Medicine - junior doctor prospects
Discussion
My son's just started Year 11 and, having toyed for a while with the idea of becoming a doctor, has indicated he's giving it some serious consideration. He's on track for excellent GCSEs and obviously decision time on A-Levels is fast approaching, so I've been trying to do my own research to help guide him.
Something I've been hearing loosely over the last year or so is that junior doctor recruitment has become a bit of a s
tshow, with insane levels of competition for foundation programmes and subsequent specialty training, and a not insignificant number of perfectly capable students finishing their course and/or foundation programme without a job to go to.
I'd be interested to hear from anyone either in the profession themselves, or perhaps with kids somewhere on the path, on the extent to which this is true and any thoughts on how it might pan out or correct in the coming years?
Something I've been hearing loosely over the last year or so is that junior doctor recruitment has become a bit of a s
tshow, with insane levels of competition for foundation programmes and subsequent specialty training, and a not insignificant number of perfectly capable students finishing their course and/or foundation programme without a job to go to. I'd be interested to hear from anyone either in the profession themselves, or perhaps with kids somewhere on the path, on the extent to which this is true and any thoughts on how it might pan out or correct in the coming years?
gotoPzero said:
There is a lot of stuff on reddit. Think there are jr dr and gp subs to join. HTH
I’d be worried that might end up a bit like Pprune - Professional Pilots Rumour Network? Mountains of negativity because the ones who haven’t managed to get jobs are the ones with time on their hands to post, so it appears that it’s all doom and gloom while everyone else is just cracking on with working hard. I’m just speculating with nothing to back that up. Cheers, there are indeed some bits from junior doctors on there which at face value have been quite educational, albeit so bearish that I do wonder if there's some selection bias at play as Crumpet said.
Which kinda goes back to my aim of getting a sense from anyone with a slightly bigger picture view on whether this dynamic's here to stay or likely to shift by the time my son might be affected. Seen a few docs and surgeons posting over the years and given PH demographics they'd presumably be quite senior so thought it worth a go. We were also going to see if there's anyone we could try sounding out through his school's alumni network and other parents.
I did find this page quite instructive - it shows the past and present NHS competition ratios for training spots across the various specialities...
Which kinda goes back to my aim of getting a sense from anyone with a slightly bigger picture view on whether this dynamic's here to stay or likely to shift by the time my son might be affected. Seen a few docs and surgeons posting over the years and given PH demographics they'd presumably be quite senior so thought it worth a go. We were also going to see if there's anyone we could try sounding out through his school's alumni network and other parents.
I did find this page quite instructive - it shows the past and present NHS competition ratios for training spots across the various specialities...
There are lots of problems with career progression with bottlenecks and crazy application processes, but there always have been.
There are also lots of crappy bits of being a doctor - anti social hours, lots of exams, high costs of training but this is also true in other careers.
There are few other career pathways that are as diverse and fulfilling. It is all encompassing and will dominate your personal as well as professional life for ever but I have enjoyed the ride and still look forward to going into work after more than 30 years. I learn new things every week as medicine never stands still.
My advice is to only do medicine if you really have a calling. One of my daughters has done medicine and loves it. My other one was brutally honest said there is no way she wanted to live her life like I have and so chose another career!
There are also lots of crappy bits of being a doctor - anti social hours, lots of exams, high costs of training but this is also true in other careers.
There are few other career pathways that are as diverse and fulfilling. It is all encompassing and will dominate your personal as well as professional life for ever but I have enjoyed the ride and still look forward to going into work after more than 30 years. I learn new things every week as medicine never stands still.
My advice is to only do medicine if you really have a calling. One of my daughters has done medicine and loves it. My other one was brutally honest said there is no way she wanted to live her life like I have and so chose another career!
No one in my family are doctors, and I couldn't speak a word of English aged 10. I applied for medical school because the careers advisor told me 'They don't want people like you'. I got offered a place after someone else dropped out last minute, and nearly dropped out before the start of year 3 - I pretty much failed every exam in the first 2 years including having the honor of been the only one of two (from a year of 180) to fail one particular paper. The head of Year 2 sent me to the Dean after I 'correct' a mistake he made in a lecture in front of the whole year, I think everyone was expecting I would be kicked out but for some reason the dean took me under his wing and the rest was history......
That was all a long time ago now, and if you ask me now what other job I would right now the answer would be none (Fast jet pilot aside
).
The resident doctors (junior doctors) years I look back as an utter privilege. What other job in the world do total strangers whom you have never met before will literally put their lives in your hands just because of you job title? The responsibility and trust all doctors go through is something very few people outside of the profession will come close to understanding. Equally at the same time, the experiences you go through in a single day, from dealing with death, finding parking, trying to learn some new skills etc can to totally overwhelming. It's why in the medical school interviews there is alot of focus on how the candidate will cope with life as a doctor, but the reality is at 17/18 no one really knows.
Adam Kay's recollection of events isn't that far off the reality, though he does miss out the bits that I personally found (and still find) really enjoyable, the commandry with colleagues and the feeling of reward/achievement you have a the end of the day.
https://www.bbc.co.uk/programmes/p0b6k5gx
If you want to make easy money, medicine is 100% NOT the path to follow, but if you want to be part one of the most rewarding (and privileged) professions around its hard to think of anything else that comes close. It really isn't job, more a way of life.
That was all a long time ago now, and if you ask me now what other job I would right now the answer would be none (Fast jet pilot aside
). The resident doctors (junior doctors) years I look back as an utter privilege. What other job in the world do total strangers whom you have never met before will literally put their lives in your hands just because of you job title? The responsibility and trust all doctors go through is something very few people outside of the profession will come close to understanding. Equally at the same time, the experiences you go through in a single day, from dealing with death, finding parking, trying to learn some new skills etc can to totally overwhelming. It's why in the medical school interviews there is alot of focus on how the candidate will cope with life as a doctor, but the reality is at 17/18 no one really knows.
Adam Kay's recollection of events isn't that far off the reality, though he does miss out the bits that I personally found (and still find) really enjoyable, the commandry with colleagues and the feeling of reward/achievement you have a the end of the day.
https://www.bbc.co.uk/programmes/p0b6k5gx
If you want to make easy money, medicine is 100% NOT the path to follow, but if you want to be part one of the most rewarding (and privileged) professions around its hard to think of anything else that comes close. It really isn't job, more a way of life.
Edited by gangzoom on Wednesday 3rd September 11:09
To suggest another alternative, pharmacists get paid more for less training (until the doc gets fully independent)
Used to share a house in my student days with a trainee doc, trainee dentist, and trainee pharmacist.
Pharmacist had made the best choice of the three, imo. Least study, least stress, best pay.
M.
Used to share a house in my student days with a trainee doc, trainee dentist, and trainee pharmacist.
Pharmacist had made the best choice of the three, imo. Least study, least stress, best pay.
M.
^ If you want an easy, stress free job than you need your head checking to even consider medicine. But if you want one of the most rewarding professions to go into, that bring personal enjoyment (and decent financial compensation) the literal blood, sweat, and tears are well worth the reward.
I went into medical school for all the wrong reasons, but looking back it was probably the best worst decision I made at 17/18.
I went into medical school for all the wrong reasons, but looking back it was probably the best worst decision I made at 17/18
.I'm pretty sure the appeal to him isn't principally financial, though equally it's not some saintly ambition he's had forever. I think it's partly the intellectual challenge of active problem-solving in an interesting/varied context, and (perhaps cos he's a clever and cocksure 15 year old) also partly the idea of being someone on whose shoulders this all-important responsibility sits, as you alluded to gangzoom. I guess we'll see whether those make for sound motivations that can be finessed into a convincing personal statement 
Mind if I ask what your area of practice is gangzoom (and Biglips if you fancy chiming in) and any thoughts on it specifically in the context of this discussion? As it sounds like you've been around a while.
Mind if I ask what your area of practice is gangzoom (and Biglips if you fancy chiming in) and any thoughts on it specifically in the context of this discussion? As it sounds like you've been around a while.
The best thing about the job as it's already mentioned is the learning is constant, and its not just the clinical bits, over the years I've done in no particular order;
Some really bad stuff too, I'll never forget desperatly calling around every ITU for 50 miles ar 1am during the last Flu pandemic looking for a bed for a pregnant lady (pre COVID), than COVID - it was like watching Contagen but in real life......but none of that trumps standing in court facing a barister.
I've also done quite a bit of formal medical education including writing up a PhD thesis in the topic. Showing students my own awful exam grades never fails to raise eyebrows - But helping students struggling is what I love most as it people who helped me when I was in that position who got me to where I'm now today.
My job role in the last few years has been far more corporate(direct report to the Exec team). Getting a vote at the Exec board and been a direct report to the CEO is my next aim. But I still do clinical work, some research and teach. No two days at work are the same, I can go from talking to people about a life changing diagnosis to having to deal with the latest unexpected organisational crisis in a matter of minutes. The intellectual engagement is amazing, and I'm still amazed I get paid to do what I do!!!
A medicine degree really is like a golden ticket, the world is your literal oyster. I could have easily gone to work for industry, emigrate aboard etc etc but I love the NHS and my job so have never seriously entertained any other job/role.
An appreciation of that the role really is a vocation and not something you clock into 9-5 is probably the most important thing to get across at the UCAS stage.
- Organised a conference for 200+ people
- Just completed a Level 7 Senior Leadership apprenticeship
- Published around a dozen first author papers in academic journals
- Led a truly aglie population level Ai data analysis project with industry that gave us access to ££££££ worth of computing power
- Now working with multiple vendors on some very big digital implementation projects
Some really bad stuff too, I'll never forget desperatly calling around every ITU for 50 miles ar 1am during the last Flu pandemic looking for a bed for a pregnant lady (pre COVID), than COVID - it was like watching Contagen but in real life......but none of that trumps standing in court facing a barister.
I've also done quite a bit of formal medical education including writing up a PhD thesis in the topic. Showing students my own awful exam grades never fails to raise eyebrows - But helping students struggling is what I love most as it people who helped me when I was in that position who got me to where I'm now today.
My job role in the last few years has been far more corporate(direct report to the Exec team). Getting a vote at the Exec board and been a direct report to the CEO is my next aim. But I still do clinical work, some research and teach. No two days at work are the same, I can go from talking to people about a life changing diagnosis to having to deal with the latest unexpected organisational crisis in a matter of minutes. The intellectual engagement is amazing, and I'm still amazed I get paid to do what I do!!!
A medicine degree really is like a golden ticket, the world is your literal oyster. I could have easily gone to work for industry, emigrate aboard etc etc but I love the NHS and my job so have never seriously entertained any other job/role.
An appreciation of that the role really is a vocation and not something you clock into 9-5 is probably the most important thing to get across at the UCAS stage.
Edited by gangzoom on Friday 5th September 06:58
My experience has been very similar to Gangzoom’s description.
I had a ball at medical school. You don’t need to be particularly bright, but there is a large volume of work and lots of exams. We worked hard and played hard. Great days.
What you also need in spades is resilience. Joe Public physically and verbally abusing you whilst trying to help them, working anti-social hours, moving jobs and locations very frequently, big debt, lots and lots of post grad exams.
It’s worth it though. It is a huge privilege to be a doctor. Pay is good if not spectacular. Pension is still good even if not as good as it once was.
Consider speciality carefully. Aged 57 it is hard to drag myself out of bed at 3am to rush in for an emergency and then put still in a full day afterwards. It happens very frequently and nothing can explain how terrible you feel. It takes several days to recover each time at my age and then you are on call again!
Conversely, non front line specialities will give you a better work/life balance than the above BUT I will never be replaced with AI or a physician assistant.
Hope that helps and good luck with the decisions
I had a ball at medical school. You don’t need to be particularly bright, but there is a large volume of work and lots of exams. We worked hard and played hard. Great days.
What you also need in spades is resilience. Joe Public physically and verbally abusing you whilst trying to help them, working anti-social hours, moving jobs and locations very frequently, big debt, lots and lots of post grad exams.
It’s worth it though. It is a huge privilege to be a doctor. Pay is good if not spectacular. Pension is still good even if not as good as it once was.
Consider speciality carefully. Aged 57 it is hard to drag myself out of bed at 3am to rush in for an emergency and then put still in a full day afterwards. It happens very frequently and nothing can explain how terrible you feel. It takes several days to recover each time at my age and then you are on call again!
Conversely, non front line specialities will give you a better work/life balance than the above BUT I will never be replaced with AI or a physician assistant.
Hope that helps and good luck with the decisions
Biglips said:
Conversely, non front line specialities will give you a better work/life balance than the above BUT I will never be replaced with AI or a physician assistant.
Having done lots of work with AI, and currently engaged with ongoing work in AI ranging from ambient dictation to coding, to clinical risk detection I can confidently say NO clinician need to be worried about AI replacing them. The 'gut feel' we all have from eyeballing a busy ward, the small hints in even a way someone describes their pain/issue etc that leads you to request that all important test is something AI has zero chance of replicating, partly because most of us don't even know why/how we make those calls on-the-fly.
It's why whenever anyone asks me about how to get into leadership, research, teaching etc, my answer is focus on developing your clinical skills first. The 'added value' I bring to the various none clinical project/work I do isn't better coding skill, data analysis, or management skills, it the ability to know that you don't need to jump up and down about every abnormal blood test, but also if someone who's never seen a doctor in 10 years suddenly present 2-3 times in a row complaining of weight loss they are the one you need to escalate and prioritise.
There is no replacement for the clinical experience, and medics are in the unique position of been able to experience the entire journey if they wished, from doing the job of the porter pushing the patient down the corridor into theaters (TV makes it look far easier than reality), all the way to meeting the family in the bereavement office (and sometimes beyond if the coroner is involved). It really is a unique privilege, but one you have to earn through hard work, integrity and dedication.
gangzoom said:
Having done lots of work with AI, and currently engaged with ongoing work in AI ranging from ambient dictation to coding, to clinical risk detection I can confidently say NO clinician need to be worried about AI replacing them.
I do think some specialities will be hit by AI such as pathology, screening eg radiology. Anywhere where there is high volume standardised work. Computers are already outpacing clinicians in these areas^We’ve actually just implemented SkinAnalytics, and part of the national AI programs into USS, CT etc. What becoming very clear is the AI tools are fantastic at improving work flows and productivity, as well as reducing overall risk. Given the workload across the NHS is ever increasing, work force a constant constraints the Ai tools will certainly help to ensure patients get more accurate/faster diagnostics without burdening already over worked Radiology colleagues. The one thing to be clear with AI it will still miss things (just like humans) but it will do it on a systemic manner (rather than random often for humans), so if you aren’t careful with implementation you essentially end up designing a system that will systemically discriminate against a certain cohort of people.
I honestly cannot see AI ‘replacing’ any clinician, but with digital pathways - like auto pre-populating request forms, or even automated queuing investigation like serial Trop/ECGs if you put in a coded working diagnosis of MI it could make life much easier for everyone. However the risk of so much automation is you make any diagnostic confirmation bias worse, which will lead to harm……Just how badly the PostOffice got it with their digitalisation program via Horizon is a real warning to the NHS, except if we get it wrong the consequences could be even worse.
The fact I get paid to essentially think about and work on stuff like this is I still find mad, it’s the kind of thing I would do for free.
I honestly cannot see AI ‘replacing’ any clinician, but with digital pathways - like auto pre-populating request forms, or even automated queuing investigation like serial Trop/ECGs if you put in a coded working diagnosis of MI it could make life much easier for everyone. However the risk of so much automation is you make any diagnostic confirmation bias worse, which will lead to harm……Just how badly the PostOffice got it with their digitalisation program via Horizon is a real warning to the NHS, except if we get it wrong the consequences could be even worse.
The fact I get paid to essentially think about and work on stuff like this is I still find mad, it’s the kind of thing I would do for free
. Edited by gangzoom on Friday 5th September 18:01
Mortarboard said:
To suggest another alternative, pharmacists get paid more for less training (until the doc gets fully independent)
Used to share a house in my student days with a trainee doc, trainee dentist, and trainee pharmacist.
Pharmacist had made the best choice of the three, imo. Least study, least stress, best pay.
M.
Good advice here probably a LOT less rewarding but a very valid path into medicine. Used to share a house in my student days with a trainee doc, trainee dentist, and trainee pharmacist.
Pharmacist had made the best choice of the three, imo. Least study, least stress, best pay.
M.
gangzoom said:
^
Interesting stuff
That’s quite an insight. I know someone who has left clinical medicine to work full time in health AI and he is very bullish about the future of AI. Of course he would beInteresting stuff
Edited by gangzoom on Friday 5th September 18:01
This is a good example of the diversity and rapid pace of change of medicine and why it can be such a great career
Mortarboard said:
To suggest another alternative, pharmacists get paid more for less training (until the doc gets fully independent)
Used to share a house in my student days with a trainee doc, trainee dentist, and trainee pharmacist.
Pharmacist had made the best choice of the three, imo. Least study, least stress, best pay.
M.
Good advice here probably a LOT less rewarding but a very valid path into medicine. Used to share a house in my student days with a trainee doc, trainee dentist, and trainee pharmacist.
Pharmacist had made the best choice of the three, imo. Least study, least stress, best pay.
M.
Biglips said:
That’s quite an insight. I know someone who has left clinical medicine to work full time in health AI and he is very bullish about the future of AI. Of course he would be
Giving up the job security and NHS pension to work for a tech company......Most Consultants have never had a proper performance review in their working livies. Upset the wrong person or fail to deliver on a KPI and you are out.I do lots of work with tech companies and have the direct mobiles of some of the CEOs, zero chance I would leave my NHS role.
The clinical work really is the USP medics have, once you give that up there is no coming back. As mad as it sounds am thinking about going back onto the assessment units/ED to help balance out my corporate work, as it offers me the most exposure to frontline work for the least amount of time commitment!!
Edited by gangzoom on Saturday 6th September 06:31
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