Starting training as a doctor has always come with a sense of trepidation. But starting out in 2018 is an especially foreboding experience. With a no-deal Brexit on the horizon, an ageing population and escalating rates of chronic illness, it’s difficult to see a career in the NHS as anything but tough going.
Although starting any new job comes with a degree of anxiety, the rising sense of dread amongst junior doctors cannot go ignored. To quantify these feelings, and to get an understanding of their root causes, we carried out our own research of junior doctors.
The results were stark. Over two thirds of the doctors surveyed, all from this year’s F1 cohort, are nervous about their ability to cope with the emotional toll of their job. Virtually all are anxious about working in unfamiliar situations or clinical settings. And of course, the majority are concerned about the personal impact of working long and antisocial hours.
We asked new F1 Dr Aniket Sonsale (and former Messly team member) how he was feeling about starting life as a fully fledged doctor this week “I’m excited and nervous,” he said. “I’m facing an enormous learning curve so I know I’ll have to rely on the advice of more experienced colleagues. In my training I’ve already seen how stressed and busy everyone is, so I don’t know how easy this will be.”
The concern with lack of support from peers is borne out by the survey too – nearly three quarters of respondents worried about not know who to approach for advice on the job.
As doctors are more pressed for time than ever, seeking out mentorship and support has become deprioritised. The BMA and other organisations help support doctors in areas like employment issues but no-one is dedicated to helping doctors share day-to-day practical support and advice with each other.
One such example of this is the erosion of the doctor’s mess, as budget cuts have caused many hospitals to heavily reduce funding for messes over recent years. Speak to anyone who graduated before 2000 and they will tell you how the doctors’ mess was the beating heart of their junior doctor experience, a place where they got advice from their peers and shared experiences with other doctors over a cup of tea or game of pool.
In a second survey, we found that a staggering 96% of doctors surveyed found messes are now less active than previously, with 83% stating that this makes it harder to connect with and build a rapport with other doctors and the same number believing that this makes it difficult to ask for help from colleagues.
The impact of this is clear – over 80% of junior doctors asked here found solidarity to be dwindling, with just over half finding it difficult to access help and advice from more experienced colleagues.
We asked senior anaesthetist Dr Nadia Masood for her take on the issue.
“When I was a junior I was reliant on the mess to get advice from seniors and to share tips with other doctors. It was a great source of support and I don’t think I could’ve have survived my first few years without it.”
“But the reduction of funding for doctors’ messes means increasing numbers of new doctors won’t receive the level of support that I benefited from. Having that infrastructure of support – and the camaraderie it delivers – is absolutely essential in the early stages of your career.”
The mess serves as much of a pragmatic role as it does pastoral – helping doctors share the information and resources they need to do their jobs:
“The information I need to do my job properly – whether it’s basic information about my hospital or the latest clinical guidelines – is spread around in many disparate places online and is not easily accessible,” said Registrar Dr Christopher King from Woolwich Hospital. “It’s not always clinical answers that I’m searching for. As junior doctors we get used to receiving rotas at the last minute, not knowing what weekends we’ll be working or being able to plan life around work, all of which adds to a sense of isolation.”
At Messly our has always been to help better support junior doctors through their careers. Our service has helped 11,000 junior doctors so far to make better choices around their careers and training through access to reviews and ratings of training programmes.
In light of the above, and the learnings from speaking to hundreds of doctors over the last year, we are re-launching a broader Messly service. This will make it easier for doctors to connect and share their experiences, supplemented by bringing together all the resources needed to get your job done.
You can expect to hear more over the coming weeks, before we go live in September.
As part of this, we have launched a Mess Champions programme to revitalise messes across the country, bringing back the sources of support that are sadly lacking. We will be working hard in the background to help these Champions to bring doctors together, organise events, collate resources. With over 60 hospitals registered in the first two weeks, we are really excited to see how this develops.
We are confident that we can bring back a sense of belonging to our profession, and ultimately make it more fulfilling and rewarding to be a junior doctor. For those starting their careers this week, we wish you all the very best of luck and hope to support you in this and throughout your entire medical career.
You can register from today, and we’re offering cool rewards if you invite your friends (Mess parties and coffee machines for your Mess, amongst others).