This isn't a satisfying 'I quit my job and here's the message chain' post I'm afraid, but rather a post I'm making to commemorate finally making a decision for myself in a suffocating and abusive system. It does have some examples of crappy work environments at the very least.
I love the NHS, the UK's national healthcare service. It provides free healthcare at point of use for everything you could need, and we honestly don't pay all that much more in tax for the peace of mind it gives.
But, I finally hit my breaking point. The NHS values a linear, upwards progression system in medicine that is great if you want your life to be predictable and safe, but unfortunately (as with other medical systems), its layered systems breed a hierarchy, as well as abuse that you're just expected to put up with. I'm convinced it thrives on a sunk cost fallacy of assuming you'll go the whole way despite the bullshit, because 'that's just how medicine is'.
I've been in academia for a decade. Med school took me longer than most since I've always struggled with mental health issues so in a way me quitting was predictable, since medicine thrives on type A personalities who can deal with the abuse/long hours/stress etc. This unfortunately means that any disabled students that do quit never have the opportunity to effect real change where it's needed, and it contributes to an INCREDIBLY ableist culture for both doctors and patients, with people contributing to the same bullying and expectations you'll just 'put up with' the uncaring system because 'that's what they did/they had it worse'. Additionally the idea that exhaustion is a metric for a job well done, not something to be avoided but to be expected.
It's definitely better than it was. But it definitely isn't right. To reward anyone who's stuck with me this long, here are a few of the things I've experienced contributing to a crappy work atmosphere, that I'm dearly hoping won't be as rife in other areas of employment:
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Supervisors simply not showing up for scheduled, mandatory, one-on-one meetings because they forget/can't be bothered, without telling me (it would be one thing if they got busy with a patient but that was rarely the case)
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Inadequate training with an emphasis on personal responsibility to keep up to date with all areas of patient safety, so that if something goes wrong your supervisors can try to shirk blame onto the most junior person there
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Senior doctors shouting/swearing at/belittling juniors, both in private and in front of colleagues/patients
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Being reprimanded for reporting the frequent times you get there early/stay several hours late due to poor staffing/managers telling you just to work more efficiently rather than providing adequate staffing (though to be fair I assume this happens everywhere)
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Being unofficially expected to do jobs above your pay grade at the expense of patient safety – this is a big one. We're expected to work 'only within our competency levels', but are also frequently challenged to step out of our comfort zones. Should you draw a line in the sand and dare to ask a senior to help with an area outside your expertise you get labelled as incompetent or cowardly.
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Getting shamed for taking sick days. Again I know this happens elsewhere, but in a service that places an emphasis on making sure you tackle burnout (or else it's your fault for not practicing self-care), you sure do feel like shit for calling in sick, especially since the juniors tend to be the linchpin on the wards. After all, if you're not there to do bloods/arrange scans these don't get done. And if you're not there to take notes for the seniors who else will? Them?! They're FAR too important to ever write their own notes!
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Similar to previous ones but – getting taken advantage of, by everyone. The shit jobs always make their way to the lowest rung, and you already have a hundred other shit jobs to do, but your seniors etc don't see that. All they see is a junior who's unable to do the tasks they've been given by you, unaware that approximately 100 bleeps and calls per minute from other staff members are coming through, meaning there's never enough time to do everything in the allotted time, so you stay late to catch up, get burnout, and get scolded for not being more efficient. Especially if you're the only junior in a specialty, because your colleagues are absent/on-call/on study/elsewhere/non-existent and your immediate seniors are busy doing whatever they need/want to do (e.g. In theatre to get their surgery hours/on study for their unending exams). Don't be surprised if you go to a hospital and get seen by a junior doctor who is sometimes the only point of contact for that specialty for the entire hospital on certain days, doing all the legwork to ensure that the 15+ inpatients on your ward all have their correct meds, prophylaxis, notes, scans, bloods, referrals etc etc done. All while remembering to self-care, reassure the patients with a calm demeanour, address complaints/concerns, explain procedures, chase sign-offs, study for exams, study to keep up to date with your current specialty, replace cannulas/catheters etc because the nurses are also incredibly overworked and understaffed, maintain a social life/hobbies/relationship etc etc etc etc
Obviously there are lovely seniors. Our colleagues are generally stars and the nurses and pharmacists have saved my ass more times than I can count. There are also shitty, entitled junior doctors, and maybe I'm also not as good as some of my colleagues. And maybe I'll get a culture shock about the state of the job market under capitalism when I realise this is all true of other jobs too.
But at least in those other jobs I won't have the stress of worrying about accidentally killing someone, or being sued because I was too tired and got a dosage wrong. I really wanted to make it through and effect change from a position of authority, but there comes a point where you have to put yourself first. I'm proud that I'm saying enough is enough for me, and I'll see what else the future holds 🙂