Alice Barber, Intercalating
TW: bullying, suicide
Earlier this year a series was released based on the book by ex-doctor Adam Kay—This is Going to Hurt (BBC. 2022). Although I’m sure most people have heard of this series by now, the series follows Adam, a trainee obstetrics and gynaecology doctor, as well as younger trainee Shruti as they work on a busy London labour ward (this will contain some spoilers so don’t read on if you haven’t watched yet).
Whilst it was a widely popular show which has had exceptional reviews for its realistic portrayal of the medical profession (Mangan, L. 2022), I think it is important to reflect on some of the more troubling revelations from the show, as well as the impacts that this could have for the many many students and prospective medical students who watched the show alongside the nation.
Issues that it raises
There were many issues raised both directly in the series, and in conversations started by the programme. I will try to address three of the issues—whilst these are not necessarily the most important, they are the issues which made me think the most personally.
Firstly, an issue which was clear from the offset was the ridiculous amount of hours Adam worked, and the effect that this had on his ability to have a personal life. In multiple episodes he was seen being called back into work after going home for the evening, having to leave important personal events in order to do so. He was also seen falling asleep multiple times in the car due to being so exhausted from the hours he worked. Whilst policies have changed since 2006 when the series was set, it is still frequently the case that doctors work long hours, and often have inflexible rotas that mean they struggle to attend important life events—sometimes even their own weddings! (BMA. 2016) Also, although doctors are now required to work no more than an average of 48 hours a week (BMA. 2022), this is still significantly more than what is usually considered full time (35 hours) (UNISON. 2022), and leaves the possibility for longer weeks since it is a yearly average. There is still much that is needed to change with working patterns for doctors, and This Is Going to Hurt highlighted the importance of this.
Another issue raised was that of workplace bullying, and belittling of juniors, in the medical profession. On multiple occasions we see Shruti, the younger junior doctor, being belittled and in some situations bullied by senior staff. A picture was painted of an NHS where juniors should be worried about approaching their seniors rather than comfortable approaching them with their worries. Whilst this is a systemic issue which again, I think has improved since the series was set, most medical students or juniors will still have seen this on the wards in some form. Stemming from what I believe is a sometimes toxic hierarchy and the culture of competition in medical training, the issue of seniors intimidating their juniors still desperately needs addressing.
The final issue I will address is that of doctor’s mental health, and the rapidly increasing precedence of mental illness amongst doctors and medical students. A BMA report on 2019 found that 40% of doctors who responded were suffering from a mental illness, with 90% saying their work contributed to this. 80% were also at risk of burnout—with junior doctors most at risk (BMA. 2019). This is a massive problem which has only been amplified by the covid-19 pandemic. This Is Going to Hurt highlighted this problem with the suicide of Shruti—a moment which I think will stick in the memory of everyone who watched it. What amplifies the distress of this is Shruti’s suicide is not a one of case—doctors are known to be at a much higher risk of suicide, with female doctors being at 2.5-4 times the risk of the general population (Gerada, C. 2018). This issue needs urgently addressing to reduce the risk for doctors and medical students. Not only does there need to be better support for doctors, there also needs to be a drastic change in working conditions for doctors to protect their mental health.
Impact on medical students and prospective medical students
Whilst I am glad that This Is Going To Hurt raised these important issues and highlighted the desperate need for change, I also think it is key to acknowledge the impact that seeing these issues played out on national TV could have on medical students and prospective medical students. Medical students are not oblivious to the challenges that a medical career poses, but we are also not immune to worrying about the future and how we will handle the challenges. Prospective medical students are also not immune to being put off of a career in medicine by only seeing negative portrayals of medicine.
Seeing these challenges dramatised and publicised nationally also amplifies the potential to negatively impact the mindset and worries of medical students and prospective medical students. In order to counteract this negative impact, I therefore think it is so important to also highlight how things are changing and people, like the BMA, are fighting for conditions to be better in the future. It is key that the positives of a career in medicine are publicised just as widely so students can see the full picture.
What should we do now?
The issues shown in This Is Going to Hurt are big issues ingrained in the medical profession. Whilst they are going to take time and effort to change, we need to start discussions to make this happen. These discussions need to happen not only to make change, but also so that students can see that there are not only negatives to a career in medicine, and that there are people who are fighting for change.
In addition to discussions, there are also many campaigns currently fighting for change in working conditions for doctors and medical professionals, such as the Doctors Vote fighting for pay restoration for junior doctors (Doctors Vote. 2022). It is also important that medical students are involved in these discussions and campaigns, not only so that we can be involved in making change for our future careers, but also so we can see that despite the challenges, there is positive change happening that we can contribute to. If, like me, watching This Is Going To Hurt made you want to make positive change in the medical profession, make sure to get involved in organisations such as the BMA, or your medical school council, so you can be involved in making change happen to try to ensure our experiences are different to those of Adam and Shruti.
Support Resources:
- https://youokaydoc.org.uk
- https://www.mindhealthuk.org
- https://www.bma.org.uk/advice-and-support/your-wellbeing/wellbeing-support-services/sources-of-support-for-your-wellbeing
References
BBC. 2022. This Is Going To Hurt. [Online]. [Accessed 29th March 2022]. Available from: https://www.bbc.co.uk/iplayer/episode/p0b6k6kx/this-is-going-to-hurt-series-1-episode-1
BMA. 2016. Twitter: ‘Junior drs are missing their own weddings despite months of notice b/c of poor employment practice’ #junioraction. [Online]. [Accessed 29th March 2022]. Available from: https://twitter.com/thebma/status/686482329636855809
BMA. 2019. Caring for the mental health of the medical workforce. [Online]. [Accessed 29th March 2022]. Available from: https://www.bma.org.uk/media/1365/bma-caring-for-the-mental-health-survey-oct-2019.pdf
BMA. 2022. Doctors and the European Working Time Directive. [Online]. [Accessed 29th March 2022]. Available from: https://www.bma.org.uk/pay-and-contracts/working-hours/european-working-time-directive-ewtd/doctors-and-the-european-working-time-directive
Doctors Vote. 2022. A new era for junior doctor representation. [Online]. [Accessed 29th March 2022]. Available from: https://www.doctorsvote.org
Gerada, C. 2018. Doctors and Suicide. British Journal of General Practice. 68(669), pp168-169.
Mangan, L. 2022. This Is Going To Hurt review – Ben Whishaw stars in a realism-packed adaptation. [Online]. [Accessed 29th March 2022]. Available from: https://www.theguardian.com/tv-and-radio/2022/feb/08/this-is-going-to-hurt-review-ben-whishaw-stars-in-a-realism-packed-adaptation
UNISON. 2022. Part Time Working. [Online]. [Accessed 29th March 2022]. Available from: https://www.unison.org.uk/get-help/knowledge/working-patterns/part-time-working/
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