Doctors like me pay a heavy price to do our jobs. Pay us what we’re worth

Why be a doctor? Ever since I was a little girl, I have wanted to become a doctor. My mum had been a registered nurse and completed her training at the Royal Alexandra Hospital for Children at Camperdown (now the Children’s Hospital at Westmead) and her stories of those days enthralled me and I always knew that my heart lay with medicine.

I worked hard at school; a public school. I worked even harder at university, travelling four and a half hours each day by public transport to attend classes for my undergraduate degree.

“I always knew that my heart lay with medicine … now I’m exhausted and just burnt out.”Credit: Getty Images

Medicine is now mostly a postgraduate degree. This means that we have completed a minimum of seven years of university study before we can even earn a dime. If we assume that we could have earned an average of $100,000 per year (the average annual full-time salary in Australia), then we are already $700,000 behind, without even calculating the super we would have earned or the cost of our university fees.

But perhaps we earned a little from a part-time job waiting tables, delivering pizzas or packing shelves, so it’s not quite that bad. Instead, we learnt the value of money and how to put a meal together with a tin of tuna and a packet of two-minute noodles.

Then we graduated and entered the hospitals as junior doctors – who are contracted to work 40 hours per week but routinely work much more than this in the form of rostered and unrostered overtime. A junior doctor can legally be rostered to work up to 120 hours per fortnight. This is not a choice – it is mandated by the hospital in which you work based on available staffing levels, and you don’t get to opt out.

Whilst rostered overtime is paid, much of the unrostered overtime undertaken by junior doctors has not been paid, and this became the catalyst for the NSW junior doctors class action, which was settled at mediation for $229.8 million (inclusive of legal and other costs) in favour of junior doctors. Junior doctors had to take the NSW government to court just so they would be paid for the hours that they had worked. Why work unrostered overtime? Because there aren’t enough doctors employed to complete the work and even if it’s your finishing time, if your patient needs urgent clinical review, we will always stay and provide the care that they need and that they deserve.

When it comes to annual leave, I can submit preferences for when I would like to take this, but ultimately it will be pre-allocated by medical administration and I get to take it when they say I can take it, for a maximum of 2 weeks at a time. We also get to submit roster requests but hey, I haven’t spent Mother’s Day with my children for the past five years so I wouldn’t say that they are accommodated all that frequently. Just ask John Hunter medical administration about “marshmallowgate” and what they think of junior doctors – and this is just the tip of the iceberg of how junior doctors are treated in our hospitals. (In January an email was accidentally sent to a junior doctor from Newcastle’s John Hunter Hospital HR department, comparing junior doctors to “marshmallows” – slang for someone who is not strong or confident.)

Having completed my first years in a hospital, I then joined the training program to become a specialist physician, which involves becoming a member of the Royal Australasian College of Physicians (RACP) in order to complete training for a cost of $4067 per year. I must complete three years of basic training and pass a written and clinical exam before I can complete a further three years of advanced training. I must pay RACP $2239 to sit the written exam and $3350 to sit the clinical exam. RACP can also send me anywhere in Australia to sit my clinical exam, and I must pay all travel and accommodation costs out of my own pocket. I have now spent almost $30,000 on college fees, exams, and course preparation fees to try to pass these examinations.

Most candidates spend 12 months preparing for the written exam. Annual leave is spent attending courses and conferences in preparation. Doctors work their rostered hours and then go home and study in their free time. That’s a minimum of two hours each day on days when they are rostered to work, and up to eight hours on their days off. That’s well over 1000 hours of study – and they might not even pass. When they don’t pass, they are all too often told that they are not committed enough. I have now sat these exams multiple times and have failed them multiple times.

As a female doctor, I am often told that I’ve failed because I have children. I reject this notion because I have mostly been a mother in name only for the past three years. I haven’t cooked a meal in over 12 months, I can’t even tell you the names of my children’s class teachers. This isn’t the type of mother I wanted to be, but I don’t know how to get my life back and the truth is, I’m exhausted and just burnt out.

Members of the NSW Australian Salaried Medical Officers’ Federation are on a three-day strike over pay and conditions. On the right, a locum doctor job ad.Credit: Janie Barrett

Between college fees, my Australian Health Practitioner Regulation Agency (AHPRA) registration, medical indemnity insurance and Australian Medical Association fees, I pay $130 per week to be a doctor. Most junior doctors are employed on short-term contracts ranging from 12 months to three years. During this time, you are contracted to a hospital that may second you to another. When this happens, you work away from home, leaving partners, children and friends behind. It’s an isolating time, often requiring you to travel long distances to a place where you don’t know another person. I’ve sat on the floor on many occasions and just cried.

So why do I continue to be a doctor? As I reflect on this, I remember the words of my eldest child. I attended a school assembly where they showcased a video montage in which the children had been asked: “Who inspires you?” Replies such as “Superman” and “my dog” (or rabbit) were the norm.

My daughter bucked the norm and proudly proclaimed, “My mum inspires me because she makes sick people better.” Wise beyond her years. She was right – not that I seek to inspire anyone, but simply because I want to help sick people get better, and that’s why I continue to be a doctor.

Premier Minns, please pay doctors what they are worth. They’re only asking to be treated equally to their colleagues interstate.

Anonymous due to the author’s concerns about repercussions.

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