#JuniorContracts - #NotFairNotSafe: We need your support!

by Roshana Mehdian

@RoshanaMN

11/11/2015: Junior Doctor Contracts - Where are we now?

A lot has happened since I last wrote about the threatened imposition of a junior doctors contract in the UK. Opposition has been so widespread that we are being covered in one form or another in the media almost daily. Despite the uproar and the near unanimous condemnation of this contact; our government plans to press on with its implementation.

We are now at a stage where the British Medical Association, our union, is balloting for strike action, with results expected in the coming weeks.

Other developments:

• A protest rally in London drew 20000 junior doctors and supporters calling for the halting of this contract imposition, this was followed by protests in cities up and down the UK

• The shadow health secretary Heidi Alexander announced her condemnation of the contract
• The Conservative party’s own member of parliament and Chair of the Parliamentary Health select Committee rejected this contract in its current form
• Ireland, Wales and Scotland have all rejected the use of this contract for their doctors
• Letters of support from thousands of consultants and GPs have been written to junior doctors and to the health secretary advising him against this unsafe contract imposition
• Our Royal Colleges, in an unprecedented step, have written to the health secretary advising him not to impose this contract
• Press heavily allied to our Health Secretary has now started sensationalist smear campaigns against visible figures in the junior doctor movement including the chair of the BMA and myself

At this time, whilst we ballot, I would ask for your support. Everyone who reads this contract knows it is unsafe and unfair. The voice has been unanimous: ‘STOP!’ they say. Our government won’t listen.

10/3/2016
As a female surgeon I followed the #ILookLikeASurgeon campaign with much excitement; what a worthy and relevant cause for a global movement! Women being mothers, daughters, sportswomen, fashionistas, etc... AND being surgeons.

I couldn't have known that just a few weeks later, I would be contacting the organisers of this movement to help me demonstrate that the world stands in solidarity with junior doctors in England, as they face the imposition of a contract that threatens patient safety and is unfair to dedicated professionals. I feel that the values imbued in our campaign against this contract – the primacy of patient care, fair treatment and conditions, and an end to gender discrimination – are relevant globally and not just in the UK.

The government has announced it will impose a draconian contract on all junior doctors (any doctor who is not a consultant or general practitioner) in England from August 2016, in the middle of one of the worst retention and recruitment crisis the country has ever seen. Needless to say, with such poor conditions on offer, physicians will vote with their feet, leaving the system even more understaffed and overstretched. This will have a profoundly deleterious effect of patient safety. Those that are left will have to cover the gaps and work unchecked hours. Tired doctors make mistakes. Patient safety is hit again.

Please watch this video for the story to date.

Why is the contract so bad? 

• It removes the mechanism for safeguarding (monitoring hours and fines for overworking) - to ensure doctors are not too tired or overworked and therefore do not harm patients by being so.
• It is even more unsociable than the current contract, further disruption to our private lives will not properly be renumerated - Pay rates for Saturday evening are to be classed the same as working Tuesday morning. Who will provide childcare on Sat evening? Do doctors not deserve to be renumerated for working the most unsociable hours? A hit to morale, our ability to pay our mortgages or look after our children and thus a massive hit to recruitment.
• It is potentially discriminatory - it penalises those who take maternity leave, part time working or researchers; leading to potential financial hardship for women bearing children and discouraging lifesaving research. How can we allow such a step back?

Our union, the British Medical Association, voted to ballot us for industrial action. The government should never have let it come to this, but I'm afraid they only have themselves to blame.

We will fight this - not just for us, but for those on the cutting block next, our nurses, for those across the world facing similar battles, and ultimately for our patients!

I am truly in awe of how, as a profession, we fight through adversity (be it the challenging situations at work, the emotional toll or this latest contract saga) with such resilience. All of us, including our colleagues; nurses, physiotherapists, cleaners, clerks, pharmacists etc...in the healthcare world deserve recognition for what we do, not least a fair and safe contract.

Please stand with us in solidarity this Saturday, October 17th and tweet to make your voice heard!

Sample tweet: "I stand in solidarity with the #ILookLikeASurgeon community and oppose the #NotFairNotSafe #JuniorContract!"

Thanks for reading.

Roshana Mehdian, MBCHB MRCS BMSC PGCEMedEd

Trauma and Orthopaedic Registrar, Concerned Junior Doctor
@RoshanaMN

#ILookLikeASurgeon: Creating an "Upward Spiral of Happiness"

by Paula Ferrada, MD, FACS

@paulaferrada1

While reading an article about finding happiness, I found one reason to always smile: Gratitude! Finding things to be grateful for, stimulates your brain in a way that act almost as a natural antidepressant.  For all foreign graduates reading; you know how hard it is to become a surgeon in the United States and the things we did and still do to become one… so regardless of the situation I am on, I always take time to remind myself: I fought for this position because I wanted with passion to become a surgeon- and I won! This was my choice!  And immediately things are better (or at least better in my brain which is the beginning for improvement in other places).

#ILookLikeASurgeon VCU Department of Surgery thank you all! ‪#‎diversitymatters‬

So I made a list of amazing things our profession offers, things that I am grateful for while being a surgeon.

1. Immediate Gratification: I am a trauma surgeon. Immediate gratification for us is evident- I don’t need mountain biking or bungee jumping to have an adrenaline rush… There is not highest high that saving someone’s life! And this feeling,  is totally irrespective of what anyone else thinks or say- even if no one pats you in the back. There is no better satisfaction than walking out of a room and knowing you did it!

2. Wonderful Patients: The satisfaction to see patients that are grateful, and more importantly that recognize that they are a pivotal part of the team; patients that want to get better, that participate and are engaged in their healthcare. This is for me, especially true after I see them recover from a life threatening event. When after being in the ICU for months they come to clinic with their families, and back to their normal life! I feel privileged to be part of their recovery.  

3. Team building and leaderships skills on the go: I truly believe surgeons since early in our training are placed in situations where leadership skills have no other choice but to develop- sure; it would be amazing if we all had formal training, and I am not saying all surgical training programs will prepare you to be a Chairman or CEO; BUT; you will learn to prioritize, to triage information and clinical urgency, to manage a team, to deliver information to patients and colleagues effectively. For all residents: You know all those extra hours preparing morbidity and mortality conference? They will serve you well as public speaking training; time management and control of your audience. Seize these opportunities!

4. Job security: Surgery in one of the specialties that thus far is irreplaceable. The best cure for cancer in most cases is a complete resection, the best way to stop life threatening bleeding is in most cases,  in the operating room; the only way to control sepsis from bowel necrosis is resection; and I can go on and on with examples. We are blessed to be in a field in which we are needed! And likely for many years to come!

We have so many reasons to stay strong! If we are proud of who we are and what we do- If we maintain a sense of belonging, and camaraderie, we have more chances in moving the walls that prevent us from reaching higher; we have better chances at making this profession even more rewarding and change the things that discourage many talented professionals from staying in it.

These are the reasons I’m grateful to be a surgeon--what are yours?

~Paula Ferrada, MD, FACS

@paulaferrada1