; Campbell, Denis (19 November 2015). "Jeremy Hunt statement on weekend hospital care is misleading, experts warn". The Guardian.
  77. ↑ Freemantle, Nick; Ray, Daniel; McNulty, David; Rosser, David; Bennett, Simon; Keogh, Bruce E.; Pagano, Domenico (2015). "Increased mortality associated with weekend hospital admission: a case for expanded seven day services?". The BMJ. 351: h4596. doi:10.1136/bmj.h4596. PMID   26342923. S2CID   206907375 . Retrieved 2016-01-12.
  78. ↑ "Bullying, bad behaviour and broken IT uncovered at worst trusts for junior doctors". Health Service Journal. 29 June 2020. Retrieved 18 August 2020.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.