Voices: Doctors like me are leaving the medical profession – this is why
I voted in favour of the junior doctors’ strike and this week’s results were the vindication I needed to keep going as a doctor working in psychiatry.
When I wake up to the bleep on my night shifts to find that the pillow I’d been sleeping on is stained with the dried blood of the doctor there before me, because they were injured the night before by a patient lashing out; or when I am working as a lone female clinician because there are no nurses to help look after a 12-bedded male psychiatric intensive care unit – or when I look at my static £50k student loan debt (half of what it would have been had I grown up in England and not Wales); or still feel breathless after catching Covid-19 on the wards two years ago – I find myself questioning every decision I have made from the age of 15 to enter the medical profession.
The daily erosion of my colleagues’ spirits is leaving nothing but a fragile veneer of motivation.
They are exhausted from being the vessels into which society pours its frustration about waiting times, especially because they are patients, too. Anecdotes of friends standing at the top of a staircase, considering the option of injuring themselves down just to get time off, no longer surprises me. Yet somehow, seeing even the most idealistic of colleagues leave the profession remains shocking to me. Not because we don’t deserve to prioritise our wellbeing, but because the government has allowed the situation to get to a point where we feel that we are simply not valued.
Knowing that 98 per cent of us are also united in questioning whether the system sufficiently values our NHS, strengthens my resolve that it isn’t me who is at fault for choosing the profession – but a government that chooses to confuse our ability to survive the pressure with our willingness to do so.
The NHS is not a charity, but it does increasingly appear to be running mainly on goodwill. A recent BMA survey showed that 79 per cent of doctors often think about leaving the NHS. As many as 40 per cent said that as soon as they can find another job, they will go. Many of the vocation-driven employees who would never have been swayed from the profession have now either left or are looking more uncertain by the day.
Up to a third of those staying in the profession want to leave to work in Australia, but still, the irony of a former penal colony now making the UK look like a career prison appears to be lost on our government. The profession may house many saints, but we simply cannot afford to make this a criterion for every single clinician we need.
If a magical money tree does not exist, why do ministers appear to believe there is a magical doctor tree? Perhaps they believe they can borrow them from elsewhere?
Peter Kyle, the shadow Northern Ireland secretary, accused the government of turning the NHS into a “parasite”, leeching clinicians from abroad. The following day, an Eritrean taxi driver told me he trained as a doctor, but despite the barriers to translating qualifications he doesn’t feel he’s missing out on much: the NHS is not as enticing as when we were able to rely on colonial ties for recruitment. There are ways to fund higher pay, but there is no amount of magical thinking that will find us more doctors if the pay stays as it is.
We can’t borrow doctors – and we can’t wait a decade to train a new generation (not least because who will be left to train them?). And to those who call existing doctors “selfish” for wanting to be valued fairly, you are missing the point: if healthcare workers withholding their skills are selfish, then surely by that thinking we could accuse anyone who did not choose to enter the profession of being selfish, too? Such a claim would be absurd.
In my experience, if an accusation of being money hungry is bandied about, people will give you a reason to make it true and just leave medicine altogether for the private sector. That’s the last thing we need.
If we choose not to prioritise healthcare in this country, then we are not the world leader that we think we are. The government needs to reverse, in full, the 15 years’ worth of below-inflation pay which has led to a real-terms pay cut of 26 per cent – or more of us will be heading for the door.
Christiana Boules is a doctor and writer currently working in South London