A Reflection on The Junior Doctor Contracts

Naomi Jacks, a doctor now working as a health and wellbeing practitioner, gives her perspective on the effect of the proposed Junior Doctor Contracts.

As the debate continues surrounding junior doctor contracts, I have felt mixed emotions.

One of my thoughts is – wow thank goodness I am out of that at the moment. The second thought that comes simultaneously with the first is – empathy for my poor friends and colleagues.

I can vividly picture them (any of this sound familiar?)

  • on their 10th out of 12 shifts in row updating the patient list with blurry eyes;
  • 3am in A&E and  breaking bad news to a widow;
  • powering through that night shift running from ward to ward managing patients they’ve never met, despite not having eaten or drunk anything in 10 hours;
  • maintaining that physical energy to keep those regular chest compressions going during another cardiac arrest;
  • finding patience and the right communication skills to manage complaints about waiting times;
  • agreeing to stay those extra few hours because the locum night SHO hasn’t turned up yet;
  • trying to maintain a positive work ethic in front of medical students who they know will be them one day.

Meanwhile, making profuse apologies to friends for yet again not being able to make that dinner or birthday party because they are working the third weekend in a row.

I also have that sad, heart breaking feeling when I see sad news about junior doctors. Of course these are the extreme stories, but like my own experiences of depression and being on the verge of ending it all because I saw no way out of a black hole I had gotten into.

I am frightened for this new generation of doctors.

After all the years of study and the debt incurred, they come into a working environment where the way they have been trained to practice medicine safely is just not always possible.

Don’t get me wrong, it is an absolute privilege to be a doctor and we forget how great it is to be able to interact with different people on a daily basis and ultimately in many cases improve people’s lives in one way or the other. I miss this.

Although not a direct contributor to my mental health condition, it was working in a busy A&E department with very difficult working conditions and hours that was the tipping point. I’d have no time to do anything enjoyable whatsoever, and then I’d still go in to work and be told we weren’t working hard enough.

The situation with the current contract is not going to make this any better. There are two issues in my view:

  1. Firstly the actual contract itself – that has its flaws and difficulties and a lot has been said about why this is#NotSafeNotFair.
  2. Secondly is what it tells us about the Government’s attitude towards doctors’.

For many of my colleagues, their resilience, determination and passion for the job is inspiring and many I know will continue to dedicate their lives to their vocation often at the expense of their own health. For others, they are pushing through because they feel this is the only option after spending years studying, and they have no choice but to sign that contract in August.

They feel guilty for having doubts about whether they can sustain this job. They are further faced with a health secretary who is imposing a contract that is even more unsafe and unfair than the current one.

This is what we call the perfect storm.

I encourage any junior doctor who is feeling low, anxious, fearful, confused, stressed to talk to someone about this as soon as possible. This does not mean you have a mental health problem. Hoever, even if you did that would be okay. It also doesn’t mean you need to decide about staying/leaving NHS. This decision can be made later. But it does mean you are at risk of burn out and potentially of developing depression and most importantly you are not alone.

In my current job as a health and wellbeing practitioner, I am giving advice on a daily basis to my clients about how to protect themselves from this situation – spending time with others, keeping active, giving time to others, learning new skills/hobbies, sleeping well, eating well and staying hydrated.

These things seem all very obvious and simple – but can you really say you do all of these? Read this article on 5 ways to take care of yourself.


  • Share how you feel amongst your peers, seniors and trainers . I imagine actually everyone is struggling and as a profession we need to have some transparency around this. We all have a responsibility for each other.
  • Make some goals or PDPs that focus on the things that will help you maintain some balance, some perspective and ultimately continue to do that job you love (or once loved).
  • Prioritise those things now.
  • Don’t lose sight of what is important – YOU. Yes our patients are important and that’s why we do what we do. But we all have one life to lead.

#juniordoctorcontracts #NotSafeNotFair



Check out our blog for more on the junior doctor contracts.

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Sara Sabin

With a solid corporate background, Sara specialises in advising doctors in how to prepare a non-medical CV and how to prepare for a non-medical interview. She is also the Co-Founder of Medic Footprints.