Jonathan Segal: Are we creating a generation of uninspired doctors?

Jonathan SegalSo the time has come for junior doctors to plunge themselves into a specialist career. Should this be time for excitement? Time to step up to commitment? Or time to reflect on my plan E or F, as what follows may highlight that having a plan B in this game may not be enough.

For me the reality of the situation started last week. Our first proper careers evening: we had friends comparing what they wanted to be, tips were shared, interview techniques swapped, course information traded … some may even say we were excited.

I expected a meeting with the usual introductions, but what instead got: “What follows for most of you may be bad news.”

After this initial jab in the face, the real uppercut hit moments later. We were told to stand in corners of the room. The careers adviser explained that each section of the room represented various medical specialties. He advised us to stand in the area that represented the career path we most desired.

The room contained 20 or so trainees. Each candidate tentatively moved towards various corners, some even stood with pride as if to say, “I am proud to want to do this career” – not quite patriotic, but along the same lines.

The corners you would expect were heavily populated, particularly surgery and core medicine. We were then told to leave our original positions and reposition ourselves in the GP section of the room, leaving only one or two in their original corners. At first I thought this was the typical ice breaker game – “Tell me why you want to be a GP?” “Where did you grow up?” and so on – but what followed was a game of different sorts and played with my hopes and aspirations.

The careers advisor explained that the room now represented what most doctors – some 80% of people in the room – would become. What about choice? What about diversity? What about all those shattered hopes of some trainees who just do not want to be GPs?

When starting medical school some seven years ago now, I remember the morale being high. The dean of the medical school stood tall, giving inspiration: “As doctors you are some of the most valued people in the country, your job is secure, you will have job satisfaction, and, most importantly, a job in medicine can take you to different extremes, from surgically removing a cancer to delivering babies to giving life saving medications… .” I remember thinking, so many options. How I would love to be a fly on the wall in this years freshers’ talk to medical students.

I understand the need to cut training posts, the bottleneck further up the training ladder, etc, but what is to become of talented doctors stuck in a career that they didn’t want ? Is there a risk they may take less interest in it? With further NHS cuts probably looming (despite the government’s promises) surely we need to motivate those doctors we have left?

I fear we will be left with a generation of doctors both frustrated and uninspired, wondering what could have been if they had practised 20 years ago. That dream of being a great surgeon shattered at the first hurdle. The big question on my mind is whether this will affect clinical care. We can only hope that doctors carry integrity into whatever field they end up in.

The even bigger question is, can anything be done? My logical guess is a no – maybe a voice is all we were meant to have. Should we start lining up on the conveyor belt before we are pushed on?

Jonathan Segal is an FY2 at the Princess Alexandra Hospital in Harlow, Essex. His passion has always been medicine, and he hopes to become a CMT trainee . His interests outside medicine include marathon running and 5 a side football.