 What is up guys, Carmen medic here, and welcome back to another dose. In this video, I'm gonna be talking about the parts of being a doctor that I really don't enjoy. If you don't know, my name is Nasser, and I'm a doctor living and working in the UK, about one and a half years into the job. I have a sister video to this one, talking about all the different things I love about medicine. So if you're looking for something a little bit more uplifting, then maybe check that one out first. A quick disclaimer to preempt some of the comments that will inevitably show up on this video. I love my job, and I talk about that in extensive detail on a lot of other videos on this channel, but that doesn't mean that there are downsides to this job as well. Ones that I think medical students and aspiring doctors or aspiring people in the medical field should be aware of, and should know when making educated and informed decisions about what they want to do in the future. This video is not me complaining about my job, but rather, describing, explaining the realities of the job to those who otherwise might not be aware. All right, so let's start by talking about the hours, and there's quite a lot of different things to unpack here. Working as a doctor is about as far from providing a good work-life balance as I could have imagined. Let's start by talking about the total hours, which doesn't tell the whole story, but I think it's a good place to begin. In our junior doctor contract, we are contracted to work something like an average of 46 to 48 hours per week, but this changes quite a lot depending on the specialty that you're in. Oftentimes, it turns out being a lot more than those 48 hours, so for example, next week I'm working 55 and a half hours, and then one week, a few weeks ago, I was wrote to work something like 72 and a half hours of 73 hours, and I'll post a screenshot or an image of my schedule over here, which shows that I'm scheduled to work something like 52 hours in week one, 72 and a half hours in week two, and then 42 hours in week three. So as you can see, oftentimes you're scheduled to work a lot more than the contracted average hours that you're supposed to do, but that doesn't even account for all the hours that you spend coming in early to prepare the patients for your ward rounds before your seniors come into the hospital or the hours that you stay late, because often we're understaffed, overworked, and there's a lot of outstanding urgent tasks that need to be done before you get home, so you often end up staying late to complete those as well, and all of that, of course, is time that we're not paid for, but just looking at the total number of hours doesn't quite tell the full story. There are other jobs out there that require you to work longer hours, more consistently or more significantly, things like corporate law, which my sister does, and I've talked about that quite a few times in previous videos. A lot of jobs in the finance and investment banking sector, things I don't really understand or know too much about, but I know my friends working in these sectors and they work long, long hours. But when you work as a doctor, you tend to work a lot of on-call shifts, so these are shifts that can be 12 hours, 13 hours long, you tend to work a lot of weekends, and you tend to work a lot of nights, especially as an SHO or a doctor after the first year, anything between F2 up until the registrar. Now, once you're kind of going with the schedule, you start to realize that you're spending a lot of time in the hospital during what we would refer to as unsocial hours, so these are hours after the traditional 9-to-5 or hours on the weekend or on nights. These are old times when you would otherwise be meeting up with your friends, you would be able to go out and schedule and plan your own activities. These are times when you would want to relax and kind of take a break away from work, but instead you find yourself back at the hospital. What this makes particularly difficult for me is having scheduled and regular activities in my life. So let's say I want to play basketball twice a week from six to seven PM with all of my friends. One week I might be able to make that, but then the next week I'm working on calls, so I'm working until nine PM, or the next week I'm working on the weekend, so I can't attend that game. Or if it's my friend's birthday on the weekend, someone's wedding or some big social gathering, if I'm working weekends or nights, it makes it infinitely harder for me to attend those events, or I just can't attend at all because I'm scheduled to work. So what ends up happening is you have your weekend or your days off on random days during the week when all of your friends are at work. So let's say I do weekend nights from Thursday evening until Monday in the morning. I have Monday off and Tuesday off. When am I gonna see my friends during that time? My friends are all at work during the week. They're less likely to want to hang out in the evening. And it just makes it harder to see them and harder for me to do activities that I want to do. Another thing about the schedule is that it's just completely different every single week. You know, one day I'll be working Monday to Friday, nine to five, and it's like, oh, a little bit of stability in my life. Let me go to the gym a few times a week. Let me go out for dinners, schedule time with my friends, et cetera. And then the next week I'll have Monday, Tuesday on call, Wednesday off, and then Thursday to Sunday I'll be working nights, and then I'll have Monday, Tuesday off, and then I'll be Wednesday to Friday on call, and then I'll have a weekend. So it just completely changes depending on the week, and it's constantly changing every week. I'm at the point where just before I sleep, I check my phone and see what am I doing tomorrow? How many hours am I working? Where am I working? Cause I might be on a different ward, in ED, in ambulatory care. So there's a lot of unpredictability and non-conformity or irregularity that comes along with the schedule. I find working like this extremely tiring, particularly with the 12 and 13 hour shifts. So let's say I'm scheduled to be at the hospital from eight in the morning until eight at night or nine at night. This means that by the time I wake up, get ready and go to work, finish work and then come back, I've barely got just enough time to eat something really, really quickly and get into bed and sleep. This is particularly true when I have a string of on-call shifts or a string of nights or a string of weekends when you're expected to be in the hospital for 13 hours a day. That's more than half the day that you're at a physical location away from your house. So even if you had all the energy in the world, all the motivation and excitement to do your own passion project outside of work or go meet up with friends, you've got a very limited amount of time to do it in. But obviously after working so long, you're really, really tired and you're exhausted and you need to relax, you need to unwind and reset before the next day. Something like we go to work and sit at a desk playing around with numbers and Excel sheets or in Zoom meetings and things like that. You know, I'm dealing with life or death situations throughout the day. I'm holding my own call bleep. People have cardiac arrests and we need to resuscitate them. There's lots of really unwell patients, difficult family members, very difficult patients to deal with. It's a particularly emotional and stressful job I think both mentally and physically. So by the time I get home, you know, all I can do is just sit down and try and unwind before starting the next day again. And then this doesn't even touch on night shifts which are just a beast of their own. Honestly, having to flip your schedule around from days to nights and being the only doctor responsible for something like 250, 300 patients is unbelievably stressful and comes with so much emotional and physical just pressure and stress that it's really hard to explain. I'll probably end up making a separate video about night shifts entirely. But yeah, just another difficult thing to add to the list of hours within the life of medicine. Not to hit on this point too much and to summarize briefly, being a doctor is hard but we all know that being a doctor is hard and working as a doctor is hard. In summary, the work schedule of a doctor is quite hard. And you know, hopefully this section emphasizes the difficulty with the scheduling and the rota and the hours. But I'm sure you already knew that doctors work hard and have a hard job. So let's move on to the next section. All right, the second big thing I wanna talk about stress and responsibility. So surprise prize, being a doctor can be extremely stressful. Seriously, there's a lot of stress associated with the job. The best example I can think of is that when you're in the hospital, you're sitting around on the ward and the crash alarm goes off. If you're unfamiliar, crash alarms are this loud, annoying sound which is meant to grab your attention and does a very good job of that which is pulled or issued when someone is critically unwell and needs medical attention immediately. And you get this call either through a big alarm sounding on the ward if you're physically there or through a small plastic device called a bleep that you carry on your person and it alerts you to a cardiac arrest or a crash call somewhere in the hospital which you then have to go to. So picture this, you're sitting at your desk typing up your notes or having lunch in the cafeteria or whatever and then suddenly this alarm goes off. And all you know is that someone is really unwell and could be dying and you need to get there as soon as possible. Could you just imagine being in a typical office job and every now and again you get a little beep on your phone that tells you someone is about to die or is on the verge of dying and you have to rush over there and quickly assess the situation, start treatment, start management, help save this patient if they are really unwell. It's just an incredibly alarming thing that happens on a regular basis for all the doctors who are working. And this can happen at any time. I've had it happen in the first five minutes of my shift when we're sitting in handover not even having started our day. And I've had it happen in the very last five minutes of our shift. It's equally stressful regardless of the time but it's just the idea that at any point in the day this could happen and you have to spring into action and go deal with this highly stressful situation. This can be anything from a patient having had a fall and hit their head, someone who has collapsed and is unconscious, someone having a major hemorrhage or a bleep, someone whose heart has stopped and is in cardiac arrest. It's hard to describe the stress that runs through my body when I hear this alarm go off. I'm comfortable and I'm competent in going to these situations and assessing the situation and beginning treatment and management and things like that. But even so, you know, it's still stressful. And of course there are a lot of situations which are particularly difficult to deal with that require lots of people. And sometimes that help isn't always there immediately and it can be really difficult to manage. This is particularly true when you're working on call out of hours or on the weekend or on nights when there's just significantly less staff around, especially on nights when I'm the only doctor covering 250, 300 patients. By the time my colleagues get there from the emergency department, it can be a long time of stress dealing with that on your own. I've had two recent night shifts that have just completely shifted my experience and understanding of what it means to be a doctor and just how much stress I can be put under as a person. First one was in my previous hospital when I was dealing with just a particularly unwell patient who was requiring all of my mental and physical energy, both of my hands to carry out all of the activities in front of me. And then a nurse came up to me actually and told me about a patient experiencing chest pain with ECG changes, which is significant for something like a heart attack. And then whilst I was trying to manage that situation, a patient fell and hit their head and was bleeding. And I was the only doctor around and the only person who knew about these three things and having to, you know, appropriately escalate these different patients and come up with a prioritization and treatment and management plan for all of them was unbelievably stressful. And then even more recently, a week or two ago, I was again on a night shift, only person responsible for about 250-300 patients had a patient who was having a major hemorrhage, so very, very large bleed in front of me. And at the same time, I was getting cold nonstop on my phone by nurses in different parts of the hospital telling me about unwell patients elsewhere, patients who were having seizures, patients with new increased significant oxygen requirements, patients having a full patients with chest pain. And I remember just being in the office on that ward, looking at my piece of paper where I had written down all these different patients and what was going on with them and think and I almost burst out into tears. I've cried a handful of times in my life, maybe four or five. And I just, I almost lost it. I was thinking to myself, what am I supposed to do here? You know, these are five really unwell patients who all need my attention and all need my help within a really short period of time. And I remember thinking to myself, what am I supposed to do? How am I supposed to deal with this situation? I think that's a really good example of just how much stress you can be put under and these situations you can find yourself in where there's a lot of responsibility to do the right thing. It can be very, very tough to deal with. Not just to clarify, there is a senior available somewhere in the hospital and you can always call, on-call consultants, et cetera, for help if you need. But that doesn't change the fact that you are the person who's there and you are primarily responsible for what's going on and you need to make the decisions about where to go from here. So although you can call for help, you can call for advice, things take time. It's not quite like the movies where you say, you know, give me a stat dose of this or pick up the phone to your consultant and you're like, hey, how do I fix this? And they tell you what to do and you do it and the patient gets better. It's really not like that in real life. Things take a lot of time and that's something that, you know, any medical students who are approaching, starting to work will learn very, very quickly. So there is help available if you need it and you can always reach out to other people. But again, it doesn't change the nature of the situation. And just to bring the point home, these situations that I've described really aren't uncommon. These are things that you do and face on a day-to-day basis. If it's within working hours in the hospitals while staffed, things are a lot easier to deal with when you put out a crash call, there's a lot more support and there's a lot of people who come. When you're working out of hours or on the weekends, you know, evenings or nights, things can be really, really difficult. Hopefully this little chapter has given a little bit of an insight into the types of situations that can arise and just how much stress can be put on an individual as a doctor throughout our shifts. You know, the level of responsibility that we hold is just absolutely huge. It's really hard for someone who's not in healthcare or not in the medical field to kind of understand and appreciate that. I think the knowledge of the general public about how hospitals run and how things work within a hospital is very, very different to the reality, at least particularly here in the NHS, I would argue. And so it's difficult to describe and put across but hopefully this kind of segment has done a good job with that. As we've talked about and hopefully you've seen time management and efficiency are really important in helping me make the most out of my free time as a doctor. And something that really helps me with this is Notion, the sponsor of today's video. Talked about Notion many times before and I will keep talking about them probably for as long as I'm making YouTube videos. I absolutely love Notion. Notion is a productivity and note-taking tool that is incredible for organizing your entire life. It helps with things like task management, project tracking, to-do lists. And you know, if you're a university student or someone who's managing a lot of different projects in their life, then Notion is absolutely perfect for you. I use it for everything and I mean literally everything. So we've previously talked about Notion AI and how it can be a really helpful assistant to help you in making your writing shorter or more concise and effective and even change your writing tone, can summarize content that you don't have time to read, explain content that is too technical, even generate things like cold emails for job hunting, literally everything. But today I wanna tell you about a new feature which is called Notion Q&A. This little circle down here in the bottom right corner which I'm really excited to show you. The key thing here is that Notion Q&A goes beyond traditional AI chatbots because it understands and uses context from the information in your own Notion workspace such as your notes, previous actions that you've taken and decisions that you've taken to provide you with a more accurate and relevant answer to your question. So Notion as a platform acts as your second brain and then Q&A functions as your assistant ready to answer any questions that you might have. So let's run through some examples of what you can ask it. For example, something that I commonly have a question about is which videos did I do a X or Y sponsorship in? So in this case, better help sponsorship in. And now it will search my Notion workspace with the context of the information that's in there and tell me which of my previous videos and scripts I have done a better help sponsorship in and link me directly to them. So to look through my Notion workspace and tell me you've done a better help sponsorship in X, Y and Z videos and then it will link me directly to those pages where I've done those sponsorships. So if I click on them, it'll open that script for me and I can have a look through and do a little bit more reading, see where it was from. Very, very helpful. So something else that I wanna ask it is when is the date of my upcoming exam which is called the MSRA? It's part of one of the exams that I need to do for course surgical training here in the UK. Like I'm saying, when is the date of my MSRA exam? And then it will look in my Notion workspace and find my notes that are relevant to the MSRA exam and then find the words that are relevant for the date and tell me when that date is. Or I can ask it, when is the referencing deadline for my CSP application? And it will do the same thing. Very, very helpful. This saves me from having to find those initial pages, click into them and then scroll through all of my different deadlines and information to find the specific answer that I'm looking for. Other questions that you can ask which may be more relevant to you are things like, tell me which books I read in September or what are some of the articles in my reading list that mentioned space travel or summarize all of my activities that I have planned for my trip to London. It's just so convenient asking questions and receiving AI generated answers with links to my own relevant Notion pages if I want to dive deeper. It's kinda like having a personal assistant that you can bug 24 seven with questions. One more important thing to note is that nation AI protects data privacy and only references pages that users have access to. So this is particularly useful if you use a team in Notion. When I had a team on my Notion workspaces, I would give particular access to pages and workspaces to particular team members. And so if they were to use Notion AI, they could only receive results and answers from the pages that they have access to. If you're already a Notion AI user, you can get started with Q and A already in your Notion workspace by clicking the circle in the bottom right corner of the screen. And if you're interested in trying it out, then you can join the wait list by clicking on the link in the description down below or the link on screen right over here. Thanks again to Notion for sponsoring this video and let's continue. This is a really good one. If you think that doctors are the only people who are stressed in the hospital, you'd be very, very mistaken. Of course, patients are gonna be stressed, their family members are gonna be stressed and every other member of staff is going to be stressed. Everyone from nurses to physiotherapists, occupational therapists, radiographers, porters, administrative staff, secretaries, everyone is constantly stressed and given how social of a job being a doctor is and I've talked about this before, I spend so much of my day talking to other people, a lot of people that I've met for the very first time that I don't know before. Given how much you're talking to people who are new to you, you spend a lot of time managing the stress, the anger, the frustration that oftentimes comes along with talking to these people which can be extremely, extremely stressful and takes quite a significant toll emotionally. What I particularly dislike is having these conversations and negative emotions and stress from other healthcare colleagues. From patients and family members, I can understand they're in a foreign environment, they're probably in a very unhappy or dark place in their life, they're going through something physical which is obviously not pleasant but when doctors and healthcare staff speak to each other in anything but a non-polite and respectful way, it really gets under my nerves. I like to think that I talk to everyone in my day-to-day interactions in and out of the hospital with the utmost respect and kindness and whatever. That wouldn't change for calling my colleagues in the hospital, talking to my colleagues in the hospital and I just find it incredibly strange that we don't give each other the maximum amount of kindness, niceness and respect particularly when talking on the phone. This obviously differs from hospital to hospital and department to department that you work at. In my previous hospital which was a very large tertiary centre here in London, picking up the phone and talking to another specialty was just an unbelievably stressful experience in itself. You know, when people call me and ask me to do things or ask for my advice or ask me about a patient or whatever, I do my best to get all the information to them and explain it in a nice and concise way and blah, blah, blah, blah. But sometimes I would be calling particular specialties namely cardiology and rest. I think we're two of the most stressful ones, maybe radiologists as well. And just the amount of sarcasm and rudeness and sass that you might get on the phone or just, you know, flat out insults about why you don't know X, Y or Z which may or may not be your fault at the time was just unbelievable to me. I couldn't imagine speaking to anyone like that, period. Let alone my colleagues in the hospital who were all working towards doing the same thing which is helping the patient that we're talking about or the patient that's in front of us. But this really just comes from a root of everyone being at such a high baseline level of stress. Or let's say registrars taking referrals on the phone when they're getting a phone call every few minutes and they're having to deal with those phone calls and the referrals whilst also seeing patients and having to deal with everyone on their ward. Obviously they're gonna be stressed and they're gonna be more short than usual when they're talking to you or they're gonna have heightened emotions, let's say to put it nicely. So I kind of see where they're coming from but I just cannot imagine talking to other people like that. And so when someone talks to me like that it makes me feel like, you know, what are we doing here? Why are we treating each other like this? Why are we talking to each other like this? Anyways, going on a bit of a rant, let me, let me refocus and stop going on a tangent. The point that I was trying to make is that colleagues can sometimes be not so nice when talking to you on the phone or in person because of their amount of stress that they're under. Anyways, the next cohort of people that are under stress and can be difficult to manage or talk to are patients. So patients are understandably, you know, not feeling well, stressed, probably scared and just unsure about what is happening to them and maybe what their future, you know, treatment and management and sometimes even prognosis is. And being the professional in the situation and the one who's providing the service of treatment and medicine, et cetera. You know, you're the one who has to hold always the moral high ground. You have to hold the sense of comedy and respect and kindness and whatever, all of those things. This can kind of create a situation where, you know, sometimes you have patients who are particularly rude or who are very stressed and, you know, shouting or angry or talking in a very unpleasant way. You kind of have to suppress all of that and keep your sense of comedy and zen to be able to do your job and treat these people and help them. And that's not to say all patients are like this. In fact, from my experience, I think that's absolutely not true and so many patients are unbelievably kind and nice and really express their gratitude and thanks for everything that, you know, has been done for them in the hospital. And I always let them know that I really, really appreciate that because when they do, it's, you know, it's a very nice reminder of what we're doing here is actually meaningful and making a true impact on the people in front of us. But that doesn't mean that you don't deal with a lot of very difficult patients as well. One of kind of the big topics that comes up over and over again is conversations about DNA CPR or end of life decisions. DNA CPR stands for do not attempt cardiopulmonary resuscitation. What this means is if a patient's heart or lungs stop functioning, we are not going to attempt to restart them. Restarting them typically involves what you will have seen in the movies which is jumping up and down on someone's chest, delivering electric shocks and some very powerful, strong medications that can sometimes help restart a patient's heart. Performing CPR and doing this resuscitation process is absolutely nothing like it is in the movies. In the movies, you jump on the chest for a bit, you deliver a shock and the patient comes back to life. This never happens and it's not like that at all. Delivering CPR or cardiopulmonary resuscitation is a treatment in itself and it's a very traumatic and harm causing and harm inducing treatment. And so we as medical staff do not offer this treatment to people who we think A will not benefit from it. So we are unlikely to survive CPR if they do survive, we'll have a poor quality of life after treatment. So if you do survive CPR, you need to go to ITU or HDU and if you are not going to be able to come out of ITU or HDU after you were to survive CPR, then we would not offer this treatment. There's a lot of different reasons why we wouldn't offer CPR, but for a lot of people, this decision is a very big deal, understandably so. And both patients and their families can be very, very passionate or impassioned about how they feel about these decisions and they want to make it known also rightfully so. And a lot of the time, the kind of clash between the medical professionals and the patients or their family about this topic is a lack of understanding of what CPR actually involves. You know, what percentage of people actually survive something like CPR just close to 10% and then what percentage of those people actually make it out of the hospital, which is again something like 10 to 20%. So your chances of resuscitation are unbelievably low or extremely low. And particularly if we think that you're not going to survive or you're not going to benefit from CPR, the chances are very, very low. We end up having a lot of quite difficult discussions around this topic, which is obviously quite sensitive, quite emotional. People feel very strongly about these things. Sometimes dealing with the patient and their respective family can be quite challenging. I like to think that I have really good communication around this topic and around most topics. When discussing things with patients or their family, I think King's, the medical school that I went to, did a very good job of teaching us about communication. And then also I did a geriatrics placement or care of the elderly placement last year as my first job as a doctor where we were having these conversations very, very regularly. And so I feel like I've gotten a very good understanding of how to have these conversations and how to be respectful and kind of random and explain things in a way that maybe a very impassioned patient or family member might be better able to understand. But yeah, all this to say, you know, we do have very difficult and emotional conversations about patient's health, patient's life, patient's prognosis, that patient's dying or about to die or having died. And these can be very difficult conversations to have. Particularly in my first year working as a doctor, I would have nights where I would wake up in the middle of the night and think to myself, did I do this properly? Or did I explain that correctly? Or should I have said this or should I have said that? And, you know, that's never a nice feeling to have. And my rule of thumb is just do the best possible job you can do when you're at the hospital so that when you leave, you don't have any regrets, you don't have any questions in your mind, you're not unsure of anything. And I think that's something that I've gotten significantly better at over time because there's nothing worse than coming home and thinking to yourself, should I have done this, should I have done that? But it's kind of the emotional burden that a lot of us carry because medicine is such a broad and wide field and there's a lot that you can do and there's a lot that you can do. Sometimes not giving treatment is the correct thing to do and it's a very difficult decision to make and a very difficult conversation to be had. All right, let's talk about A. There's no way I could make this video without talking about pay. It's notoriously a very taboo subject which people don't like to talk about but it's very, very important and extremely relevant particularly here in the UK with ongoing junior doctor strikes that have been going on for several months now. So let's get into it. So in the UK, after medical school, doctors enter what's called the foundation program which consists of two years, foundation year one and foundation year two. A foundation year one's starting salary is 14 pounds per hour, one four pounds per hour which is just about above the minimum wage here in the UK. This works out to about 29,000 pounds per year if you're working a 14 hour work week. Now like I mentioned before in a lot of specialties you do not work 40 hours a week, you work more than that and so your average yearly salary coming out of medical school is somewhere between 29,000 and 32,000, 33,000. Now, the median average salary in the UK is 33,000 pounds. Let that sink in for a second. The average job in the UK will give you a better salary than being a doctor. Right now, I am being paid the same or less than the average person working a job in the UK. Now hopefully everything that I've talked about before and everything that I'm about to talk about and what you know about the medical field and about being a doctor hopefully explains to you that being a doctor is not an average job. Now I don't think anything makes that more clear than some of the points that I made earlier in this video. With the current cost of living crisis in the UK and inflation being out of control and at unprecedented levels, the pain of public sector employees has to rise with that. It's an absolute joke that our pay has remained the same for the last decade. I'm currently paid the exact same salary that a doctor in my position was paid 10 years ago. The salary has not increased with inflation at all which is just nuts. On top of that, studying medicine takes a much longer time than a lot of other degrees. Here in the UK, medicine is a five or six year program. Me personally, I did an undergraduate degree in Canada for four years before I started medical school here in the UK for another five. So I had nine years of education before I started work as a doctor. And depending on what country you studied medicine in whether you did one degree or two degrees, regardless, you're gonna have quite a significant amount of debt built up. Now personally, I think the fact that some of the brightest, most studious, disciplined motivated minds in the country are given the same or slightly above average national UK salary is absolutely disgraceful. Health care professionals around doctors are being paid higher salaries than doctors. So what I mean by this are medically associated professionals I think they're called. Things like physician's associates or physician's assistants. Just look at this advert that I'm gonna post somewhere here on screen for a physician's assistant job with a salary of 31,000 pounds straight out of school. It's not that I think PAs don't deserve this salary. I think PAs absolutely do deserve this salary. I just think for the work that doctors do we deserve to be paid more. The literal title of the job is physician's assistant or in the best case scenario, physician's associate. The entire job is to assist the physician that you work with. How can you be paid the same or worse? PAs or physician's assistants or associates don't work on call. They don't work in the evenings. They don't work weekends and they don't work nights. They're not responsible for carrying a bleep to deal with those life-threatening emergency situations that we talked about before. They don't have the ultimate responsibility for caring for the patient because that always falls on the doctor. They're not able to prescribe medication. They're not able to request scans with ionizing radiation. These are things that only doctors can do and yet our salaries are the same. If not less, make this make sense. Again, I don't have anything against PAs. I've worked with quite a lot of PAs during my time as a doctor for the last year and a half and they're all fantastic. A lot of them are incredibly knowledgeable, well-skilled, smart, motivated, et cetera just like a lot of the doctors but we don't do the same job. We don't carry the same responsibility and we don't have the same set of skills and to equate them or make them the same and use PAs to replace doctors in SHO rota gaps or even Regisvar rota gaps as it's come out recently on Twitter is absolutely insane. From a medical legal point of view, putting someone who's not a doctor in the position of a doctor to diagnose and treat patients is just ludicrous and to then pay them more than the doctors who are supposed to be doing that job is really, really demoralizing. The pay for UK doctors is abysmal compared to other First World country standards. We've got Australia far, far ahead and then Canada and the US light years ahead with significantly massive pay bumps in comparison to that of the UK. So why are UK doctors paid so little? I was recently in New York visiting a couple of friends for about 10 days just for vacation and I met a lot of dentists and doctors in my time there and the first thing they would say to me when I told them I was a doctor in the UK is that doctors are paid really bad in the UK, right? It was literally the first thing that came out of their mouth. It's like a joke in the medical fields across the world about how badly doctors are paid in the UK. It's just so, so, so frustrating and this is only a small part of the bigger picture. I'm speaking about healthcare pay because I'm a doctor and that's what I care most about but public sector pay in the UK has taken a significant hit in the last decade and then here's a nice table explaining how much junior doctor pay has been cut since 2008, 2009, which is 26% which is unbelievable and shocking to even think about. You're taking some of the brightest and smartest and most motivated people in the country after years and years of studying for me personally, almost a decade and you're paying them a starting salary of 29,000 pounds the average salary in the UK. So joke and then what bothers me the most is that in the UK the kind of path to success or financial freedom isn't even enticing. It's not even like we're working towards some light at the end of the tunnel. If you've watched this channel for any period of time you know how much of a motivated and hardworking person I am. I'm all for working very, very hard in your initial years of a job, grinding it out, making good connections, building up respect, skills, et cetera and then progressing and advancing in your career. That's a completely fine idea for me. I'm very happy with that. I think it should be the case. However, in medicine in the UK what am I really working towards? I have this very difficult, emotionally challenging and stressful life and job which pays me a very meager amount compared to the amount of work and responsibility that we have and this stays the same for about the next eight to 10 years. I'm currently working as an F2 doctor. After F2 I'm gonna start surgical training. That'll be for surgical training one and two and then I'll become a registrar and do ST or specialty training three, four, five, six, seven and eight and then after that I will become a consultant which is the equivalent of an attending in the US which takes four years from after finishing medical school. When I am a consultant in nine years from now bearing in mind I finished medical school last year and a half and I studied for nine years before that. In nine years from now when I become a consultant if I take the fastest possible path to get there which isn't even possible because of training bottlenecks and the difficulties and the small number of positions available, et cetera, et cetera, et cetera. If I was to take the fastest possible path there in nine years from now I would earn 88,000 pounds per year. This is an absolute disgrace. Please explain to me how I'm supposed to live in the UK. Have a family, save for my future and invest in my house, in my stocks and shares, et cetera on this salary in nine years from now. Have a look at this table of my salary over the next eight to nine years before I become a consultant. I'm currently in F2, the average salary depending on the jobs you work is 34,000 pounds. Then it's gonna go to 40, 51, then back down to 40. Apparently, 51 and then 58. How are you meant to raise a family on this salary? How are you meant to enjoy life and have disposable income to spend on entertainment and vacations and fun, whilst also saving for your future, potentially wanting to buy a house, make big investments in assets and things like that on this salary. And this is if I take the shortest possible time to becoming a consultant, which like I said is very much not going to be the case in order to apply two core training programs like I'm applying to next year. A lot of people take a year out and work in a job that is in a particular specialty that they want to do to be more competitive. And then between CT3 and ST1, a lot of people do the same. They take several years out in order to be more competitive to apply to that job. And then between ST8 and being a consultant, a lot of people do PhDs. They do further fellowships, et cetera, before even applying to get into that. So nine years really is the bare, bare minimum. I predict if I stay here, this will be something like 10 to 12 years. How, like, this makes no sense to me. All of our colleagues who studied in finance, banking, investment, computer science, literally anything, those working in social media and advertising, you know, we've got friends doing everything and they all earn more than this. And they work in office jobs. Office jobs are important. Office jobs have their own set of difficulties and hardship, et cetera. But being a doctor is different. And I will die on this hill. The amount of emotional and physical stress that we go through and the responsibility that we hold taking care of other people is so immense. It is really hard to describe to someone not in the medical field. And to think that we're not paid proportionately for that work is really, really demoralizing. And you know, there's always gonna be people who say, being a doctor is a vocation. Being a doctor is something you do for other people. It's not about the money, et cetera, et cetera. And I think that's a really bad way to look at this. Yes, a lot of what we do is for other people and that's why we love the job and that's why we got into this job to begin with. But we also need to be paid appropriately. We need to be rewarded for that stress and that effort that we put in. A lot of doctors become incredibly burned out because of how hard and how difficult the job is. And you don't have the financial renumeration or satisfaction to kind of balance out that difficulty. Talking to a lot of my senior colleagues, even those just a few years ahead of me, but also registrars and consultants, they keep telling us about how many people have left the UK and have gone to work in Australia and New Zealand or have even left the medical field entirely and are working in other industries and sectors because of the bad working conditions and the bad pain. Personally, from my own cohort of students that I went to medical school with, a very significant amount of them are no longer working in medicine or are planning to leave as soon as they can or move to another country to practice medicine elsewhere. And I don't blame them one bit. Look at this article in the BMJ that was a survey done back in 2022. They found that one third of UK doctors are planning to leave and work in another country within the next 12 months. One third. Can you imagine losing one third of your country's doctors? I mean, it's absurd. And the UK government is doing an absolutely horrible job of fixing this problem. What they're doing is bringing in doctors from abroad who are happy and willing to work in this pain conditions, only because their relative, respective pain conditions back home where they've come from is even worse, which doesn't make this a good solution. It's just better than what they had before. The UK government is doing a horrible job at trying to fix this problem. We've got doctors leaving in massive, massive numbers and what they're trying to do is make receptionists at GP's triage patient calls that come in through the front door. They're trying to make pharmacists able to do clinical and physical exams so they can then prescribe medications. They're trying to use PAs and HCPs to try and fill in the gaps and roles of doctors because of the understaffing and the poor rota staffing. So they're just trying to fill the gaps with people who are not doctors and making them do the doctor's job, despite having nowhere near the same level of training, clinical knowledge or experience. Instead of doing the one thing that they actually need to do, which is retain their existing doctor population, they need to make better work environments for them and pay them better so that they're happy and willing to stay instead of leaving in large, large numbers. They need to help fix the bottlenecks in medical training that we have when we're applying for specialty training in surgery, in anesthesiology, in resp, in cardio, in whatever. They need to increase the number of spaces available for those doctors, not increase medical student numbers at the beginning of this entire process. What is happening to the medical profession in the UK I think is an absolute disgrace. And I haven't even touched on, you know, comparing our industry to others where people in equivalent number of years after university will be making so much more money. Those studying, you know, finance, investment, banking, computer science, they leave university and make 80 to 100,000 pounds plus is their first job out of university with significantly less time spent in school, in education and training, et cetera. And in my opinion, a significantly less emotional and physically stressful job. On top of, of course, all of the perks that come along with working for a big private corporation, things like healthcare insurance, dental insurance, annual retreats, corporate away days, training and investment in your own skills and profession, summer and Christmas parties, access to the gym, sleeping pods, you know, game rooms, whatever you name it. Okay, so I've gone on a big, pretty passionate rant about pay and this job. And I'm sure, you know, some of you are watching this video and you're saying, well, if all these other jobs make so much money and you care so much about money, why don't you go and do that job? The thing is, I actually want to be a doctor. I want to be a surgeon and I want my profession to be medicine. That is who and what I want to be in this life. This is my calling. I love my job. I can't possibly imagine myself doing anything else. And I feel so incredibly privileged to do what I do when I'm in the hospital. I come home and I know that I've done good. I know that I've impacted people in a meaningful way and that I have sometimes very much made a very significant change in their life. I'm proud of my work and I cannot wait to be a surgeon, but I deserve to be appropriately paid for the work that I do and the responsibility that I take on. That is the bottom line. And so does everyone else working in healthcare. Nurses, physicians, associates, healthcare assistants, occupational therapists, scrub nurses, we all deserve above average pay because we don't do an average job. We do more and we deserve better. Given that the NHS is a public service here in the UK, the UK government needs to do better. The last thing I want to say about this chapter in poor pay is that I'm inevitably going to get a bunch of comments which say something along the lines of NASA, you're clearly in medicine for the wrong reasons, you're only doing it for the money, clearly you care so much about money, that's not what medicine is about, blah, blah, blah, blah. I am financially very comfortable. I currently earn more money from this YouTube channel and it's surrounding entrepreneurial endeavors that I will in 10 years from now working as a doctor in the UK. I do not need this job in any sense of the word from a financial point of view. I work as a doctor because I love this job and I genuinely cannot wait to be a surgeon and the best possible surgeon that I can be and I will be that surgeon. It just might take many, many years from now. I just want to be adequately paid for the work that I do end of rent. One of the more difficult things that I've found about being a doctor is that it's not only the job itself which is difficult, it's also about all the additional and surrounding things that you have to do on top of it. For example, you remember that hectic work schedule that I was talking about, right? So outside of those hours, we're also somehow expected to keep up a number of things. So we need to keep up a medical portfolio where we have to reflect on our practice, demonstrate our competency to practice medicine and do things like performing teaching to more junior doctors or medical students. On top of that, we need to be involved in research projects, so things like audits in the hospital or quality improvement projects or actual research that we then need to try and publish or present at conferences either nationally, regionally or internationally. We need to attend other conferences. We need to sign up for courses in our own time to keep our skills up to date and learn new skills. We need to study for and take very big, difficult exams which take months and months to study for. All of this in our spare time, all of this unpaid for by our company, by our boss, by our HHS and all unaccounted for hours. These are significant hours to be putting in to a very hectic and already busy rota. So like I said, I'm applying to core surgical training and in order to apply to core surgical training, I've needed to do so many hours of teaching throughout the year. I've needed to complete audits and clinical projects and research. I need to study for and take an upcoming exam which I have to pay for out of my own pocket. We're talking hundreds of pounds on exams and courses and skills just to be able to apply for and progress in my own career. I have friends working in law and investment banking and finance and when they want to learn a new skill and take a course, the company pays for that. When they need to study for an exam, they get given time off. You know, these are all such basic things that you would expect, but in the NHS, we just have to do this by ourselves in our own time and pay for it out of our own pocket and it's required for the job. This isn't an extra curricular thing that I want to do just for fun or to boost my own skills. It's just required to be a doctor and to progress in this career path. And then the exams are the biggest thing that gets me. You know, we have to pay thousands of pounds in fees to write exams and then spend tens, if not hundreds of hours studying for those exams after work, on the weekends, on our annual leave and our days off, just to be able to progress in our career. I've just finished a set of night shifts over the weekend and in my rest days that are lawfully given to me in order to rest after a set of nights, I'm going in to spend extra time in theater so that I can increase the surgical experience that I have in order to have a stronger application for my core surgical training application. These are the types of sacrifices that we make. We take annual leave just to be able to prepare for exams or we take annual leave just to be able to attend conferences that we otherwise would not be given the opportunity to. This is exhausting and it rubs me of my time. It rubs me of time with my family and with my friends. And it's just, it's so difficult to keep up with all these things on top of the already very demanding job. So I've shared a lot in this video and I've let out a lot of personal feelings and grievances that I have with this job of being a doctor. This video has definitely been more on the kind of negative side than a lot of my videos usually are when talking about medicine. But I think it's really important that we talk about these things as doctors, especially for high school students aspiring to become doctors or people in medical school who are going to be doctors soon, knowing these realities of the job and preparing for them socially, emotionally, financially, et cetera. I think it's really, really important. Information is key. Information is power. And if you know all these things, then you can prepare for them or make decisions for or against them as you wish and as fits your life. Like I've said a thousand times before, and this isn't only going to be true of me personally. It's true for a lot of people who are working as doctors here in the UK. We love our jobs. We genuinely enjoy what we do and we get a lot of personal satisfaction and happiness out of doing this job. I know I certainly do. It's just the surrounding factors around the medicine part. Making things really difficult sometimes. And that's what I wanted to share in this video so that people were aware of these surrounding factors that can make the existing very lovely and beautiful job very, very difficult. Anyways, thank you so much for watching this video. I hope that you learned something new, whether you're a member of the public who's not in medicine or if you're a medical student or maybe you are a doctor and you either agree or disagree with a lot of the points that I've made. Honestly, I would love to hear from everyone in the comments down below regardless of where you are in your life or what job you work in. It would be interesting to see if other people share similar opinions. But anyways, thank you so much for watching and I'll see you in the next one. Peace.