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As part of your Medicine interview preparation, you need to understand the new Junior Doctor contract and what this means for you. This guide includes everything you need to know about this interview hot topic, with tips on how to discuss the Junior Doctor contract at interview.

What Is The Junior Doctor Contract?

The Junior Doctor Contract is the contract of employment for all NHS Junior Doctors, outlining pay scales and other details. The government tried to update this for 2016, but it sparked a bitter dispute between them and the BMA.

In January 2020, the amended Junior Doctor contract was accepted by the BMA. You can read more about this on the BMA website.

The Controversy

The controversy around the Junior Doctor contract began in 2013 when the Department of Health shared its proposals. It said the updates would make pay fairer, and wanted to spread emergency and elective services across seven days a week – but junior Doctors felt the contract was risking patient safety and was unfair to them. The Guardian has a detailed overview of the issues

The Old Junior Doctor Contract

In the old contract, Junior Doctors were paid a standard rate for shifts where the hours fell between 7am and 7pm on Mondays to Fridays. If a FY1 Doctor were to work these standard hours, they would have earned a basic salary of £22,862. This basic salary would go up as the doctor progressed through their training, and their time served increased.

However, Junior Doctors are also required to do on-call shifts outside of sociable hours. This earned an extra supplement known as banding, which could add an additional 40 to 50% to their basic salary.

The Proposed Pay Changes

The changes to the Junior Doctor Contract effectively increased basic salary but drastically reduced the supplements for on-call shifts outside of sociable hours – effectively meaning they were being paid less. The Guardian explained what the proposals meant for pay

Safety Concerns

Junior Doctors were also concerned that the contract would increase stress, tiredness and burnout among their peers, and that patient care will suffer as a result. The increase in antisocial hours was also not reflected in an increase in pay.

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The Junior Doctor Strike

In November 2015, 98% of Junior Doctors voted to reject the contract, and in favour of industrial action. This lead to four Junior Doctor strikes between January and March the following year. Each of the four strikes lasted 24-48 hours on 12 January; 10 February; 9-10 March; and 26-27 April.

Key things to know:

Updates To The Junior Doctor Contract

In 2018 the Junior Doctor Contract was reviewed and updated in a few key areas – however, the BMA still had issues surrounding out-of-hours pay and less than full-time training.

The chair and deputy chair of the Junior Doctor Committee (JDC) had regular meetings with NHS Employers to discuss and resolve issues identified by BMA members concerning the new contract. At the end of May 2019, negotiations over improvements to the 2016 junior doctor contract concluded.

How Is The New Contract Different?

The new Junior Doctor Contract will bring a £90 million investment over the next four years. The BMA has a document comparing the 2016 Contract with the latest version.

Junior Doctor Interview Questions

Some of your interview questions may ask you how much you know about the Junior Doctor Contract, as a way of probing your depth of interest or knowledge of the topic. You may also be asked specific questions about life as a Junior Doctor, for the same reasons.

Example question: How do you think Junior Doctors cope with stress in the workplace?

When you answer this Junior Doctor question, you should keep in mind that the mental health and wellbeing of staff is becoming increasingly important in the NHS. This is a good chance to demonstrate your understanding of the common pressures a Doctor may face during their work. You may know this through work experience or your wider reading- and you should be able to demonstrate an awareness of strategies for coping with pressure and stress.

Tips for answering:

  • Explain why Junior Doctors may be experiencing stress during their work
  • Discuss the many different types of stress encountered, for example working antisocial hours, dealing with psychologically and mentally challenging situations, balancing a career with your personal life, studying for postgraduate exams and having a fear of making a mistake
  • Demonstrate how you’ve arrived at your examples. Was this first-hand through work experience or talking to Junior Doctors? Or was it through additional reading, watching documentaries etc.?
  • Talk about how you’ve seen or read about Doctors dealing with these stressful work situations, such as creating job lists, delegating tasks to different team members and asking for help when they recognise a problem out of their expertise
  • Consider how doctors relax outside of the work environment, for example through sports, socialising and talking with friends
  • Acknowledge how important it is to talk about stressful situations, such as an emotionally difficult case at work. This prevents people from bottling up their emotions, and by talking with other Doctors they are speaking with those who truly understand their situation
  • If appropriate, link what you’ve seen with your own personal examples of managing stress.

Negative Answer Traits / Common Mistakes

  • If you haven’t explored the career much or have little work experience, you may struggle with answering this question. You should attempt to draw from your own personal experiences of dealing with stress and relate strategies you have found successful
  • Although you should focus on the strategies for managing stress, you should not miss out the first crucial step – a Junior Doctor needs to be able to acknowledge when they are stressed, to begin with
  • Don’t over or underplay the stress involved with being a Doctor. You want to ensure a balanced and realistic insight into the stresses involved.
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