Transcript of interview with Michael D. Cearns (medical student)

This is a full transcript of an interview from October 9th 2015.

Michael D. Cearns
Michael is a medical student in his sixth and final year of training at a London medical school. He will be one of thousands of junior doctors forced to work under the new imposed contract due to come in on 1st August 2016. I started by asking him what his main reason was for wanting to study medicine.

“I think it’s fundamentally a very worthwhile thing to do with your life. You spend your time doing your best for someone who needs your help, and that alone can give you all the satisfaction you could need from a career, I think.It’s also a great balance. It’s a career you can get your teeth into, because it requires plenty of scientific understanding but allows you to develop clinical reasoning skills, to perform procedures, to make decisions that directly affect people’s lives.”

And before you started did you have a specialty in mind?

“I was always rather interested by the brain, as an organ that contains within it everything you feel, do and think – everything that makes you who you are. Diseases that compromise that somehow take something very important away from you. During my time at medical school I’ve kept my mind open in terms of my career choices, though.”

Obviously a lot has happened to the NHS in the 5 + years you’ve been studying. Has what you’ve seen, especially the row over junior doctors contracts ever made you think about changing your mind about your future career?

“I think medicine is the right career choice for me. After spending this much time modelling myself on doctors and learning the art and science of practicing medicine, I find it difficult to picture myself in another career. That’s not to say that I am pleased with the way things have been going in the NHS recently – it’s obviously becoming clear that lots of doctors would consider leaving medicine or working abroad if conditions became too difficult in the UK. For me, the proposed contract would make life very difficult indeed, and it would compromise patient care, but it wouldn’t make me personally want to stop doing medicine.”

Has there been much discussion, either with your fellow students or your lectures, about what has been happening in the NHS?

“There has certainly been a lot of discussion amongst medical students, as it affects us so directly. My colleagues at my stage in training and I will start as junior doctors in August, when the proposed contract would take effect, so it’s generated as much commotion amongst medical students as it has amongst junior doctors, I’d say.”

It’s clear from all the doctors and nurses I know, and yourself that this fight over junior doctors contracts is about care, but there is still a few out there who believe that this is doctors fighting for more money. Have you found yourself trying to defend against this perception?

“At times, and I’ve certainly seen those opinions out there. In my experience, junior doctors rarely put themselves first. Their first priority is always their patients, and that’s why under the reality of the current contract, juniors clock off the rota at 48 hours a week and start their unpaid overtime, which will always be 10 – 20 hours per week at the least. This is out of compassion for their patients who are sick; to a doctor, an extra few hours is a small price to pay for the sake of a patient who is inevitably in a much worse situation and needs their help. The newly proposed contract discredits this ethic, demanding more of junior doctors who are already maximally stretched across a resource-poor service. The result would be lower standards of care across the board – that’s what happens if you make the same number of doctors work longer, tougher hours. The main reason we’re opposing this is that the very patients we are trying to help would suffer under those circumstances. That said, I’m not trying to claim that doctors don’t think about money at all – they’re human and recognise that this contract would have a very serious effect on them financially. I can’t think of a £22,000 a year job that demands such emotionally charged work, unsociable hours and high levels of responsibility as being a junior doctor. A friend of mine works in consultancy, and her manager said to her ‘when a doctor has a bad day, his or her patient dies; when I have a bad day, someone hasn’t given me a PowerPoint on time’. It speaks volumes to me that that came from someone in the financial sector, not from someone in medicine.”

Have you had a chance to see Jeremy Hunt’s recent counter offer to junior doctors sent to Johann Malawalana?

“Yes, I did. The fact that he has responded in this way means junior doctors have put the message across, which I think is a positive step. Ultimately, there has to be fair negotiation to reach a solution. The problem I had with Mr Hunt’s letter was that it didn’t provide concrete proposals – figures, forecasts, estimates. It tried to convey the government’s proposed ambition, but without altering the original proposal enough for it to marry up with that ambition. In other words, it was likely more show than substance. If you’re changing the working conditions of 53,000 people you have to be able to predict what effects that will really have.”

And what did you make of the publishing of deficit figures delayed until after the Tory Party Conference?

“I must admit it seems a bit politically convenient.”

What did you make of the figures? Were you surprised at such a high amount for just a few months?

“Nearly a £1billion is of course a huge deficit for three months – ultimately if services being provided at the moment are to stay as they are, that deficit actually represents under-funding to the tune of £4billion a year. And if you want to increase service provision – especially routine non-urgent services at weekends – you need more funding to do that.”

“An American style health service certainly would concern me a great deal, but I don’t particularly buy into the view that the Tories are trying to systematically dismantle the NHS with the aim of total privatisation. Were that to be the case, I also don’t think the public would stand for it in the long term. For the most part I try to avoid the party politics side to these arguments; accusing politicians of lies and deceit distracts from the main issues and doesn’t advance anyone’s cause a very long way. That of course doesn’t mean I don’t disagree with the Tories’ approach to managing the NHS, and I’m sure many of my friends and colleagues would interpret recent events in the manner you describe.”

A brilliant POV that unfortunately you dont see much now. Politics is distracting from care.

“Thank you – I couldn’t agree more.”

Just one final question: with everything you’ve been through in the last 5 years, and seeing what’s ahead of you, would you still recommend to people taking up medicine as a career?

“That’s a very good question. Some of my colleagues would probably advise against it. These are turbulent times for the NHS, but from where I sit, the thing that gets doctors up in the morning, makes them work the tough hours and the nights, is the patient and the fact that they can help them. That’s more important than the political rhetoric, the salary or any of the rest of it. In that sense, I would still recommend medicine as a career. The immediate future is going to be both challenging and pivotal in determining the future of the NHS as we know it. I hope that by engaging the public, doctors can secure working conditions that keep the public safe and provide them with healthcare free at the point of need. Aneurin Bevan famously said ‘The NHS will lastwpid-screenshot_2015-10-22-21-53-51-1.png as long as there are folk left with the faith to fight for it’. We’re still here.”

You can follow Michael through his Twitter account by clicking on the picture.

One thought on “Transcript of interview with Michael D. Cearns (medical student)

  1. Pingback: Don’t let The Good Ship NHS sink. | stephenpaulblanchard

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s