The cost of being a junior doctor has increased by 80 per cent over the last seven years, figures published by the British Medical Association (BMA) last Friday (30 November, 2007) show.
Over the same period, junior doctors’ basic salaries have increased by little more than 20 per cent, and supplements paid for anti-social hours have fallen.
Research by the BMA looked at the minimum essential costs borne by junior doctors as they progress through their training.
This includes the compulsory membership of organisations such as the General Medical Council – the cost of which has more than doubled to £290 for second year junior doctors.
It also includes the costs of sitting exams – essential if doctors are to progress in their training.
The fee for receiving a certificate of completion of training (CCT) has trebled since 2000 to over £750.
Commenting on the figures, Mr Ram Moorthy, chairman of the BMA Junior Doctors Committee, said: ‘In other professions, the employer pays for the benefits of a well trained workforce.
‘In the NHS, junior doctors pay for it themselves.
‘We’ve seen the cost of our training soar over the past seven years, but this hasn’t been matched by an increase in our pay, or funding for study leave.’
The figures do not take into account the costs incurred for the attendance of training courses, or the fact that some doctors have to pay exam fees more than once.
The BMA is concerned that trainees may soon face additional fees for membership of new bodies overseeing training.
It should also be noted that take-home pay has fallen for many junior doctors because of Working Time Directive limits on hours, said the BMA.
Surgical trainees have seen the largest rise in minimum costs over the past seven years – more than 95 per cent to £8,138 for the duration of their training.
The BMA has submitted the figures to the Doctors and Dentists Review Body, which makes recommendations on doctors’ pay.
A BMA summary of costs incurred by junior doctors over the course of their training is divided into in pathways general medical, surgical, ENT, anaesthetic and paediatric training.
The BMA said: ‘The pathways described here, for a general medical, surgical ENT, anaesthetic and paediatric trainee, highlight the significant increase in essential costs faced by junior doctors since 2000.
‘We have only included those costs that could be deemed essential to training and progression – examination fees and membership of the key professional bodies.
‘In comparison, last year’s evidence provided data on all of the costs that juniors would likely face, rather than just the core costs.
‘These further costs included membership of specialty and trainee associations, revision courses for examinations and training courses.
‘Moreover, even among the essential costs, the use of mandatory examination failure rates by some Royal Colleges ensures that many junior doctors will be required to pay these fees more than once.
‘Although it is hoped that this year’s evidence robustly demonstrates the increase in essential costs that junior doctors now have to meet as part of their training, it should also be noted that the majority of junior doctors will face actual costs much higher than these.
‘This increase in essential costs should be seen in the context of declining total pay, as the average banding supplement for junior doctors has declined since 2000.
‘Furthermore, while these pathways demonstrate an average increase in costs of nearly 80 per cent since 2000, the basic pay of junior doctors has been uplifted by the DDRB (Doctors and Dentists Review Body) by less than 22 per cent across the same period.
‘None of these essential costs can be claimed as study leave expenses, so there is no need to offset these costs against an average study leave reimbursement figure.
‘Tax deductions are applicable to many of the membership fees included in these pathways, and where this is the case, the figures and calculations used have been altered accordingly.’
l Commenting on the publication of the Audit Scotland report ‘Overseas staff in the NHS – pre-employment checks’ last Thursday, Dr Peter Terry, chairman of BMA Scotland, said: ‘This report has been commissioned following the terror attacks at Glasgow Airport earlier this year.
‘It is extremely unlikely that pre-employment checks would identify people who want to work in the NHS who might possibly commit terrorist acts in the future.
‘Overseas doctors provide a significant contribution to the NHS in Scotland and I am pleased that this is recognised in the report.
‘The report suggests that current pre-employment checks are working well in NHS Scotland and it is not clear what added value the recommendations will deliver.
‘Any changes to the existing procedures, however, should not increase the burden of bureaucracy or create delays for employing individuals from overseas.
‘It is important that the NHS has a complete and accurate picture of its workforce however with the wider use of electronic personnel records, I am sure that doctors would require reassurances that their personal information is secure.’