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Junior doctors

Patrice Baptiste: What is the future of the NHS?

1 Feb, 16 | by BMJ

patrice_baptisteDuring my foundation years I wasn’t completely sure about what specialty I wanted to pursue within medicine so I decided to take a year out of training. Although not my passion, I thought a lot about general practice as this encompasses a broad range of specialties, including the possibility of a “special interest,” as well as opportunities for teaching. I would actually get to see and know my patients over a longer period of time instead of one day in accident and emergency (A&E), or a week or two on the wards, not to mention being able to have a good work life balance in comparison to working in a hospital. more…

Sebastian Taylor et al: The junior doctors’ dispute: manufacturing bad faith

14 Jan, 16 | by BMJ

The rollercoaster ride of dispute talks between the British Medical Association representing “junior” doctors and the Secretary of State for Health points either to incompetent negotiations or to the political value of failure. Jeremy Hunt has claimed that 15 of 16 points were resolved, and that money was the only remaining issue. Junior doctors disagree. Now even the terms of disagreement are in dispute.

The government declares genuine support for a national health service, free at the point of delivery, populated by healthcare workers trained to the highest standards. It does so because evaluations of the NHS—by UK citizens and the World Health Organisation alike—are so positive. In 2013, the UK spent 8.5% of national income on health, below the USA (16.5%), Germany, and France (each 11%). NHS spending is set to stabilise at around 10.5% as projected (under the “fully engaged” model) for coming spending reviews, equivalent to Germany’s health budget for 2001. [1] Using the GDP yardstick, NHS spending is modest and excellent value. more…

Elizabeth Wortley: What the junior doctors’ strike taught me

13 Jan, 16 | by BMJ

Yesterday I came off the picket line having enjoyed some lively conversations with my colleagues. As passing drivers honked their horns in support, one of my colleagues observed that it’s a shame we don’t get together to provide more support for each other regularly. This started a discussion about our attitudes towards each other on a day-to-day basis. more…

Richard Smith: Does the NHS meet the needs of junior doctors?

12 Jan, 16 | by BMJ

richard_smith_2014Bain, the global consultancy, produces what it calls “a pyramid of employee needs,” and on the day when junior doctors are striking it’s instructive to see how well the NHS is doing in meeting their needs.

The bottom of the pyramid is “satisfied employees,” and the very fact that junior doctors are striking suggests that they don’t even reach this level. The first requirement for satified employees is to have a safe work environment. Hospitals are certainly not safe for patients in that they are famously riskier than bungee jumping, and they are not entirely safe for junior doctors in that the work is stressful and risky. The fear is not so much that junior doctors will be harmed themselves but that they will harm patients and suffer disciplinary, legal, and emotional consequences. I’m assured that it’s not like when I was a junior doctor and would be the first to arrive at a cardiac arrest without any training, but “safe” may be a bold claim. more…

Jessamy Bagenal: Junior doctors strike action—frustration and mistrust

5 Jan, 16 | by BMJ

jessamy_bagenal2Junior doctors received a text on Monday 4 January informing them that the negotiations over the junior doctor’s contract had ended. Industrial action in England is going to proceed. It left one feeling somewhat flat.

The first day of industrial action will be on the 12 January when only emergency care will be provided for 24 hours. This will be followed by 48 hours of industrial action on 26 January. Finally on the 10 February there will be a full withdrawal of labour between 8am—5pm. The mandate to strike given by 98% of BMA voters runs out next week, so this seems a last minute attempt to gain some ground. more…

Jessamy Bagenal: Junior doctors—What are we fighting for?

2 Dec, 15 | by BMJ

So what?

There has been a huge increase in the number of junior doctors who have joined the BMA since June when Jeremy Hunt began new tactics with NHS staff. Repeated inflammatory and insulting statements like “when you turn medicine into a Monday to Friday profession” have enraged doctors to an unprecedented state. The strike action has been suspended whilst talks continue. Some are angry and a previously united front has fractionated. But, even if, in some alternate universe the government agreed with all the BMA’s terms for a new contract would it matter? more…

Alice Gerth: Strike action is not the answer

27 Nov, 15 | by BMJ

The strength of feeling of anger within the healthcare profession is so strong that those not planning to take industrial action are reluctant to speak out. I want the public and my colleagues to know that I will be at work, not because I support the new contract, but because I do not support striking at this point in time.

My reasons lie in the principles of “Just War” ethics. Industrial action is a form of conflict. I do not have space to go into the theory in full, but will highlight the areas I feel we contravene. more…

Henry Murphy: The Moderate Doctor

25 Nov, 15 | by BMJ

Jeremy Hunt recently told Twitter that “Moderate doctors must defeat the militants,” quoting the title of a Times article about the current war between the Department of Health and the BMA. My first response was to sit back and enjoy a flurry of hilarious responses (the reason I look at the @Jeremy_Hunt Twitter page so often). Comments included “Moderate doctors must defeat Jeremy Hunt,” ”If your definition of militant is standing up to protect the NHS against tyrants like you…,” and “So where are all these ‘moderate doctors’… I don’t know anyone who doesn’t think you are wrong and doesn’t support junior drs.” more…

Ahimza Thirunavukarasu: Thinking about empathy

2 Nov, 15 | by BMJ

Ahimza ThirunavukarasuI’ve thought a lot about empathy recently. As a junior doctor on a psychiatry rotation, this is unsurprising, as interacting with people with acute mental health problems on a daily basis requires more patience and understanding than any of my previous roles. But it is one of the reasons I’ve enjoyed the rotation.

I’ve learnt to communicate appropriately with patients from a variety of backgrounds, varying my approach on the basis of their response to me. I’ve learnt how to take it on the chin when the person in front of me hates me and isn’t afraid to show it. I’ve learnt that life isn’t fair for many of the people I’ve met; both the patients and their families. And I’ve accepted that a doctor’s role in improving these lives can sometimes be very limited. more…

Global Health Curriculum group: A changing world and what it means for medical training

30 Oct, 15 | by BMJ

core_global_health_competenciesThis month the BMA released a report on the need for pre and post-graduate medical education and training to adapt in the face of a rapidly “changing world.”

We are pleased to see recognition of the need to update postgraduate competencies. However, as doctors in training who are dedicated to the integration of global health into current postgraduate training programmes, we fear that there are important gaps that have not been adequately addressed. The report recognises increased complexity in “characteristics of the population” and “public expectations of healthcare,” but we believe that equally important is the increasing complexity of social, political, and economic systems which profoundly influence health.  more…

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