wellingtongoose (wellingtongoose) wrote,

John Watson - The Junior Doctor Years


When John graduated from university, he would be a fully qualified doctor. His first post would be as a house officer (today they are called FY1s). It clearly states on John's CV that he spent two years at least working in civilian hospitals: University College Hospital and Broomsfield. For more information read - Explaining John Watson's CV

A short meta on what John (and Mike Stamford) would have been doing as junior doctors for all the fanfiction writers out there.

1. Junior Doctors - Your Life is very unlikely to be in Their Hands

For a comprehensive post on what working life is like for a GP - The Day in the Life of Doctor Watson. However being a junior doctor is very different to being a GP.

Junior doctors are glorified paper-monkeys. There is a huge amount of paperwork that comes with looking after patients - just about everything ends up being written out at least twice by hand. If doctors have messy handwriting, it's because they don't have time to make it look neat.

During the day, house officers do the ward round with their seniors and then spend the rest of the day doing the various jobs that arise from the ward round. For example: writing out blood request forms, checking blood results - before computers they used to have to write everything down by hand and prescribing drugs. New patients who come onto the ward must have their paperwork completed and patients who are leaving must have their discharge letters written out and signed by the house officer. It's all a very boring round of admin.

Working hours for John when he graduate medical school could have been horrendous: 80 hours/week or more. However I need to point out that a significant proportion of this time could be spent sleeping. In John's day - hospitals still provided beds for their on call staff. Doctors had to do a lot more night shifts in the hospital - but consequently there was also less to do during the night because you only had to cover your own ward (and not the whole hospital). Therefore more chance of actually sleeping a decent amount.

Night shifts are really the only time a junior doctor feels like an actual doctor. There are very few senior doctors on call in the hospital at any one time: instead emergencies are often dealt with by the junior doctors on their own. When John was junior doctor he might end up covering A&E so he would get to treat the asthma attacks, the road traffic accidents, the massive burns, and the attempted suicides.

2. Everybody's B*tch

The house officer (or FY1) is the lowest of the low. In the bottom heavy food chain that is the NHS - house officers are the plankton. There seems to be loads of them but never quite enough to go around, and they are utterly defenseless.

The consultants are the top of the food chain usually don't find devouring plankton particularly appealing. They tend to be aloof, occasionally show up, demand things and then disappear again.

The people who seem to enjoying devouring house officers the most are the nurses. Doctors and nurses have a strange love-hate relationship. For a nurse with years of experience, it's very frustrating to be ordered around by a doctor so fresh out of med school that they can't tell which implement goes in which orifice. Unfortunately not everyone stops with frustration. A junior doctor is a very easy target for bullying - they are new, insecure and have no one to help them. If people have read my Dark!John meta and think that psychopaths are only attracted to medicine, think again. Plenty of them end up as nurses too.

More senior doctors use the house officer as a convenient dogsbody - sometimes making them do the jobs that one else wants like putting in enemas. If you think that all doctors are caring souls - remember they only need to care about the patient, their colleagues are a whole other kettle of fish.

Having said this, there is a very strong sense of camaraderie between doctors. Particularly at 4am when you've just bonded over a cardiac arrest and are covered in bodily fluids that will never wash out.

3. Lifestyle of the poor and overworked

Forget lifestyles of the rich and famous, junior doctors live very glamorous lives.

Generally I have been told by doctors of John's age, their house officers years were mostly spent inside hospital. The junior doctors used to get free onsite accommodation, which they took full advantage of. Hospital accommodation is usually single rooms divided into flats with each with a shared kitchen and bathroom - almost like student accommodation.

However this set up means that you get to know your fellow house officers very well because you all live together.

Junior doctor pay has never been amazing. When people think of doctor's salaries being huge - they are thinking of the doctors at the top of their field nearing retirement. The NHS pays each doctor according to the number of years they have worked therefore junior doctor pay is merely average.

I currently get £22,000/year as  base salary with and extra 40% because I do a job with long hours and night shifts. In some specialties such a paediatrics and psychiatry doctors only get the base salary with no supplement. Junior doctors pay at best grows with inflation and at worst stagnates, so John would have received something similar in terms of purchasing power.

This salary is a good solid wage for someone working 9-5, 5 days a week. However I don't and neither did John. In fact most junior doctors receive less per hour than the statutory minimum wage. This is legal because the hours we work above 48 hour/week are deemed "voluntary" and never officially acknowledged. I generally work about 60 hours a week depending on how many patients I have, John would have worked even more hours as the European Working Time Directive was not around and junior doctors were routinely expected to 72+ hours a week.

Having said this, just having a salary - any salary at all - is a big step up from living as student. It is definitely enough to live very comfortably on, as long as you are not supporting a family. John would have been even more well off than me, because he got free accommodation in hospital - I have to pay rent. Money does tend to accumulate when you don't have time to spend it, though the expenses of taking post-graduate medical exams can really dent savings.

The MRCP (for everyone wanting a career in internal medicine) has three parts and costs around £1400 to enter. The MRCS (for aspiring surgeons costs around the same amount of money. Not to mention the extortionate membership fees you have to pay to the Royal Colleges once you pass these exams.

I wouldn't say that John came out of two years as a junior doctor with a large amount of savings. Doctors tend to work hard and play hard when they have time - not to mention just being a member of the medical profession drains your bank accounts through mandatory registration fees, union and royal college membership fees, fees for mandatory courses (some of which can be covered by the very small NHS study budget), expenses to attend conferences (not all of which are reimbursable).

Semantics of Healthcare Series

Tags: character: john watson, meta: john watson
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