Five minutes with Harrison Carter, chair of the BMA’s medical students committee
As junior doctors resist the government’s plan to impose a new contract in August 2016, Thomas Cassidy interviews Harrison Carter, the chair of the BMA Medical Students Committee, to find out what the impact of the new contract has been on medical students
What are BMA student members most concerned about regarding the new contract?
They are concerned there won’t be an adequate safety mechanism to make sure that hospital trusts won’t overwork them when they qualify. The new contract includes a new “guardian” role, [someone] who is appointed by the trust to determine whether or not hospitals are making doctors work an unsafe number of hours. Essentially, under this new system, what we will have is an employee member of the trust determining if the trust should be fined. They [the trust] would be marking their own homework; why would it be in their interest to fine themselves? We aren’t convinced that this process of self regulation is rigorous enough to identify and change shifts that are unsafe.
There is also a concern around how the definition of a night shift will be changed. Under the new contract, you will have to work for a period of more than three hours between 11 pm and 6 am for it to qualify as a night shift. So, if you worked for 2 hours 59 minutes in that period of time it would not constitute a night shift; a shift could finish at 1.59 am and it would not be considered a night shift. As well as being unfair, this provides a way for trusts to sidestep the cap on doctors working consecutive nights. Another concern is that the new contract incentivises employers to create more non-resident on-call shifts, meaning that junior doctors will be paid less because they are at home and only called when things go wrong.
The new contract will also impact on women in medicine, who make up more than half of the workforce. By scrapping pay progressions during maternity leave, alongside other changes, the government's own Equality Impact Assessment admits the contract will “impact disproportionately on women.” Describing it as “a proportionate means of achieving a legitimate aim,” staggeringly, this is something the government are openly notconcerned about.
What is the mood currently among medical students?
The sad truth is that many members are considering moving away from England to continue their training. Our most recent survey shows that X% of medical students have either seriously considered, or looked at and planned job opportunities outside of England.
The government has pushed junior doctors to breaking point and this has had a trickledown effect on medical students’ morale. It shows just how poor morale is when junior doctors and medical students find themselves having to consider forcing themselves away from their home country to work elsewhere because they can’t do the job that they want to do here.
What is your advice to medical students during these uncertain times?
Firstly, I think it’s important not to forget why we chose to study medicine and that we have a duty to make sure our patients are provided with high quality and safe care. Health secretaries and governments come and go, but most of us commit our lives to the NHS and to our future patients—we should never forget them in this process.
The most important thing you can do is to talk to members of the public about your concerns. It’s also important to reassure people that on days of industrial action there will be consultants providing cover. Students can express their concerns to their MPs, we have details of how they can write to them on the BMA website. It’s also good to engage in the debate on social media.
What do you say to final year students about to start life as foundation year one doctors in August?
We don’t know when this dispute will end—it might be resolved before new foundation year one doctors begin in August, or it might happen after. The worst case scenario would be for the government to not recognise the contribution that junior doctors already make to the NHS and proceed with imposing the contract. The best case scenario would be for the government to suspend the imposition and return to the negotiation table to reach a solution that is best for patients and the future of the NHS.
What we advise students to do is to accept their offers of employment—even if they are accepting a contract they fundamentally disagree with. It is important you go to work and continue the career you have chosen. You’ve worked hard over the past five years so it would be a waste to put it all on ice. Accepting your contract of employment does not in any way mean you agree with or accept the contract, it is simply a reflection that you intend to be a doctor.Thomas Cassidy, final year medical student, University of Bristol and 2016 Student BMJ Scholar
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.