Medic aid
The job agency for burnt-out junior doctors
Rohit Chitkara could barely contain his excitement when he received a letter in the post one morning from University College London. He’d been accepted into one of the most competitive medical schools in the country, and his parents were delighted. His father, a surgeon, had warned him about the difficulties of a career in medicine, but Chitkara, who’d always had a knack for science, wanted a job where he could help people. Medicine seemed the perfect fit.
But just four years after graduating Chitkara, then 28, decided to leave the profession for good. He was exhausted with his life as a junior doctor; the long hours, high pressure, and lack of appreciation from patients had driven him to breaking point.
“People who have spent their whole lives dreaming of becoming a doctor are leaving,” he explains. “Every medical student now knows of a doctor who’s left.”
Chitkara is just one of thousands of junior doctors in the UK who have left the NHS in recent years, as health chiefs talk of a “brain drain” depriving hospitals of their talent. The General Medical Council (GMC) reports that a quarter of young medics feel “burnt out” by the strains of the job, according to a new 70,000-strong survey, while in 2017, only 43 per cent of junior doctors stuck to their NHS career path after finishing their first two years of training, down from 71 per cent in 2011.
More young doctors are opting to take breaks, work abroad, or leave the profession entirely.
The most commonly blamed culprits are long hours, stress, and the fear that minor mistakes will land
‘They’re having anxiety and panic attacks, and they end up going off sick’
doctors in legal trouble. Abeyna Jones, founder of Medic Footprints, a careers advice service for junior doctors looking to leave the profession, says that many have become demoralised.
Jones, who founded the enterprise in 2014 after four years of battling it out as a junior doctor in hospitals across the South East, says understaffing on hospital wards creates a vicious circle of doctor fatigue. “[Doctors] are already perfectionists, and they worry they’re going to get something wrong, they’re having anxiety and panic attacks, and they end up going off sick. I’ve heard of doctors who come to work with appendicitis, finish their shift and then check in to A&E.”
Jones, 35, says there was a period in her early working life when she was “crying every day”, but was reluctant to seek help from the NHS’S internal counselling service in case she was reported to the GMC.
Doctors also fear being blamed for unavoidable mistakes, she says, with many of her medic friends left outraged by the case of Dr Hadiza Bawa-garba, a paediatrician who was convicted of manslaughter by gross negligence in 2015 over the death of a six-year-old boy in her care. She won an appeal to be reinstated to the medical register three years later, after more than £160,000 was raised to help her fight the case.
She thinks older doctors may well roll their eyes at these complaints: being a junior doctor is a tricky period that all young medics must endure, the thinking goes, before they’re rewarded at the end with much cushier pay, hours, and working life. Those outside the profession, too, may be unimpressed with the current mass exodus: it costs an estimated £220,000 of taxpayers’ money to get an NHS doctor through medical school, a sum made even more eye-watering if they then jack it all in within 12 months for a lucrative private-sector role.
While previously, junior doctors might have persisted until becoming a consultant, for example, where “you got to swan around, you got paid a lot, and you didn’t have to actually do much of the hands-on work,” such roles seem to have become obsolete, according to Jones, leading younger doctors to question why they should remain committed to the industry.
Indeed Jones saw her university friends in other professions accelerating through life – moving jobs, buying houses, getting engaged – while she seemed stuck in an endless loop of exams. But it was only after returning from a year in South Africa, where she discovered how well doctors could be treated, when she decided, finally, to quit medicine. She remembers one man arriving at the hospital in Kwazulu-natal with a machete in his head (his girlfriend had lodged it there after a row), and another who had been shot after a card game turned sour; she was often the most senior doctor on duty. The work was far harder there than in Britain, but she was happier, as she felt more appreciation for her skills.
She eventually founded Medic Footprints, which connects young doctors with top private-sector employers, including Deloitte, Babylon, and Virgin. It has advised 11,000 doctors since 2014, including Dr Chitkara, who is now a year into his role as a consultancy graduate at PWC.
“You’re kind of a slave to a rota,” Chitkara says of his time working in hospitals in London and Cambridge. “I know several people who had to organise a two, three, four-way swap for their own wedding day, despite asking six months in advance.”
Having entered medicine to help the vulnerable, he was shocked by the “toxic” levels of competition, grandstanding, and even bullying. Chitkara remembers the “public shaming” of younger doctors who weren’t able immediately to answer difficult questions: “There’s lots of big egos; you have lots of doctors arguing with each other over a patient.”
Like Jones, his eyes were opened by working in a foreign hospital, describing a year in Australia as “like a completely different profession”. The management was more efficient, he says, and doctors treated far better. His boss gave him a whole week off work when his grandfather died so he could fly home for the funeral. The NHS, in contrast, didn’t allow his friend even one day off because their grandparent was only a “seconddegree relative”.
He adds that, armed with a Google search, some patients seemed to think they knew better than their doctor. “We’re a more consumerist society now, and there’s much more conflict with patients than there used to be.”
Campaigners point to the rising toll of mental illness among clinicians, with nearly one third of doctors suffering from a mental health condition, according to a 2011 report in the British Medical Journal. In a very small number of cases, it can end in tragedy. The family of 25-year-old Rose Polge, a junior doctor who walked into the sea and drowned off the coast of Dorset in 2016, told an inquest she had been plagued with self-doubt at work, adding that doctors can “feel a dreadful sense of personal failure and inadequacy if they struggle to keep working”.
Chitkara, however, is determined to remember the light as well as the dark, recalling delivering his first baby, as well as the joy of intimate conversations with patients’ relatives.
“I don’t regret going to medical school, because I learnt a lot from it and it opened doors. But I think it’s quite impressive that a monopoly employer has got to the situation where people are leaving in droves.”