Is medicine toxic?

I read an interesting article today on the need for change in the culture of medicine.

The idea that one learns best through humiliation is bizarre to me. I’m sure there are fellow students who thrive on that feeling of being challenged and pushed, but there is a certain way of encouraging someone to think outside the box without making them feel like they’re being hung out to dry.

In the past, I’ve had experiences with doctors where if I don’t provide a spot on answer within a second of being asked the question, I’m accused of being a rubbish medical student. I’ve had seemingly funny quips about whether I even attended medical school, which I’ve awkwardly laughed off. Truthfully, in that moment I probably wanted the ground to open up and swallow me whole.

I wish I could say I only speak from personal experience of being on the receiving end of an old school doctor’s grilling, but I’ve seen it happen far too many times to my fellow students. And it’s not a nice experience to watch, let alone go through. Some say that it’s all part of being a medical student. Apparently getting grilled by your seniors is viewed as some sort of twisted rite of passage. One that we all go through to reach the end goal of being able to inflict that pain on some poor soul beneath us.

I exaggarate of course, but reading this article on just how toxic medicine can be made me realise one of the reasons why I felt so demoralised by the profession.

This post is a bit of rant after a discussion over how medical school can quite frankly, be a bitch. But it doesn’t have to be. There are certain stresses to the job that you can’t change: dealing with life and death is part and parcel of being a doctor. However, medics can help make the learning and training less awful by not humilating students and making them feel even smaller than they already feel.

We already know we’re the bottom of the food chain. There’s no need to keep reminding us of how little we are.

Disclaimer: I have actually also had good experiences, despite my moaning. Some doctors know exactly how to push you as a student and at the same time make you feel like you matter to the team. Those are the doctors that are I personally have responded best to. They are the ones who I have walked away from with positive vibes about that specialty. Which is probably why I most definitely do not want to do surgery.

 

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The world of work

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Having decided to take time out of medicine for at least the next eight months, I needed to find something to fill that time. Whilst it would have been wonderful to go travelling and disappear to the other side of the world for nine months, the lack of funds and parental judgement prohibited me from doing so. As a result, I had to get a job. Not just any job either but a job that had some sort of relevance, potential for career progression, and would at least help me work out what the hell I want to do with my life.

Through some good luck, I was able to secure a position as a junior medical writer for a medical and healthcare communications company in a pretty short space of time. Medical communications, or ‘medcomms’, is an interesting industry I came across when exploring other options beyond medicine. The role of medcomms agencies is a somewhat intermediary one. They work with pharmaceutical companies to help communicate the clinical trial data of new drugs to healthcare professionals and those outside the pharmaceutical world (mostly with the aim of marketing drugs and making the big bucks for drug companies).

My first couple of weeks in the job have been fairly relaxed. As it’s my first ever full-time job post-university, I think I’m being eased into it all quite nicely. I’ll be honest, there were some periods where I was incredibly bored reading about diabetes, but work has since picked up a little and I’m being given a steady flow of tasks to work on. My work at the moment is mainly putting clinical trial data into a presentable and comprehensible presentation, as well as researching new and interesting studies on diabetes to report.

For some, this job may not be the most exhilarating and life-changing job. But in all honesty, I’ve been more content with the steady 9-5 life I’ve had the last couple weeks than the chaos that was medical school and clinical placements. I’ve been able to enjoy myself in my own time and not have what I call ‘study guilt’ constantly hanging over my head. Things with this job may change: it may get busy and stressful and I’ll come to hate it; or it could challenge me and open my mind to a totally different world of work which I end up enjoying.

I’m just going to see how it goes. At the very least, I’m getting paid.

Not safe, not fair

Today, junior doctors across England will be going on strike for the first time in 40 years. For any non-medics, the question is why? Well, I will do my best to explain.

Firstly, I should define what a “junior” doctor is. I place those air quotes around the term junior for a good reason. There is nothing “junior” about a junior doctor. You may assume a junior doctor is someone fresh out of medical school. However, a junior doctor is a term that covers anyone from those in the their first year working after graduating medical school, all the way to those training in their chosen specialties, possibly 10-15 years after qualifying. This means a “junior” doctor can be someone well into their 30s or even 40s, someone with years of training, experience and responsibility.

Bearing the above in mind, this is what the government is proposing:

  • Changing plain working time from 7am-10pm Monday to Saturday. That’s right, these hours will be considered normal working hours and will be paid as such.
  • The removal of safeguards protecting doctors from being overworked. Hospitals currently are fined if staff are made to work beyond the contracted hours. The government want to remove this safeguard that stops doctors from working up to 100 hour weeks. This is dangerous to not just the staff but the patients – would you want to be seen and treated by a doctor who is running on little to no sleep?
  • Reducing the amount of pay for working antisocial hours. The current pay system involves something called ‘banding’. It is a little complicated but it basically remunerates doctors for working antisocial hours (antisocial hours being those outside the normal working hours – see point one). Banding supplements a doctor’s basic pay and for many is a vital source of their income. Which leads me to..
  • Increasing basic pay by 11%. Sounds alright doesn’t? Wrong. Given what I mentioned about banding, it will in fact result in a pay cut. Without the extra payment for working antisocial hours, many will have a reduced income. So whilst basic pay is going up, the amount paid for antisocial hours is being reduced at a much greater rate = pay cut.
  • A 7-day NHS. For anyone who has ever been in hospital on a weekend, or used A&E on a bank holiday/Christmas, you will know the NHS is already working 7 days! Inpatients and those coming into A&E will always be seen to and not left hanging over the weekend. This soundbite that politicians keep spouting gives completely the wrong message to those who may be critically unwell and need to be treated asap.

The first of the strikes is happening today. If no agreement is made between the government and the British Medical Association, they will happen again in a weeks time, and the week after that, each with progressing severity. No junior doctor wants to strike but they are left with no choice as they are not being listened to. This contract is not only going to affect them but every person who comes into contact with the NHS. If the contract is pushed through, doctors may leave the country or even leave the profession. This leaves an NHS that will be spread very thinly trying to cover the growing shortages in staff. And who does this ultimately effect? The patients.

As a medical student (albeit on a leave of absence), I fully support the junior doctors strike. They are not only fighting for their future but the future of every medical student in England. They are standing up and protecting your NHS. Help support those striking by spreading word of what this is all about.