Tag: Medical Careers

Should we shift from using ‘junior doctors’ to postgraduate doctors?

In the UK’s National Health Service (NHS), the language we use to describe medical professionals holds significant weight. The term ‘junior doctor,’ a longstanding descriptor for doctors in training or those in their early postgraduate years in the UK, is now being re-evaluated. The British Medical Association (BMA) has highlighted the need for a terminology update to more accurately reflect the expertise and responsibilities of these vital healthcare professionals. Our article in BJGP Open discusses this issue further.

The Need for Change

The term ‘junior doctor’ has been a staple in the UK medical lexicon for decades, but it fails to capture the breadth of experience and skill these doctors possess. These professionals, who may have up to a decade of training, are fully qualified and play a crucial role in patient care, performing a wide range of duties from diagnosis to complex medical procedures. The current term may inadvertently diminish their value and expertise.

A More Accurate Representation

As the roles of these doctors evolve with advancing medicine, so too should the terminology. The proposed shift to ‘postgraduate doctors’ better represents their level of education and training, impacting how they are perceived by patients, colleagues, and the broader public. This change is particularly pertinent in primary care, where these doctors often serve as critical members of the clinical team and are involved in supervisory roles.

Enhancing Recruitment and Job Satisfaction

This rebranding is more than a semantic shift; it’s a move that could influence recruitment into medical specialties, including general practice. At a time when the NHS faces challenges in recruiting for general practice roles, recognizing the perspectives and contributions of this younger generation of doctors is crucial.

Supporting Evidence

A report by Prof Scarlett McNally for Health Education England (HEE) found overwhelming support for moving away from the term ‘junior doctor.’ The majority of respondents, including doctors, patients, and healthcare staff, favoured ‘postgraduate doctors’ as a more appropriate alternative. This change also aligns with the desire for clarity regarding a doctor’s seniority level.

Implications for Patient Care

The term ‘junior doctor’ can inadvertently cause patient anxiety, especially in high-stress situations. Introducing oneself as a ‘doctor’ or ‘postgraduate doctor’ can instil more confidence in patients. Clear designations on name badges and specific introductions can reduce uncertainty and potential bias.

A Collective Effort

The support for this change isn’t limited to the BMA; various surgical and medical royal colleges in the UK have also advocated for moving away from the term ‘junior doctors.’ This collective effort underscores the importance of language in shaping patient perception and trust.

Conclusion

As healthcare evolves, so must our language. The shift from ‘junior doctors’ to ‘postgraduate doctors’ is more than a nominal change; it’s a step towards a more accurate, respectful, and empowering representation of these medical professionals. This change not only recognizes their expertise and contributions but also enhances patient care and trust in the healthcare system. The medical community should actively engage in discussions and work towards implementing this revised designation, reflecting the realities of modern medical practice.

The F3 year: Why increasing numbers of foundation doctors are deciding against specialty training programmes

In an article published in the Journal of the Royal Society of Medicine, Paul Jewell and I discuss the issue of foundation doctors and specialist training. Only around 43% of junior doctors entered straight into a UK specialty training programme after completion of their foundation programme in 2017, a substantial decrease from 71% in 2011. Given the National Health Service in the UK is under ever-increasing workforce pressures, this is a worrying trend. The decline in entry to specialty training can be partly explained by the rise in what is known as ‘the F3 year’. Concerns over this ‘junior doctor exodus’ are not new, having been previously raised in 2010, when the figures were far more favourable than they are now. Similar trends can also be seen at earlier stages, with fewer school students applying to medical school, and fewer medical students applying to the foundation programme,4 indicating wider issues. To reverse this trend and the shortage of doctors in many specialties, solutions to encourage more foundation doctors to enter specialty training need to be considered.

https://doi.org/10.1177/0141076818772220

How can medical students be encouraged to consider primary care as a career?

In a letter published in the British Journal of General Practice, medical students Fahmida Mannan and Zain Chaudhry from the Imperial College London School of Medicine discuss how the NHS and medical schools can encourage students to consider general practice as a career option. They suggest the focus in medical schools should shift towards improving the quality of general practice placements and promoting the integration of primary care and specialist teaching, rather than consuming more time in an already overstretched curricula.

They also consider that prestige has never been the main incentive for pursuing a specialty. Their own experience is that many medical students are attracted to a career in general practice because of other factors, such as a good work–life balance, continuity of care and career flexibility. With many GPs now concerned about their workload, this inevitably influences students and junior doctors in their career choices.

Another key factor is the funding that a specialty receives. In recent years, the proportion of the NHS budget spent on primary care has decreased, GPs’ workload has increased and the income of GPs has fallen. To recruit more GPs, medical schools should improve the quality of students’ experiences in their primary care placements. However by itself, this will not be sufficient to improve recruitment and the onus falls upon the NHS to once again make general practice a rewarding career for doctors.

We are now seeing some signs of this. For example, the NHS England Five Year Forward Strategy emphasises the importance of primary care to the NHS and proposes new employment models for general practitioners. This includes the formation of GP Federations in which general practitioners will come together to work in larger groups; and the possibility that hospitals could also employ GPs and offer primary care services.