Preface

It seems that every new edition of this book has arrived fresh on the tail of some major change impacting the training and lives of junior doctors in the NHS. Previous new appointments into the Foundation Programme had to contend with the traumas of the introduction of ‘Modernising Medical Careers’. More recently, we have seen the treatment of junior doctors reach the national media once more with the new junior doctors’ contract and the ensuing, unprecedented industrial relations dispute of 2015–2016. If there is a theme, beyond the constant upheaval that our junior doctors are being subjected to, it is the increasing void between those delivering healthcare on the ‘shop floor’ and those planning what is best for the health service, often based upon misinformation and misunderstanding. In a landscape where a Secretary of State for Health so wilfully misquotes data as to lead to questions regarding his honesty and his intelligence, what message of hope can we send to newly appointed junior doctors? And as we wrote in a previous preface, through all of this turbulence, the fact remains that the leap from being a final year medical student to a junior doctor remains immense. No matter what elements may be introduced to final year curricula, or to Foundation Programme inductions, the psychological and professional gear-shift is a change that many feel unprepared for. Overnight the new doctor inherits huge responsibility, an incessantly active bleep, and an inflexible working rota.

But something else happens, overnight. The new doctor also becomes a valued member of the medical team, someone who patients look to for help and someone with the capacity to provide that help to both patients and their relatives. Despite changes in training structure, the new doctor has the potential and flexibility to learn and shape a career in just about any area of medicine they wish to pursue. And if the assault of politicians might well distress some, take solace in over two decades of UK polling data, showing doctors as representing the profession consistently rated highest for trustworthiness, with politicians languishing consistently at the very opposite end of the spectrum.

Nevertheless, such is the burden that comes with the new professional status, that nothing can make the transition that a student doctor must go through easy. At the very least, we hope that this book can act as a guide, a manager of expectations, but above all else, as a companion on this difficult journey. Carry the book with you. Turn to it when you feel most exposed or most worried. We have tried to make sure that, whatever the situation, there will be at least something that you can read and use to start you off along the right path. And if there isn’t? Don’t panic—make sure you have spoken with someone senior, and take heed of the advice on p. xxviii. Finally, when the dust has settled, please take the time to let us know and to help us continue to improve this book by sending comments and suggestions to: ohfp.uk@oup.com

TR, 2017