Medical students’ views on the new junior doctor contract

Coverage of the junior doctor contract proposals has focused on its immediate impact on those in postgraduate training and has overlooked the perspective of medical students—the junior doctors of tomorrow.1

Medical students remain the sole cohort expected to experience the full impact of the contracts, undertaking all future training under the proposed terms. Students currently accrue more debt than ever as a result of the 2012 increase in tuition fees. Current proposals include the removal of maintenance grants, which will disproportionately affect students from low income backgrounds. With only 6.3% of the student body coming from deprived areas, proposed changes will further reduce diversity because a medical profession will not be financially viable for those from poorer backgrounds.2 3

In addition, the removal of pay protection for women on maternity leave could discourage female students from embarking on a career in medicine, exacerbating staff shortages in the future while widening sex inequalities.4 5

International students, who make up 15.7% of all medical students, will effectively be forced to leave the country after recent changes to immigration rules requiring them to reapply for a work visa.6 These changes will lead to the UK becoming a comparatively less appealing destination for higher training, resulting in a retention crisis for locally trained medical students of globally diverse origins.

In recent weeks the number of ongoing seminars discussing options available to graduates to move outside the UK has risen. Dissatisfaction with new proposals has made opportunities abroad attractive for students. In the 10 days after the contracts were confirmed, doctors made 3468 requests for a certificate to practise medicine outside the UK, up from between 20 and 25 requests a day.7

Overall, the contract proposals have alienated medical students and disheartened them regarding their future career paths. The NHS faces its biggest hurdle yet, to maintain its impressive diversity and global nature.