I think aside from pay there are significant changes that could be made to help with junior doctors feeling and being valued:
1) GMC fees covered completely rather than just being tax deductible - if you require a professional registration to work this is paid by companies in the private sector
2) funding for courses and exams. If you worked at a private company or a nurse/PA and the course helps the hospital, it is fully funded with time off for study time. Juniors pay for all costs of courses, qualifications and professional exams which run in to the thousands a year. Some of these are easy to claim back from HMRC, others become a real argument. If you had a private company and paid for a course from accounts no questions would be raised, suddenly because it’s a personal deduction HMRC make it incredibly difficult. The hospitals have a study budget which is around £500 a year. The average cost of a single day course is £4-500 and several of these are a requirement of your training and therefore you end up covering this cost personally.
3) better planning of rotations. There is no need to move locations every year or rotate between the further apart hospitals requiring renting..etc. I was lucky in that my Deanery was small and we were told locations in May for an October start. Others would find out after their annual review and have 2 weeks notice that they were moving from Luton to Great Yarmouth. The days where a doctors salary was the sole income and families would relocate is not possible anymore. Deaneries need to treat trainees like adults and move away from the 1920’s idea that their partner does not work and can move around the country.
4) Setting minimum staffing levels (same as nursing) so that when a lost is vacant, it doesn’t become someone else’s job to cover two roles. Very common that the solution to a long term staff vacancy is that someone covers 2 roles such as the surgical and orthopaedic oncalls, but for no additional pay. Or removing trainees from training activities (clinic, theatre, endoscopy) to cover these gaps. There is no incentive for the hospital to rectify this as it is a cost saving, but it again makes it a toxic relationship where the staff do not feel valued.
The biggest issues with junior doctors is they for 10-15 years we have changed their roles and hospital staffing to maximise cover and efficiency. To do this no one works in teams anymore, so you don’t work with the same people or have clear pathways of who to contact or regular contact with seniors to learn from. This does get better in later years of training (in surgery at least), but it is easy to see why those in junior grades feel that they get paid less than those that came before them, while receiving no teaching or training and getting told it’s ok because if they become a consultant or partnered GP (which a large proportion never will) that it will be worth it.
