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Rapid response to:

Opinion Dissecting Health

Scarlett McNally: Renaming junior doctors—to improve value, respect, and patient safety

BMJ 2023; 381 doi: (Published 10 May 2023) Cite this as: BMJ 2023;381:p999

Rapid Response:

Re: Scarlett McNally: Renaming junior doctors—to improve value, respect, and patient safety

Dear Editor,

Scarlett McNally’s article (McNally, S. Brit Med J 2023; 231. It’s time to rename junior doctors) has much to commend it. I feel that the term “junior doctor” is, if not quite pejorative, slightly undermining. She also indicates that 62% of such doctors are over 30 years of age. We are often compared to the aviation industry; would we be happy to board a plane flown by a “junior pilot”? My point is that the terms junior doctor or junior pilot do not impart the requisite recognition of many years of hard work, knowledge, sacrifice, and professionalism.

There are too many titles for doctors in the UK. McNally advocates the terms Foundation Year, SHO, and Registrar for doctors in training grades.

Senior House Officer (SHO) and Registrar were previously used terms for doctors in training, and were superseded. SHO was changed to Core Trainee in 2005 following Modernising Medical Careers, and Registrar was changed into Specialist Registrar, and subsequently Specialist Trainee. The change from Registrar followed the Calman report, in 1996.

The easy understanding of the seniorities, and ubiquitous use, mean that these terms are still used widely, colloquially, by patients and staff. Some of the staff, indeed some of the doctors, were not even born when the term registrar was abolished. That they continue to use it, a full generation after its anticipated demise, speaks to its clarity and popularity. I would support a return to the use of the terms SHO and Registrar.

Competing interests: No competing interests

25 May 2023
Gary C Cousin
Oral and Maxillofacial Surgeon
East Lancashire Hospitals Teaching Trust
Haslingden Road, Blackburn BB2 3HH