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Is the phrase ‘junior doctor’ demeaning to highly skilled NHS trainees?

Orthopaedic surgeon Scarlett McNally is leading a study – commissioned by Health Education England – to suggest an alternative name to ‘junior doctor’. She says: 

“In the past few years it’s come to light that the term ‘junior doctor’ is considered demeaning by some postgraduate doctors. These doctors have done a huge amount of training and have a lot of skills, and yet patients or relatives will say things such as, ‘I’ve only seen the junior doctor.’

“Health Education England has therefore invited me to lead some work on changing this term. We don’t want doctors to think that we’re focusing on this while ignoring more difficult issues, because other work is going on. However, the terms that we use are important, because how you name people changes how others value them.

“One of the difficulties we face is that Modernising Medical Careers, which reformed postgraduate medical education, produced a range of job titles that are still confusing for staff and patients.1 Another issue is that over 30,000 doctors who aren’t consultants are also not in a training programme.

“So, we have two questions: what to call individual doctors and what to call groups of doctors. We’re likely to end up with two things. The first would be a basic term that would replace ‘junior doctor’ for the public. The second would be a set of terms that could be used within healthcare to indicate a doctor’s skill level.

“Research has shown that the public wants to know who is a doctor and who isn’t, as well as who is in charge. Other healthcare staff need to know whether someone’s an SHO or a registrar, for example, but no more detail than that. When you’re going through training it’s really important to you and your supervisor whether you’re an ST4 or an ST3, but to everyone else that level of detail isn’t important.

“Over the summer we’ll be conducting a survey asking whether people agree with our proposed terms and whether they would suggest others. We’re also asking what terms they find demeaning, because we’re trying to remove terms such as ‘sub-consultant’ or ‘middle grade,’ which can be interpreted as pejorative.

“I’m hoping to write a report by the end of the year stating where we’ve got to. We’re not going to make hard and fast rules that everybody has to stick to, but we’re going to make some recommendations.”

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