Letters Leaked report on seven day NHS

Government’s lack of knowledge of how medical hierarchy is structured

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1331 (Published 08 March 2016) Cite this as: BMJ 2016;352:i1331
  1. Alistair J Millar, anaesthetics specialist trainee year 3
  1. Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford M6 8HD, UK
  1. alistairmillar{at}doctors.org.uk

I was surprised by the terminology used in Torjesen’s article on the leaked report about seven day services.1

As all who are in any way associated with medical training in the UK know, the current contract for junior doctors did away with the terms “registrar,” “house officer,” and “senior house officer” in favour of job titles that more accurately reflect our level of experience. The term “junior doctor” now encompasses all doctors who are not in post certificate of completion of training or associate specialist roles, from foundation year 1 trainees to specialist trainee year 7 grades, as well as non-training grades of equivalent responsibility.

I note that the leaked information from the Department of Health continues to use these out of date terms. It amazes me that a governmental organisation with oversight of healthcare provision has so little knowledge of how the medical hierarchy is structured. Parallels might naturally be drawn with the English secretary of state for health’s recent reference to paramedics as “ambulance drivers.”

I would be grateful if the editorialists could tell me whether they too were surprised at such outmoded vocabulary, and whether any steps have been taken to correct our governmental overseers.


  • Competing interests: None declared.


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