A junior doctor has responded to Tim Worstall’s cheeky suggestion in these pages that she and her colleagues be described as “medical students” from now on. One of the many concessions the medical profession has wrung out of Wes Streeting since the election is to have junior doctors rebranded as “resident doctors”. The sensitive souls think it is demeaning to be called “junior” even when they are fresh out of university. Tim’s argument is that they are “still training, and never far from supervision”. One day they will be fully trained consultants and can call themselves doctors, but not yet.
Perhaps unfamiliar with Tim’s provocative style of writing, Dr Georgina Salisbury has taken the bait. She rightly says that “resident doctors have never been called medical students” (not to their faces anyway), but she goes too far when she insists that she is not a “doctor in training”:
It’s not just Tim who’s at fault. Less forgivably, former Tory Health Secretary Victoria Atkins was criticised back in 2023 for describing junior doctors as “doctors in training”. Whatever you think of us and our “impertinent pay demands”, it’s simply an untrue statement, akin to describing all journalists as “writers in training“ because they are not the editor of their paper.
Either Georgina has a very short memory or she is gaslighting us. Until October of last year, junior doctors were officially known as “doctors in training”. Thanks to the splendid Wayback Machine, you can see that the NHS careers website listed four types of doctor: GPs, consultants, specialty doctors and “doctors in training” :
Doctors in training
As a doctor in training you’ll earn a basic salary, plus pay for any hours over 40 per week, a 37 per cent enhancement for working nights, a weekend allowance for any work at the weekend, an availability allowance if you are required to be available on-call, and other potential pay premia.
In Foundation training, you will earn a basic salary of £32,398 to £37,303 (from 1 April 2024).
That webpage was changed shortly after junior doctors voted to accept the government’s generous offer to give them a 22.3 per cent pay rise and call them “resident doctors”. If you visit it now, the description is the same, but the term “doctors in training” has been replaced by “resident doctors” and the basic salary has been changed from “£32,398 to £37,303” to “£36,616 to £42,008”.
Fair dos. That’s industrial action for you. But to pretend that “resident doctors” have never been called “doctors in training” and that Victoria Atkins was out of order for using the phrase in 2023 is too much. After Atkins made this supposed faux pas, the British Medical Association came out and said they actually preferred to term “doctors in training” to “junior doctors”. It was, they said, “a stepping stone in nomenclature” in their endless search for a job description that didn’t hurt their members’ feelings. (For what it’s worth, I think the most accurate and neutral job title would be “doctors without a PhD”.)
Meanwhile in the letters section of the Financial Times, another doctor has been gaslighting us. Prof Ian Gilmore, who runs the neo-temperance pressure group the Alcohol Health Alliance, is cheesed off with the chief executive of the brewer Asahi for saying that while he is “absolutely not denying that there are risks” associated with drinking, there is also “lots of evidence” that moderate alcohol consumption can have health and wellbeing benefits. For this measured and inarguable contribution to an article about how the alcohol industry could be facing its “tobacco moment”, Prof Gilmore has accused him — not unpredictably — of using a “tactic” from Big Tobacco’s “playbook”:
As a biomedical scientist and liver specialist, I know of no credible, independent expert in the field who would support these statements of disinformation.
Really?! Not a single one? What about the countless epidemiologists who have identified clear reductions in heart disease, stroke and diabetes risk among moderate drinkers for decades in every corner of the world? What about the National Academies of Sciences, Engineering, and Medicine which confirmed last year, for the umpteenth time, that moderate drinking reduces the risk of premature mortality? What about Professor Sir Richard Doll, one of the legends of public health, who concluded in 2002 that “the inverse relationship between ischemic heart disease and the consumption of small or moderate amounts of alcohol is, for the most part, causal” and should “now be regarded as proved”? Hell, even the Chief Medical Officer’s cherry-picked panel of anti-alcohol academics who lowered the drinking guidelines in 2016 had to admit that there were some health benefits from moderate alcohol consumption.
Is it conceivable that all these people are unknown to Ian Gilmore or is he abusing the public’s trust in doctors to make an outrageous claim for political reasons? It would be defensible for him to say that the evidence on moderate drinking and health is contestable, even though it is only really contested by people like him. But to say that “no credible, independent expert” would agree that there is “lots of evidence” showing health benefits from moderate drinking is as absurd as claiming that junior doctors have never been known as doctors in training.
The ability to tell the difference between what you want to be true and existing reality is a crucial skill in adulthood. It would be worrying if medical professionals, of all people, are losing their grip on this.
