Could junior doctors be the next to strike? It seems that many have had enough, and may very well be joining the record-breaking list of NHS staff who have taken to the picket line. The British Medical Association (BMA) are currently voting on a proposal to undertake a three-day strike in March, with the ballot-box closing on 20th February.

Recent headlines have been dominated by reports of NHS underfunding, staff departures and continued strain from Covid and flu season. In a summary of its grievances, the BMA highlighted “fifteen years of real terms pay cuts for junior doctors in England″, and called the 26% decline in pay since 2008 “staggering and unjustifiable”.

In light of this, what are the concerns of medics about to enter the profession? The current crop of final-year medical students have, after all, experienced their clinical years under unique circumstances, entering the wards for the first time at the peak of the pandemic. We spoke to two medics of the Cambridge cohort to discuss their expectations, opinions and hopes for the future.

Aaron* had nothing but positive things to say about the intellectual challenges of the degree and didn’t even seem phased by pandemic-related disruption to his clinical years.  “You’re going to be doing medicine for your whole career, there will be opportunities to do all these things that you may have missed because of the pandemic,” he said. Despite his admiration for the consultants he has seen in his clinical rotations, he remains certain that he doesn’t want to continue in the field. “You see up close why doctors might complain [...] I constantly speak to doctors who are at a place in their career where they are stagnant.” Ben* echoed this sentiment: “Junior doctors I met while at clinical school paint a grim picture of medicine.”

“At least three quarters of medical students I’ve met while I was in clinical school were considering other careers”

I was slightly surprised at Aaron’s certainty that he wouldn’t want to continue in the profession. His father had trained as a doctor in Nigeria, meaning that he grew up under no illusion of the challenges of the profession, and Aaron had spoken with an almost relentless optimism about his time at university. I asked Aaron if he’d considered alternative careers, and, with the same beaming smile with which he’d described his love of the work, came the surprising reply: “Oh yes. I’m actually actively trying to leave medicine”.

Ben’s anecdotal report was even more bleak: “I’d guess at least three quarters of medical students I’ve met while I was in clinical school were considering other careers”, and mentions the other medic in his graduate house who is sending applications elsewhere. Ben’s desire to leave medicine “comes in waves: when you’ve had a particularly tough shift or are particularly skint you begin to consider alternative careers more earnestly.”

The students’ concerns echo the BMA’s demands – a need to address pay erosion and worsening working conditions – so it was unsurprising that both felt strikes were justified. “The pay just doesn’t reflect the level of responsibility doctors have.” Aaron tells me that just speaking to junior doctors “would convince you it is justified to strike [...] Strikes are so rare, and they are sorely needed.”

Ben consistently prioritised patient care in his assessment of the strikes, stating that “if I were a patient, I would want nurses and paramedics who were well paid, so they were giving me the best care possible”. He added that the junior doctors’ strikes of 2016 had resulted in no excess deaths: “consultants took over the wards [...] data doesn’t show that there’s a patient safety risk.” BMA guidance for striking doctors also emphasises patient safety, directing doctors on shift when the strikes begin to ensure that their patients have been safely transferred to the care of another doctor before leaving work.

Stagnating pay was a major reason for Ben’s support: “As a junior doctor you earn about £14 an hour - the same as I was earning before university when I was working in a shop [...] doctors are dealing with the seriously ill every day. It’s not sustainable for them to be paid less than £20 an hour.” This is not surprising from clinical students whose experience of hospital has been during the pandemic years, when doctors and nurses were physically and emotionally burned-out by the record number of deaths: “There was such an enormous a wave of deaths: doctors who didn’t usually experience many deaths on the ward suddenly had a high volume of patients arriving and dying very rapidly.”

When we asked them whether there was anything Cambridge-specific about their sentiments, they agreed that the “proximity to other people going on to do other interesting things, often at higher salaries” further turned their heads. BMA statistics show that even consultants are looking elsewhere, while four out of ten junior doctors are ready to hang up their surgical scrubs as soon as they find another job. The lure of lucrative alternative careers isn’t new, but the students illustrate it has become greater.

Addenbrooke’s Hospital declined to comment on the junior doctor strike proposals until a verdict had been announced. Like the students we spoke to, the medical profession seems to feel a sense of nervous apprehension about what the future may hold.

*Names have been changed