 eventually is going to come to the point where it's actually not worth it to go into medicine. And then we have an even larger problem on our hands. Welcome back to this channel, everybody. For those of you who are new around here, my name is Michael, aka Dr. Chalene and I am a board certified diagnostic and interventional radiologist in New Jersey. Now I recently was scrolling through YouTube as I usually do and came across a video that caught my eye by none other than Ollie Burton, who is a mid student in the UK. And that's all I know about him. But I came across this video and it's titled doctors are underpaid. What everybody needs to understand about medical salaries. So I had to insta-click it, but I stopped myself because I had to turn on the camera first and hopefully we can watch it together, learn something, talk about a few things, maybe we'll figure out why doctors are underpaid and go from there. So Ollie Burton, thank you for letting me react to your video. Even though you didn't let me, I'm just doing it on my own. Let's get into the video. I think this is going to be potentially quite a controversial one. Now before we begin, I know that many of you will have seen the title and you'll have instant reactions to that title. I love how he already knows people are coming for him. I love it. To become a doctor at all, you'll need to complete a minimum five years of university level education, often more than that in practice once you factor in things like extra degrees that people often take either before or during medical school, alongside having consistently excellent grades, test performance, and a very competitive CV before you even get into medical school. See, that's what people kind of forget a lot of the times, like, oh, you just happened to get into medical school. Now, before you even start this whole process that is medical school, residency, fellowship, all that stuff, you have to be like on your ADM, perfect everything, GPA, stores, etc., etc. You're basically stressed out for four years of college before even going into med school. And you're even more stressed out because you don't even know if you're going to get into med school. Trust me, I've been there. After that, once you've completed your undergraduate degree and you enter the world of work as a brand new doctor, you'll start out on a salary of 28,808 pounds. That's low. Is that what they get paid in the UK for? Well, what do they consider a junior doctor? Is it like a resident, I guess? Wow, they get paid half as much as residents in the US. And I thought we were underpaid. That seems awfully low. I don't know why it's so low. I knew they got paid less than American doctors, but that's very low. To give the caveat here, because junior doctors are contracted for 48 hours a week, as opposed to 40 or 37, 48 hours a week. What? That's like two days of work in the US. Once you move from your first year of practice into your second year, so you're a foundation year two doctor, your basic salary goes up to 33,345 pounds a year. Now on the face of it, I know the reaction. Those numbers actually seem quite good, especially when compared to those of the starting salary. They're not good, but they're good when they're only for 48 hours worth of work. You know what I mean? Well, actually, I take that back. 48 hours is quite a bit. I was thinking of, I don't know what I was thinking of. I was thinking of 48 hours was two days a week, but that's really not. It's actually two full days a week. And the normal person only works 40 hours a week. So 48 is, yeah, 48 hours of that salary is not good. Let's assume that someone completes the minimum investment, which is five years at medical school. You're incurring 9,250 pounds of tuition fees a year. $9,000 a year. That's it. I mean, I should have moved to the UK from med school. Plus maintenance loans of several thousand pounds to actually live off each year. And because of how student loans are set up now, I and the majority of my colleagues will be paying off 9% of our income above the repayment threshold, obviously for the rest of our working lives. I wonder what their total average debt is for med students graduating in the UK versus US. I mean, I know it's not nearly as high as it is in the US, but I'm curious. I wonder if it's on the same level because they have lower salaries, but also lower debt and we have higher salaries and astronomical debt. So I wonder if it's all relative. Maybe somebody in the comments below can do that math for me. Now the first really major thing that I need you to understand is inflation. And the rub is that for virtually all NHS staff pay has not kept up with inflation since 2010. Four shadowing here. The next video you watch may be talking about salary and inflation. Meaning that what we've actually seen in the real world is real terms pay cuts. The job is the same. The responsibilities are the same and there's more medicine to know than ever before. But the salary simply hasn't been kept up with inflation, which means that the value of that pay is less. This is so true and why it prompted me to make an entire video on this topic and how it pertains to US physicians and their salary versus inflation. And if it does or doesn't keep up with inflation, you'll have to watch the video coming out after this one. The second talking point is that of expenses for junior doctors. I am responsible for my own professional registration that I have to pay every year to the general medical council simply to be able to keep working as a doctor. I'm also responsible for my own exam fees, medical legal indemnity, courses, qualifications that I need and so on. So that's a little different than the US because we have astronomical fees associated with our board exams, all this other stuff, keeping up certifications and all that stuff. But my practice reimburses me for all that stuff and my residency reimburse me for most of that stuff. So I guess that's not the case in the UK, which is very unfortunate. All medical specialties have exams that you are required to sit in order to be able to train in that specialty at all. So this exam is compulsory. I cannot progress in my training without it. Yet I and all other junior doctors have to pay for it out of our own pocket. And the same applies for the second part of the exam, the part B, which costs twice as much. I totally agree with this. So it's funny because the tests are essentially the same prices, or maybe even less than in the US, but it's all kind of relative. They're all expensive for the amount of money we get paid. I'm telling you, the American education system for medicine, and it looks like the medical education system in the UK, they're all flawed and it's all full of these just like crazy high fees and just nickel and diming residents, med students, et cetera, et cetera, and not giving them enough money and giving them a ton of debt. Sweet. In the private sector, of course, if I were an accountant or a lawyer or something like that, all of these exams would be paid for. That doesn't make any sense. Why? You would think they would like do anything it takes to support physicians because they're pretty important in society, right? Not to toot my own horn or anything, but I feel like they're pretty important for taking care of the population. So why would you not reimburse them or pay for their exams or even decrease the prices of those exams, but instead pay for all of the lawyers and other corporate folks exams? That doesn't make much sense. And the next thing to understand is that for most of our career, doctors have a monopsony employer, which is the NHS. Just so we're clear, a monopoly describes a situation in which there is only one seller of a service. A monopsony is instead a situation where there is only one buyer. And this comes from the fact that in the UK, you cannot train as a doctor outside of the NHS. That is to say you can't go and work for a private health firm and train as a registrar and ultimately become a consultant. You are locked into NHS training contracts. I don't really understand that maybe someone can comment below and describe it for me if you're working in the UK, but there's only one hospital system, which is kind of odd. It would be like maybe us working for the Veteran Affairs or a government-run hospital. I guess that's the only real way. So if the entire healthcare system was run by the government, maybe it would be a monopoly and there would be no competition and there would be no salary competition and it ultimately just end up like this. Indeed, it takes virtually your entire youth to train as a doctor in most specialties and most won't reach consultancy level before their mid to late 30s. That's how long the training pathways take. So it takes a rough guide about seven, eight years to train to consultancy in most specialties. They have different names for things. I think consultancy is basically like an attending physician. This is not included in the five years of medical school and two years post-drive spent foundation program. They have different labels for different parts of your medical training, which I don't really know, but I think maybe consultant is the final attending physician. We all know even before we go in that doctors and other healthcare professionals essentially have to be strategically underpaid in order to make the NHS work and in order to make it accessible for anyone in society. So it sounds like the UK system has some issues as well along with the American healthcare system. So it seems to be a common thread amongst big economies. Now of course I do have to address the elephant in the room which is that will my earnings get better as I progress in my career? Yes, of course they will. This is true of roles in most industries and it's certainly true of doctors because the NHS consultant based salary is 84,000 pounds a year. So $84,000 a year for their consultant or the attending physician, I imagine. So that's still not really close to what it is in America but again, it's all relative because most of them don't have the costs we have in America for attending med school and residency and all that stuff. So yeah, I wonder what their work hours are because I tend to think in the US we work very hard compared to the UK and that's not to like talk bad on the UK. I just think the American work ethic where like physicians are working like 80 hours a week and getting paid a lot of money for it. But I think the UK doctors don't work that hard and they get paid less. But I wonder what would happen if they did work like 80 hours a week or maybe some do. I don't know, I'm curious. You are essentially asking somebody to dedicate their entire lives and make enormous, enormous sacrifices to get to that level because that's what a consultant is. It is years upon years upon years of training and experience and making medicine their entire lives. He's basically talked about where I am in my career, right? So I sacrificed many, many years, 14 years probably, 10 years of medical education, four years of undergrad, maybe even more because I did a post-bac program. But yeah, I mean, that's part of the did here and I think some of the naysayers are gonna say, well, you signed up for this. Well, just because we signed up for it doesn't mean it's necessarily fine. It's all fine and dandy, you know? I mean, there's some problems with it and videos like this are what brings awareness to the topics and hopefully we can get them fixed. All of these things are leading to people burning out, leaving the NHS for systems in which they will be paid more, increasingly going to New Zealand, US, or simply becoming jaded. I think I'm already a little bit jaded and I've only been working as a doctor for six months. This is crazy how healthcare systems across the world are experiencing the exact same things simultaneously. It's so weird, but he's saying the attrition rate is high and they're losing a lot of physicians to other countries because there are better opportunities there. And it's the same kind of concept I keep talking about and I do all these videos on other physicians quitting medicine because they just find better, stress-free environments to work in or other careers altogether. Burnouts high in medicine. And I'm genuinely afraid of a bit of public resentment for making this video, but this is how the situation is. See, but I like this. I've said it before. I like this generation because they don't care. They're like, I'm going to make this video because I feel that this is right and I feel like I need to get the word out on what's going on in the healthcare system. They don't think about like, oh, maybe I shouldn't make this because people will talk bad about me or I might get some heat on it. They just do it because like, that's what you got to do. I love it. No one's scared in this generation, I swear. Think about how people would perceive that. Imagine that headline plastered on the Daily Mail tomorrow morning. Greedy doctors ask for 22% pay rise. There would be public outcry. He has a point here. He really has a good point. Eventually is going to come to the point where it's actually not worth it to go into medicine. And then we have an even larger problem on our hands. But to reiterate, that is just to bring our salary back in line with inflation. That's not a pay increase. That's just restoration. Yeah. See, I love this guy. He really is speaking facts here. So at first glance, you see that headline, physicians want to raise their salary 22% or whatever. And they're like, oh, why would a physician need to get paid more? They already paid well enough. But they're underpaid. And the reason is because their salary has not kept up with inflation. The raise is just to keep it on the level or the same pace as inflation, like maybe other professions have. But it looks crazy, but it's really just to keep up. It's not really a salary increase. It's just leveling off or restoring, like he said. All of us healthcare workers and the public need to hold the government accountable for knowingly throttling the NHS and underfunding it year on year on year. Huge, huge chunks of the NHS have already been privatized, whether you realize it or not. And that is a slope that we are continuing to roll down and picking up momentum. It's a little different in the US healthcare system because obviously we can't strike against the government because it's mostly a private run business with the exception of Veteran Affairs Hospital and other government city hospitals funded by the government. So for us, if we were to strike, they would just be like, grow somewhere else. Wouldn't be that beneficial for us. But for them, when they have one system that controls everything, yeah, totally agree. All right, so that was a little more about the UK health system than I thought I was gonna be about, but it's still good because it kind of opens up our eyes to see that the grass isn't always greener on the other side. So hopefully you all enjoyed this video. Shout out to Ollie for allowing me or not allowing me to react to his video. You did a fantastic job. We should be friends. And maybe should I, I always wanted to go to the UK just to check out the healthcare system, but maybe you'll have me or like Ollie Abdaal. Maybe one of us will do something over there. That's ultimately the goal. I want to go over there and check out the UK health system and see the differences between that and the US. So as always, smash like, subscribe button, follow me on Instagram and TikTok if you don't already. And I'll see you all on the next video. Bye.