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Rhiannon Harries on how we can better support surgical trainees

08 Jan 2016

Miss Rhiannon Harries

Without a doubt being a surgeon is the best career in the world, however morale amongst surgical trainees is the lowest it has been for years. There’s no denying that the junior doctors’ contracts dispute have dominated junior doctors’ stresses and worries over recent months but in reality this is just the tip of the iceberg.

I, like many of my surgical trainee peers, get a little fed up with constantly being told how very less experienced we are compared to the ‘good old training days’ of our senior consultants- but we live in a different era to the ‘good old training days’. An era of European Working Time Regulations.  An era of endless tick-box exercises to prove our competence (or incompetence). An era of intense scrutiny due to surgical outcome reporting and the very real threat of medico-legal action. An era when patients demand the highest quality care, and rightly so! So how can we make the most out of surgical training in this era?

A colleague once said to me ‘I feel like a temporary annoyance on the wards’. Foundation doctors and core trainees can go the entire rotation without their supervisors knowing their name. The firm structure and apprentice model has been eroded over the generations. We all appreciate that consultants are busy people and there is minimal time allocated for them to dedicate to teaching and training their juniors. But this needs to change! If we as a nation demand the highest quality of surgical care we need to ensure that we dedicate time, funding and resources to producing the future deliverers of that high quality surgical care. Rotations longer than 4 months and complete staffing levels on each rota would almost certainly help too.

Most surgical trainees can recall that one (or more if you are unlucky) rotation that is not exactly the highest quality training experience, typically where the consultant doesn’t like to give much away. And as trainees we accept this. We accept that there will be good and bad aspects of each rotation we undertake. But should we? Surely every hour counts in an already time depleted training programme compared to our predecessors.

Another bug bear of many surgical trainees is not receiving your rota until a week before you start your rotation or having minimal notice prior to having to move areas within the training region. I’m in my 30s. I have a mortgage, a family and a social life (yes hard to believe as a surgical trainee). We all entered this career knowing we would sacrifice some Christmases, birthdays and important family events but please treat us as professionals. We deserve to have adequate notice to be able to plan our lives. As the saying goes…All work and no play, makes Jack a dull boy! Why should a career in surgery be any different?

The small perks of working as a doctor in the NHS that used to exist have long been abolished. Foundation doctors in England, Scotland and Northern Ireland are no longer entitled to free hospital accommodation. A small thing but it really makes a difference to your first year of employment, especially for those now graduating with over £60,000 of student loan debt. We are also no longer entitled to rest facilities for night cover. Perhaps shortsighted as we all know work does not stop for a surgical trainee when they leave the hospital.

I rarely buy lunch in the hospital, I prefer to bring my own. However the other day I forgot it. I bought a sandwich, a bag of crisps and a drink. It cost me £5.49! This alongside the car parking charges many doctors across the country pay on a daily basis is enough to render you bankrupt. Now lets not forget the numerous (and many mandatory) courses, exams, conferences, medical indeminity, training fees, registration fees, college membership fees and specialty association fees that trainees cough up for annually and it’s no wonder most still have what seems like never ending debt, many many years after graduating. We are in real danger of undoing all the hard work we have done to ensure diversity exists within the medical workforce and returning to the days when only the rich and elite studied medicine. This would be to the detriment of trainees like me.

All this, alongside threats of an imposed contract that undermines trainees, is it any wonder there is low morale amongst surgical trainees, or why junior doctors are either leaving surgery, the UK or the medical profession in droves? Trainees and trainers must remain united to address this crisis, to protect our beloved profession, before it's too late!

Miss Rhiannon Harries is President of the Association of Surgeons in Training. @rhiharries

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