Viewpoint: Deterred by the doctor's salary?
Where would you want the brightest people in the country to work? Would you have them making you money as stockbrokers; defending you in court as lawyers; writing your next headline as journalists; or would you have them saving lives as doctors? Most people would rank their health as one of the most important aspects of their lives, but is medicine financially attractive enough to entice the cream of the crop? I am not sure. In financial terms medicine might not be the best choice for the bright young future of tomorrow.
A UK junior doctor's salary begins at £ 20,741 (€ 29,698; $42,127) in England for 2006-7, according to the BMA (www.bma.org.uk/ap.nsf/Content/ddrbfactcard0607). In comparison, the median starting salary for a graduate in 2006 is £23,136, according to a recent survey of more than 230 of the United Kingdom's leading graduate employers (www.agr.org.uk/news/agr_in_the_news/id.55.html). That is nearly £2500 more than a medic. To make matters worse the medical degree is long and the extra time studying compared with other graduates means more debt at the end. Therefore, junior doctors potentially lose out twice; they have more debt and earn less.
This is not to say that every graduate will get a job or earn more than a doctor, but medicine is certainly not the most attractive choice financially for top school leavers. For example, graduates who work as fund managers or investment bankers earn a median salary of £36,000 according to this survey.
Obviously this is not the whole story. People do not choose careers based purely on starting salary, and medicine has good prospects for salary rises as you work up the ladder, but starting salary is certainly an aspect that people look at. Having said that, there are always multitalented people who are capable of doing whatever career they please, and it would be a shame for these people to discard medicine because of starting salary alone. Regardless of this, medicine can be a rewarding career, and there are many reasons to choose it, but it is a shame to give people a reason not to choose medicine.
So when top school leavers realise that you can earn more money, study for less time, have less debt, work in a plush environment, and have a company car by becoming an investment banker instead of a doctor, let us hope that the lure of medicine draws them towards saving lives instead of making money. This is not a cry for doctors to be paid more money, but it stands to reason that as a society we want the best people to become doctors, and medicine should be made as attractive as possible.
Competing interests: None declared.
Provenance and peer review: Not commissioned; externally peer reviewed.
Brendan Spooner, fourth year medical student, University of Birmingham
Email: bbs362@bham.ac.uk
Student BMJ 2007;15:383-426 November ISSN 0966-6494
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REVIEWS
Viewpoint: Deterred by the doctor's salary?
( Brendan Spooner - November 2007)
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Adrian Jennings
( November 26th, 2007)
Anaesthetic ST2, University Hospital, Birmingham ajennings@doctors.org.uk
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Spooner is right to be concerned that the medical salary is not competitive compared to 'City' jobs, particularly when balanced against the expense and duration of training.
Unfortunately, things do not improve after qualification. Study leave budgets have been consistently reduced in recent years, while the requirement to attend training courses to buff one's CV has increased. Postgraduate exams cost £1000-£1500 each, even if papers are passed first time. The consultant exit exams of the future are likely to be even more costly.
There are additional costs to the hospital medic as rotations tend to involve expensive commutes. Several geographical relocations with incurred house buying/selling fees may be required to obtain the illusive consultant post.
Doctor's salaries are likely to fall in the next few years as the 40-hour week comes into force and jobs are rebanded. However, the cost of training will remain unchanged, reducing further net earnings.
A governmental review of these escalating fees may be required to keep a career in medicine attractive: tax relief would be a good start.
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REVIEWS
Viewpoint: Deterred by the doctor's salary?
( Brendan Spooner - November 2007)
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Sean Ninan
( November 24th, 2007)
FY2, Dewsbury and District Hospital sean9n@hotmail.com
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There are many reasons to choose a career in medicine. In my brief career as a junior doctor, I have done more good than my peers in law and investment banking may manage in a lifetime. There are days when I have come home exhilarated at the new procedure I performed or an intervention that has led to a positive outcome for a patient. While some patients may prove demanding, many are very appreciative of the work that you do.
And it's interesting - diagnostic challenges and therapeutic conundrums engage your mind to a degree which few professions can match.
I can't pretend that financial reward isn't an issue for myself or my peers but I can reassure Miss Spooner that the starting salary for junior doctors is actually around £30,000 (nearer £32,000 in my case), well above the median graduate wage that she quotes. And she might like to consider that there are few routes to easy money. My girlfriend and my brother are hotshot lawyers with top firms who earn around the same as me (albeit with steeper rises to look forward to) but do boring jobs and work much, much longer hours than doctors do.
It's not so bad, honestly!
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REVIEWS
Viewpoint: Deterred by the doctor's salary?
( Brendan Spooner - November 2007)
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David King
( November 2nd, 2007)
FY1 Doctor, St James' Hospital Leeds davidanthonyking@gmail.com
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As a recently qualified doctor, I am happy to reassure Brendan Spooner that the financial situation for medical graduates is not quite as bleak as he portrays in his article "Deterred by the doctor's salary". It is true that that the basic starting salary for FY1 doctors is £20,741. However, this does not take into account "banding", which, depending on how many hours you work, pushes your annual salary much higher.
For example, as I am contracted to periodically work nights, weekends and long days my basic pay is increased by two-thirds to £31,500 a year. The hospital also provides my accommodation free of charge, with no heating, electricity or council tax bills. After tax this leaves me with a disposable income of around £1600 a month. I am sure even the lawyers, journalists and stockbrokers, of whom Mr Spooner seems so envious, would be quite pleased if they had this much to spend in their first job.
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