What do junior doctors do? Duties, responsibilities and salary explained as strikes get underway

As of today, Tuesday 11 April, junior doctors in England have officially begun the first day of their four day strike. Unions and the government have been urged to “get on with” negotiations as NHS bosses warned that there is a heightened risk to patient safety during the walkouts.

It has been estimated that some 350,000 appointments and operations have been rescheduled as a result of the action as senior doctors and other medics who are not on strike have been diverted to cover services such as A&E and maternity care.

The NHS Confederation, which represents NHS trusts, urged the government and the British Medical Association to “get on” with negotiations.

“We would emphasise today, once again, the importance of finding a way for these two sides to start to talk to each other because at the moment it feels like their positions are extremely entrenched,” the organisation’s chief executive Matthew Taylor told Good Morning Britain.

“Both sides are going to end up negotiating – we all know that – so I guess we want to say ‘please get on with it’.”

But the BMA warned that unless the government entered talks it would “reserve the right” to conduct more strikes.

Dr Vivek Trivedi, co-chairman of the British Medical Association’s junior doctors’ committee, told the PA news agency: “Strikes are by nature designed to be disruptive, to put pressure on the government to come to the table to ultimately work towards an end to this dispute.

“Where we go forward is, of course, reserving the right for further industrial action if the government doesn’t negotiate with us, but that’s all we want them to do. We just want them to come to the table in an honest and meaningful way. But of course if they don’t, then we would reserve the right for further industrial action.”

What do junior doctors do?

The British Medical Association (BMA) explains that “junior doctors are qualified doctors in clinical training”. It says that junior doctors have “completed a medical degree and foundation training and, across their career, can have up to eight years’ of working experience as a hospital doctor, depending on their speciality, or up to three years of working experience in general practice”. 

Junior doctors work under the supervision of a senior doctor, and they put into motion plans of the more senior doctors. Medical School Expert explains that these duties normally entail “ordering tests or x-rays, referring to other medical teams or discharging the patient home from hospital” and “will also frequently review sick or deteriorating patients”. 

According to the BMA, some common titles for junior doctors include:

• FY1 - foundation year one junior doctor

• FY2 - foundation year two junior doctor

• ST - speciality trainee in a hospital speciality, includes StR (speciality registrar) or have a number signifying the amount of years spent in training, eg ST4 psychiatry

• SpR - speciality registrar in a hospital speciality 

• GPST - speciality registrar in general practice 

• SHO - senior house officer

How much do junior doctors earn?

The NHS Health Careers website says that junior doctors in foundation training will earn a basic salary of £29,384 to £34,012 (from 1 April 2022) and junior doctors who started their specialist training in 2022 will have a basic salary between £40,257 and £53,398. 

“As a doctor in training you’ll earn a basic salary, plus pay for any hours over 40 per week, a 37% enhancement for working nights, a weekend allowance for any work at the weekend, an availability allowance if you are required to be available on-call, and other potential pay premia,” the website says. 

According to the BMA, three junior doctors would make just £66.55 between them for taking out your appendix. The BMA has highlighted the low pay as part of a new advertising campaign in support of the pay dispute by junior doctors in England.

Three doctors with 10, seven and one year of experience would make just £28, £24.46, and £14.09 respectively by performing the potentially life-saving procedure, the trade union for doctors said in a press release.

Dr Jennifer Barclay, a surgical doctor in the North West, said: “There is nothing ‘junior’ about the work I have done as a doctor. I’ll be trying to focus on steady, controlled hand movements, thinking about the next steps and communicating with the rest of the team.

“Meanwhile, my bleep is going off incessantly in the background with more and more patients waiting to be seen as soon as I get out of theatre. For that hour of work that might save a life I can be paid £19.”

She added: “Surely, this life, the training, responsibility, debt and crushing workload is worth more than £19 per hour? I’ll be on the picket line this week because doctors believe that it is.”

Dr Robert Laurenson and Dr Vivek Trivedi, BMA junior doctors committee co-chairs, said: “It is appalling that this Government feels that paying three junior doctors as little as £66.55 between them for work of this value, is justified. This is highly skilled work requiring years of study and intensive training in a high-pressure environment where the job can be a matter of life and death.”

A Department of Health and Social Care spokesperson described the campaign as “misleading” because “it does not take account of the additional earning capacity and pay progression available to junior doctors”.

They continued: “The most experienced junior doctors now have a higher pay band – meaning they received a cumulative increase of 24% over four years. We’ve also increased rates of pay for night shifts and created a permanent £1,000 allowance a year for junior doctors who work less than full time, on top of their usual pay.