Junior Doctor Strike - from a chronic pain perspective

Hi All,

This has been very controversial in the news and I wanted to way in with my opinion as a trigeminal neuralgia sufferer who has been in and out of hospital for the past month to have urgent pain relief and in addition 2 private surgical procedures.

Whilst I sympathise with how they perceive their role as doctors I think the message here is that they are no more than 'junior' - all the studying in the world cannot prepare you for the real world of medicine. A recent experience of mine is that a junior doctor called in with me on pre-rounds to obtain some more information prior to actual rounds. I explained I had been diagnosed with trigeminal neuralgia and had been treated in the resuscitation section of A&E the previous evening being drugged with ketamine, morphine and lidocaine through the vein. I asked her was she familiar with TN to which I received a very snotty reply in that of course she was - she had spent the previous seven years studying. I apologised in that I didn't want to cause her any offence but many senior doctors had never even seen this condition and in no way was I being disrespectful. She then went to examine my face and I had to physically restrain her from touching me - she was apologetic and stated that her hands were clean and I had to inform her in no way was anyone touching me as this would surely set me off again. She reported this to the senior doctor and during actual rounds she informed the senior staff that I was a difficult patient in that I wouldn't let her examine my face. She was given a dressing down by a senior doctor in that she clearly hadn't a clue and I was right to prevent her from touching my face. The senior staff apologised and later one of the senior nurses stated to me that 'these juniors think they know everything'. 

I have no doubt that the junior was trying to offer excellent patient care but her snotty attitude and superiority complex is just not on. She tried to make me out to be a difficult patient and it backfired but what about the times that pain patients who clearly know more about their condition have to deal with this attitude and I reiterate no amount of schooling can teach the real life of medicine and patient care.

In addition they are in a job which with the proper on the job training has a massive potential to earn them large amounts of money. I spent years in Uni studying law and came top of my class - most people don't know that solicitors starting out receive minimum wage. This is not the only profession that asks for lots of training and still has a hierarchy with the juniors being treated as mere apprentices.

I have huge debts too from student loans - this is the way it is. I think these juniors should accept that they have a lot to learn and instead of ranting and raving about pay should concentrate on learning with the larger picture in play that some day they could be a consultant with massive earning potential.

Just one mere opinion. 

Anyone else have experience of dealing  with juniors?

Lou xx

47 Replies

  • Yes, I had one diagnose me with carpal tunnel syndrome.  He then offered me an operation.  When I agreed he grinned from side to side and rubbed his hands together.  I have never left a consulting room so fast.  Needless to say he did not get to practise on me.

  • I'm sure that's true if you live in London - in Belfast starting salary is approx £14K and if you want to succeed you have to be first in and last out of the office everyday - attend events and basically devote every waking minute to doing the donkey work on cases. Why should a junior be paid more than a paramedic if they cannot do the above unsupervised? Basically they are babies in the work place and should be paid accordingly. 7 years plus of school does not a doctor make. 

    Ask any of the successful consultants today and I bet they worked every second learning - my current consultant works over 80hrs a week according to his secretary and takes no more than 2 weeks a year off. How on earth are doctors supposed to learn if they work 40hrs a week?? 

    If they wanted a 9-5 job they shouldn't have studied medicine. 

    Also you have not mentioned your experience of juniors?

  • Just a little rider to what I've written, it's unhelpful to compare professions but who are the very wealthy amongst my acquaintance/friends - the lawyers. In my professional life, who were the most arrogant?  The lawyers. Then again some do bread and butter work, just like some Doctors. Which professional do I need more help from on a daily basis - the doctor. 

  • When I was on the wards, the day started at 0700 until 2030. Or 1900 until 0830. Never got away on time as didn't any of the other nurses. No matter how we prioritised and managed our work, there were never enough hours in that long day/night shift. It then overran onto the next shift and subsequently onto the next shift.

    As nurses we were never allowed to strike and to be honest, morally, I couldn't of brought myself to. The only 'stand' we could make was to 'work to rule' thus jobs didn't get done; we would have a coffee & lunch break and go home on time but even that would cause personal turmoil!

    Interestingly, you start your post with a point about getting paid for unsocial hours; so is the strike now only about money?

    I'm not wishing to start an argument with you but as I've said in another post on this thread, we're not being told the facts about this strike action, so have you given us an indication?? Is it purely about Saturday pay?


  • Sorry but I know a young solicitor who, in her first year of practice was so low paid that by the time she had paid travel expenses, sustenance and child care she was basically paying for the right to be employed. And this was hardly different from the situation each of her fellow students had moved on to.  Not only was she paid a pittance, she had to carry her own (full) case load and  handle work on cases for every other solicitor in the building.

  • I meant lunch money not rent :)

    As far as salaries go, I think that there are too many ridiculous payments made whether it is public or private sector.  But more so it is the disparity that is the problem.  I don't believe that my education entitles me to a larger slice of the wedge.

    So what if I have more qualifications than the guy who cleans up all the grunge, that was my choice and if it wasn't for him I probably wouldn't be in a fit state to use them.

    Yes we all want the moon but it would be an awfully smelly place without someone to do the menial tasks!

  • True but the street sweeper doesn't hold someone's life in their hands. A decent wage for everyone but recognition within that, that some folk have a Hell of a lot more responsibility, be they health care workers, social workers etc. If they make a mistake,  it's a bit more serious...

  • I think it's hard being a patient and hard being a junior doctor. Years ago I had the matron on the children's ward come charging in with a red face muttering "will you please stop imitidating my junior doctors". While taken aback upon reflection I stood acused. They certainly weren't coming  anywhere near my 3yr old son while I stood by passively. And nor should we when our well being is on the line. But it can be hard on them. Its got to take huge confidence to sally forth into the Frey. And I for one wouldn't want to be on the receiving end of me when I am off on one.  But We have to each do the best we can and by and large most of us do. 

    I agree with Daniel that it is about more than pay. I had years of knocking about the children's wards and saw the effects of on call working. And what really rattles my cage is when you hear others quip. "Well we've been doing it for years" . Doesn't mean it's right though does it. Basically when the shit hits the fan so to speak I want someone well trained bright eyed and bushy tailed and motivated for me and mine. A bonus would be good social skills to lessen the trauma. (It has taken me months to get up from my knees after a cast off comment from a consultant) Even if after giving thier best shot it's a failure. And they are worth every penny I reckon. Warts and all.

    On a much less political tone. Here's Hoping that your pain settles down. And you get some peace from the beast.

    Go well.

  • Yes I agree with others that it's much more complicated than just pay.

    Certainly I think there probably are some junior doctors that think they know it all because they've "got an ology", but you get that attitude in many walks of life.  And doctors do have to learn the art of giving off an air of authority and sound like they know what they are talking about from early on.  Some if not most are bound to make mistakes in that way, even if they are not naturally arrogant.  As Ned says it can't be easy for them.

    I'm not normally a fan of striking, particularly in fields that cause difficulties to the public, but personally I find myself fully in support of the doctors in this strike.  The government are trying to spread an already struggling workforce over seven days a week without increasing the numbers.  Whatever the doctors are paid for their hours I  personally don't want to be treated by a tired and potentially clumsy doctor.  

    As Dan said many people in all sorts of professions are not allowed to work over a certain number of hours.  Yet people who are supposed to be learning how to save our lives are expected to work possibly three figure hours in a week.  Ridiculous.

    And the main reason I support the strike is because the government have made it abundantly clear that whatever the doctors objections, feelings, reasonings or whatever, they will simply introduce the contracts come what may.  All because they THINK we have given them a mandate to give us 24/7 hospitals.  Well maybe we did say that would be a good idea as it may help speed up waiting times etc.  But no-one in their right mind would expect them to do so by making already overworked people and resources work even harder.  

    It's way past time this bully boy government realised not everything can be reduced down to pay and money.  Well not for the civilised members of our society anyway, just the greedy money grabbing ones like the . . .  er . . . Tories?

    I don't like the situation but I for one don't blame the doctors.

    Sorry you had a difficult experience, hope you get some relief from your pains soon. 

    Gentle hugs, Margaret.xx

  • We could debate this ad naseum. I concede it is a political issue with successive governments bringing their own policies. My protest related to the comment you made that '.....Gordon Brown nearly bankrupted the country'. The economic situation was a direct consequence of the banking crises. That was reinforced recently by Mervyn King, the former Governor of the Bank of England. 

    Unlike some, I do not even attach blame to top heavy overpaid management structures in NHS Trusts. Although as scandals have exposed, some are better managed than others. I have not had relatives directly employed by a Trust but I have had a one providing services at a senior level and a relative who was a Vice Chairman. My brother in law was a Consultant who worked outside the UK.

    More than anything I am a user and have witnessed indices of good and bad management.

    Yes, it is political as the Government  does not want the NHS to continue as it was conceived. There are many MP's who admire the libitarian ideals of America'a far right. Dr Liam Fox being one.  Jeremy Hunt is incompetent and he could have managed the Junior Doctors' concerns much more adeptly.

    The person who complained about the junior Doctor was obviously deeply affected by what had happened. That is very unfortunate but bad manners and insensitivity exists across all walks of life and all tiers of the medical profession. Although I sympathised with the feelings I did not agree with the  views expressed about the strike. To bring Gordon Brown into it I felt was untrue in fact, and something of a non sequitur. 

  • Please, can we speak of pain and how difficult it is, and medications? I know my doctors get overpaid, but this is the US. and I just want some way to survive the pain and live my life.

  • When my nan was in hospital dying of heart failure, one of the junior doctors turned round to mother and said there was nothing else they could do for her so she would be discharged and we could take her home.  'Home' was 300 miles away!  Fortunately we 'kicked up a stink' because she was then kept in until seen by the specialist the following Monday.  He reversed the decision without quibble basically saying she wouldn't be going anywhere except in a box (which we already knew).  But both my aunt and mother had had a devastating week-end trying to work out the logistics of getting their mother to somewhere safe.

  • Ok people, let's get a grip and answer the question Lou asked. Yes, she may have added in the strike elements but it's her view & experience.

     Firstly, 'junior' doctor means any doctor up to consultant, so a specialist registrar, with years of experience, is still classed as junior. It gets confused with the title they're given but it isn't just newly qualified doctors that are striking.

    I personally am now, as a patient, quite aware of their point but five strike days hasn't changed anything within the government thus far. The only thing that changing, I would think, is the patient's view of the doctors themselves. The government have in no way suffered throughout these strikes; the patients have.

    We haven't actually seen the exact changes that are being implemented with the new contracts. We don't know what the doctors' hours & pay are and what the proposed hours & pay are to be. Neither side has put it in black and white for us, as a general public, to look at so we can make a decision to support or not.

    We hear Jeremy Hunter saying it's now only about Saturday pay but the doctors' picket line placards saying it's not about pay. Who do we believe? Without steadfast evidence of what it is they're 'fighting over', as patients, we're in limbo and the victims of all of this.

    How much longer are the waiting lists for appointments and surgery going to be now??? 

    I KNOW IT'S JEREMY HUNT (before anyone points it out but I can't go back and correct anything since HU changed the settings!?)

    Anyway, going onto Lou's question; it's doctors, nurses, healthcare assistants & even a ward clerk that I've experienced having no knowledge (ahem, belief) that chronic pain exists.

     The doctors & consultants in the pain clinic obviously (well I think) believe it exists but on the wards, zeesh, you'd think I was a 1. Attention seeker 2. Chronic worried/hypochondriac 3. Drug addict 4. Lazy 5. Bored and wanting something different to do 6. Wanting people to think it must be bad if I've been admitted to hospital with it.

    Sometimes some, sometimes all. I've even heard a qualified nurse telling her student nurse that chronic pain doesn't exist!!

    Way too many experiences Lou to type into a smart phone but as some of the more 'special times' pop into my head, I'll elaborate!!

    Hope you're feeling more settled now.


  • I apologise to anyone for offence taken. My point was that it takes years and years to hone and perfect a skill. I think those starting out should do what it takes to learn and perfect what used to be deemed a vocation. I think everyone has the right to strike but  I wanted to focus on chronic pain patients and their view of doctors who think they know best but have clearly a lot to learn. I think we have all been doubted at some point and its 'all in your head etc...' 

    Hierarchy is there for a reason - to protect the patient. I can't help but wonder how many doctors striking have been bullied into this by the unions and are true and genuine life savers with the hypocratatic oath ingrained in their hearts.

    I pray for all patients who will be collateral damage and I think Ray is right - the public are outraged that they actually striked. I think the government unfortunately will win this battle. After all there are many immigrants who would be grateful to do the same job for the money.


  • I think that the actual term of Junior Doctor is a cause of some confusion. This catagory can mean all Doctors including Registrars. HTH.

  • A 'junior' Dr is one below Consultant level and not, as it could be construed, a less than fully qualified Doctor. They are the wheels that keep the NHS, often when their Consultant is doing private work. I have needed to pay privately on two or three occasions and found it beneficial in terms of finally getting diagnosis. I live in Wales so unaffected by the strike but the pressures in the service are apparent. 

  • As said by many the 'junior' is misleading as you could be a junior for decades and very knowledgeable. I'm sorry you've had a bad experience but I think the issues of misbelief of chronic pain and striking of junior doctors are completely separate.  It's a warped world where people are expected to do nothing whilst being trodden over by the government. I understand that it seems difficult that the junior doctors have had to take the decision to strike but it was not taken lightly. I find it unbelievable that anyone would not understand thier position and in terms of wages and hours I seriously don't think that less than £8 an hour for upwards of 60 hours a week is ok (that's what some end up earning). Your comments are snooty to say the least. 

  • Hi Lou, hope you're feeling a bit better today. 👍🏼

    As far as chronic pain understanding goes ther is a long, long list in my view,  of people who do not understand at all what it means and what it's like!  I'm always amazed at how you can still find any compassionate hospital workers given the jobs they do, the hours, low pay and fatigue! 

    As for junior doctors I really think they have their hands full and always have done and need our support against a government fully set on dividing it's people, rationing funding and making austerity for anyone who isn't a political party donor, a way of life now. Some of them are a bit rubbish from time to time and it's hard to be 'patient' in extremis but perfection is the route to madness....

    I have heard senior doctors calling mr hunt to account for his misuse of statistics so lying really and when I hear him talk about a mandate from the people! What a joke! I'm no mathematician but only 40% of people actually voted? The Tories won a majority so how many people actually voted and gave them the mandate for a 24/7 nhs without any extra cash to make it so? Mr hunt claims he has been in talks for 3 years with the bma - so before the mandate was served by the people? It is all a crock. Rather than have us all debate whether a junior doctor is worth the minimum wage and is more useful than a hospital cleaner then may be we could ask why we can't afford a proper 24/7 service ? May be we could ask why asset stripping and tax evasion is allowed to erode public finances? 

    Doctors are our brightest people and the future ones are coming out of university with nearly £100,000 of debt. Certain types of lawyers too - bright minds. Big debts. Big challenges. On this one, I hope we can all be in it together to protect our medical profession. 

  • For me personally the worst incident I have come across of a recently qualified doctor displaying their lack of knowledge was when I was in an ENT clinic and an obviously recently qualified (or on reflection possibly still learning) young doctor asked me what conditions I had. I explained I have ME and fibromyalgia and her response was, "ME? So what's that then?" Clearly the medical profession still don't teach their students about a chronic illness that affects what these days is believed in reality to be around 500,000 people in the UK.

    She clearly wasn't up to speed with the equipment as she had to get the nurse to show her how it worked, she clearly wasn't up to speed with filling in the paperwork as she made heavy going of it. But those things didn't bother me so much as we all have to learn somehow. But the fact she hadn't even heard of ME and seemed quite happy to admit it was quite shocking, in my opinion. She had to go and ask a more senior consultant about it and surprise surprise within a couple of minutes I had three doctors in the room attending to my every need. Clearly they weren't too impressed with her response either.

    Gentle hugs Margaret.xx

  • Just when it was getting interesting. 

    Understandable but lets face it. It has given us all something to take our mind off pain for a bit.

    I'd say that's a good thing! Hey ho.

  • Second thoughts?


  • Hi Lou  while I fully support that your experience has not been the best, but my daughter and next door neighbour are both nurses. My daughter works in Wales and my neighbour in England, they have both said that the situation has been monopolised by the government to put down the doctors and get patients offside. The English patients are actually getting a better service as they are being treated by consultants during the strike and are getting the best care. As far as A and E is concerned the patients who need A and E services are again in the best hands by being treated by senior staff, it has shown that less people are attending thinking they will have a long wait, the majority of these patients are ones that should be seeing their GP or other services but are attending A and E because it's difficult to get a GP appointment.  I don't want to get in to a political debate but it is another cost cutting exercise by the government by making a 24/7 NHS there will be no unsocial hours pay and affects the drs differently depending on their circumstances.

    The bottom line will be that NHS staff will move abroad and the NHS will collapse, it won't end in the doctors because once that is pushed through the Nurses will be next, we have to try and look at the bigger picture anyone who has been in to hospital over the last 12 months will know how hard the staff on the wards work.

    As I said no one should experience what you had to go through but if we don't keep hold of our doctors and nurses we will be even worse off.

    I hope that you are coping with your health as best you can

    Sending my full support to you with hugs Sherylxx

  • I think we all have had such experiences. I've had too many to list. Even from older docs who do not know or understand pain.

  • We used to have a GP at our surgery who was "affectionately" known as Take Two Asprins and Gargle as that was his answer to any pain. :D 

  • To all. On a lighter note, does anyone manage to edit their posts? I can see I have had several instances of the curse of the predictive text. If as a consequence, my posts have made no sense I apologise.

    As for pain, I feel rather manic as the nerve block and facet joint injections have worked and I can walk. I wish that I had not lost the last four years to sometimes overwhelming pain but I am happy to be where I am today.  

  • Hi.  Yes I have no problem editing my posts, though I have seen others complaining of that too.  I think it may just be one of those HU glitches.

    Glad you are not in so much pain now.xx

  • Thanks for your nice words. I am a little paranoid (in addition to those medically diagnosed) that every twinge means the effect is wearing off, but Hey-Ho I am trying to be positive. As this site bears testimony there are a lot of people worse off than I.

     I tried the little drop down arrow but it didn't work for me. There is a gremlin in my machine. 

    Yours Carole

  • Run rabbit. Must be great for you to get a bit of relief.

    Re edit. I lost the plot when the format changed. But then Realised little arrow right drops! Took me ages for the penny to do likewise.

  • Oh goodness not only am I beaten by the predictive text but once again my response has gone to the wrong person: ukmsmi4 

    Apologies to you both.

  • Yay! Good to know you've copped a break from pain. Try the rhisolysis to keep the pain at bay for longer! 😜

  • Oh, I've not heard of rhisolysis. Will look it up and give it a go. Thanks

  • I didn't realise it was the medical term, what I refer to as ablation. I thought it was a herb. Lol.

    I return to Clinic in June. I have been told I would have another course of nerve block and facet joint injections, before graduating on to rhisolysis. It seems pointless to me and I shall ask in Clinic. Thanks

  • Yes, haha... When I read down the posts I saw you were lined up for that. I don't know why they muck about either - assume the injections calm the inflammation so the rhisolysis has a better chance of working... A lot depends on the skill of the Doctor. They have to get the needles just right. 👍🏼😜 I've only been waiting 17 years for this! It has made a huge difference to me. 

  • Thanks for your post. I think he got the needles just right this time - it blinking hurt. My surgeon Mr Alwyn Jones is very well regarded but my treatment is funded from my Trust, to the Carfiff and Vale on the basis that an operation may be necessary. Can you help me understand? Should I ask for  rhisolysis when I go to Clinic. I thought I had done my research but clearly not. My hands, feet, neck and shoulder are significantly affected but I buy in help and have a very supportive family. Life has been much better in the last fortnight  and there has been a dramatic reduction in medication. 

    Thanks very much, for your help.

  • Thanks for your good wishes. 

  • No sorry it wasn't intended for you. I expanded it to include management etc. I think I had one of my episodes diagnosed as: ' A Rush of Blood....'  I suppose we cannot get away from the providers of the service but, apart from the Consultant at the Pain Clinic who spoke throughout on his mobile 'phone, I haven't really had a bad experience. Dragging of feet, misdiagnosis etc but not jndifference. The lack of money has been a problem as my Trust had to 'buy in' the Spinal Surgeon from another Trust.  I've paid for MRI, CAT scans etc - my back is not my only issue, but Wales has a very sick population and the needs are very great. Anyway, have a nice weekend.

  • Ooooh, I've thought of another 'experience' although not doctor lead this time.

    As I used to be a nurse, whenever I walk by the 'job vacancies' board, I have a look (not really a good idea as it upsets me) and there was a post vacant for an administrative assistant in the Pain Management department. As I was perusing the board, two current hospital  'office looking employees' were also looking. When they got to the Pain Management post, one of the women said out loud to her colleague (this is God's honest truth)

    "I'm not working there, those patients swinging the lead saying they've got chronic pain because they've got back ache. It would drive me insane having to sort the files on the lazy fu@#ers".

    There, how bout that?! Maybe she can cure us all!!


  • That's pretty shocking!

  • Yep, shocking but sadly, true!

  • Can't believe that!!! Some people haven't a clue. I reckon if you were not in so much pain you would have slapped her silly. All I can say is karma is a bitch - one day that person will wake up in pain and need specialist help. Not that I would wish that on anyone xx

  • I was quite proud of myself for not 'saying' anything; my mum walked away, waiting for the sparks to fly but I said nothing and calmed myself by rolling my eyes and like you, wondered if one day she'd wake with some kind of ailment!!

    Such is this life.......


  • Hiya. I had a spinal tap done by a junior. I would never have agreed to it, if I'd known. After the fifth attempt, under supervision, she managed it and just sent me home on my own. Clueless.

    On the ward rounds, the most helpful have been final year students.  They have explained clearly what they have been doing, something consultants never do. I agree they can be arrogant but I've been lucky, I guess. They've usually been a mine of information. Last one I saw was lovely and had just worked 24 hours straight! I agree with the strike. They're trying to protect the health service, as well as their conditions.  Good luck to them. I hope they bring this govt to its knees!

  • But it won't bring the government to its knees; the health service will suffer and subsequently, us, the patients. Do you know, factually, what the 'current' contracts are and what the proposed contracts are? I've been trying to find out, categorically, what they're 'arguing' about but no one, including in the press, is forthcoming!!

    As patients, we can't decide which 'side' to be on if we only hear propaganda; I'm not interested in their annual salary per say, I just want to know exactly what the grievances are. We're lead to believe that the doctors are being told to work seven days a week, 20 hours a day with no day off. Obviously, if this is the case, then of course, as a patient, I'd feel unsafe whilst under their care as they'd be exhausted etc, etc but until it's detailed, I don't believe I/we can comment.

     I also believe that because so many people are being treated by our health service despite not contributing any money to it, it will implode soon anyway.


  • Well reading that as a patient, looks like they're being better protected; just Saturday daytime pay is no longer paid as an unsocial rate.

    It's been widely reported that now the only disagreement is that Saturday rate so are the doctors now striking over that money??

    I accept that the link is biased towards the employers and how they're reducing the expectations of consecutive long days etc so there may well be other hidden issues but on that evidence, I'm afraid, I don't understand why they're still walking out on us.


  • Junior doctors do vary. Very much agree with you on that,  but I think that is unfair to classify all junior doctors using the experience of one.  The junior doctors are paid well below minimum wage and expected to work excessive hours. Adding two more days with no increase in personnel or the potential funding of personnel is ludicrous.  The concern isn't specifically about higher wage but to have more resources to cover another 48 hour period of care.  

  • I recently read an article about the strike and the fact that many of these doctors are putting their own careers in jeapordy- they are supposed to complete so many hours and perform so many procedures before they move up to the next level. Hope this all ends soon or our doctors won't be qualified. Scary thought.

    I think we all want the same thing here - strike to end. 

    Hope an agreement is reached soon.

    Lou xxx

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