Intended for healthcare professionals

Feature Junior Doctors

How to fix doctors’ rotas

BMJ 2019; 365 doi: (Published 27 June 2019) Cite this as: BMJ 2019;365:l4367
  1. Emma Wilkinson, freelance journalist
  1. Sheffield, UK
  1. emmalwilkinson{at}

Not being allowed to attend your own wedding is just one example of how inflexible rostering in the NHS contributes to discontent among junior doctors. But there are solutions, finds Emma Wilkinson

Every junior doctor has an example of missing an important family event because of a rota clash. Unsociable shift patterns and long working hours are just part of the job, right? Senior staff members may point out that they had it just as bad, or maybe even worse, before the European Working Time Directive.

Earlier this year the #NHSMeToo campaign highlighted that inflexible rostering is causing many junior doctors to ask themselves whether they want to continue in medicine. Doctors shared stories of being unable to take time off to attend their own wedding. Or to have a honeymoon. Or being denied compassionate leave after miscarriage, stillbirth, or the dieath of a relative.

Many reports, including recommendations from the British Medical Association1 and Health Education England,2 outline how rotas for junior doctors should work—including the need for protected time for training and career development. But the stories from #NHSMeToo showed that some rota coordinators offer little flexibility or make swapping shifts so complicated that it might as well not be an option.

The importance of flexible rotas

Joanna Poole, an anaesthetic registrar in Bristol, began to collect a dossier of mistreatment of young doctors.3 For her, the story of a doctor who left his shift midway through, killed himself, and was not found for two days, led her to say enough. “What has gone wrong for that to happen?” she asks.

Poole is now working with grassroots lobby group the Doctors’ Association UK to collect positive stories that show how junior doctors’ working lives can be improved, under its #CompassionateCulture campaign. The importance of flexible rotas is a recurring theme, …

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