The last year has been a whirlwind. I have questioned many things. The state and sustainability of the NHS. The role of doctors. My future in Medicine.
You can’t deny the atmosphere. There is an air of uncertainty. I’ve spent time in both the hospital and general practice. Wherever you go, you cannot hide from the fact that things have changed and not necessarily from the better.
My decision to pursue a career in Medicine was filled with enthusiasm and optimism. The idea of helping others, some at their lowest points through the provision of good quality healthcare excited me. It is very likely that I was naive. I made the decision at an early age and whilst I knew that every profession had its challenges, I never expected it to be quite like this.
For context, I am currently in Foundation Training. I know I do not just speak for myself when I say that things have been quite depressing recently. Speaking with friends who are so obviously burnt out, hearing of colleagues ending their lives due to the immense pressures they were under and coming across others who are making plans to leave the country and practice medicine elsewhere. Staff mental wellbeing is worsening and with increasing ambulance delays, increasing elective surgeries waiting lists, healthcare workforce crisis and a cost-of-living crisis; the quality of patient care is declining.
After the pandemic, I thought that the value of those who kept our national health service afloat would be acknowledged with something more than claps. Between the barrage of abuse that GPs have been receiving and the persistent state of an overwhelmed health service. It is only so long that such a system can be tolerated before the frustrations build from the lack of change.
For context, the NHS is likely going through its biggest workforce crisis in its history. A significant percentage of doctors have expressed their plans to leave the NHS. Paramedics, nurses and physiotherapists are all striking and doctors could be swiftly following suit too.
The problem is, for so long the NHS has relied on the goodwill of its workforce and dare I say, exploited our goodwill too. We have normalised certain things in the workplace that shouldn’t be normal. Things like:
· Insufficient and unsafe staffing levels
· Being asked at the last minute to cover more patients than is safe due to staff shortages
· Having to request annual leave 6 weeks in advance and it still might be rejected
· Toxic workplace environments
· Lack of training opportunities and an increasing focus on just service provision
· Poor work life balance
· Specialty training bottleneck
· Having to take on extra shifts just to make ends meet
· Real terms pay cut
Forgive me for wanting to work in an environment that is adequately staffed. Where healthcare workers are well resourced to give high quality patient care and professional development is encouraged through accessible and consistent training opportunities. An environment where staff are appreciated and well-paid and can live healthy and balanced lives. I am aware that change isn’t always as quick as we would like for it to be, and the current economic climate does not make it easier. But the truth is, if we don’t value our healthcare workforce and treat them better, staff will inevitably leave, and the populations health will suffer as a result.
I personally have no interest in moving to another country at this stage of my career. But I can’t help but question my future practising Medicine in the UK. I care about my patients, and I care about the health of the most deprived communities, but it is becoming increasingly difficult to care for them in a stretched system. For so long, practising medicine in the UK has been almost synonymous with practising in the NHS and now that doctors are tired of being overworked and undervalued, many are looking for other options and I don’t blame them.
At times I feel guilty. I know how lucky we are to have a system like the NHS. Many of my relatives are still here today because of the NHS. For clarification, I do not blame the NHS. I am unsure who to even direct my frustrations toward. But at some point, it is more harmful to stay in an environment that doesn’t enable you to thrive. The challenges are bigger than me, but as doctors we shouldn’t have to pay the price, especially when we are working so hard to keep the system afloat.
Through it all, I am learning that my interest in Medicine is not limited to the NHS. This mindset increases the options that are available to me. Whilst some of them are dependent on further medical training, a good proportion of them aren’t. My success as a doctor should not depend on my ability to thrive in an environment that is so obviously failing me and my peers.
I haven’t fallen out love with Medicine. I am slowly falling out of love with working in the NHS.
An anonymous doctor
This article is an opinion piece. Any views or opinions expressed by the author of this email do not necessarily reflect the views of the Melanin Medics