Changes in HSE structure and doctor's pay?

dissed doc

The main difference between on-call as a junior doctor, and doing late nights as a lawyer/investment banker/whateverbusiness is

a) someone might die, tonight and by being present you can stop that because tomorrow is too late

and

b) someone might not make enough money tonight unless you stay in really late and type up some powerpoint presentations, but they will also make plenty of money tomorrow, so no harm done.

It's not "responsibility", it's about what actually *matters* in life, and not about magic fiat money moving around an accountant's desk.

The way you can tell if being an lawyer/banker/whatever is valued, then ask yourself

a) do people take out insurance to make sure that there are plenty of lawyers/bankers/whatevers available when they need them

I think you find the answer is no, they don't. No one ever really says "you know what, I can't move because my cancer has eaten awya at my lungs but I could really do with a banker. Good thing I took out banker isurance so I can do some investing - pity I cancelled the health insurance but who needs that eh?".

drkpower

dissed doc wrote: »

The main difference between on-call as a junior doctor, and doing late nights as a lawyer/investment banker/whateverbusiness is

a) someone might die, tonight and by being present you can stop that because tomorrow is too late

and

b) someone might not make enough money tonight unless you stay in really late and type up some powerpoint presentations, but they will also make plenty of money tomorrow, so no harm done.

That is all a little bit naive, really. I mean, I get your point, that objectively speaking, the work of a doctor bears more responsibility than a lawyer. But, by that logic, you could say that a bus driver's job bears more responsibility than a CEO of a company. One has life and death in their hand, the other doesnt; Simple; case closed, right? As i said, a little naive and it doesnt really get you anywhere.

The point is that the subjective stress that a doc experiences in their job is not necessarily increased because life or death is at stake. Once you are immersed in 'life or death' for a while, it doesnt really worry you so much. In fact that is a vital part of being a doc; that you dont become immersed and excessively stressed at the thought that your next patient might die if you send him home. From my own direct experience, the stress of being an NCHD is broadly comparable to being a litigation solicitor.

As for your insurance point, again it really isnt that relevent and, to be honest, it is incorrect. And it is strange coming from a doctor; insurance pays for the legal representation docs get when things go wrong. And plenty of other businesses have specific insurance that will cover their legal representation in different ways.

TheLastWord

ttmd wrote: »

Sorry I will try to keep my responses shorter.

Look I will agree I cannot hope to have enough perspective on the junior levels of the profession. But I still think you most doctors will have lower level of financial worry, which is a big perk of the profession.

I do not think its good to talk about finances in isolation. But on the contrary I think medics can poo poo the issue a bit too much.

The bottom line through your posts, is that people who study medicine and qualified doctors, are disingenuous not to admit that their career choice was (at least pre-dominantly) financially motivated, and their future will always be so. And by God are they bloody lucky to have a stable job. You're sick of their moaning and don't have a real appreciation of the hours and quality of life of an NCHD.

You completely dissed a poster who said that their priority in life was not financial gain - an obviously honest answer, which was well justified.

What's particularly interesting is that you tell us about your brother and his unstable architecture career, and your American cousins and their crippling education bills to justify your stance that doctors have it easy financially. And at the same time you're telling us that your mother, sister et al. are doctors. Maybe you should look a bit closer to home for the source of your bitterness.

ttmd

TheLastWord wrote: »

The bottom line through your posts, is that people who study medicine and qualified doctors, are disingenuous not to admit that their career choice was (at least pre-dominantly) financially motivated, and their future will always be so. And by God are they bloody lucky to have a stable job. You're sick of their moaning and don't have a real appreciation of the hours and quality of life of an NCHD.

You completely dissed a poster who said that their priority in life was not financial gain - an obviously honest answer, which was well justified.

What's particularly interesting is that you tell us about your brother and his unstable architecture career, and your American cousins and their crippling education bills to justify your stance that doctors have it easy financially. And at the same time you're telling us that your mother, sister et al. are doctors. Maybe you should look a bit closer to home for the source of your bitterness.

Why are you calling me bitter? They have done well, good luck to them and I think in a broader sense, I have been positive about medics and they job they do.

My posts are primarily about some of the perspectives they have on their profession. Is it not fair to contrast the experiences and difficulties they have with people outside the profession, and personal contact not relevant?

I criticised the poster because they said finances were not a CONSIDERATION not a priority. I took issue with this because I think its easier to say that when you have a good salary. I am sure some has plenty of other concerns in her life and work, and I would be not flippant about them. But finances are the issue under discussion.

You seem to think I believe doctors are some sort of money grubbing mercenaries? Thats just not true.

There are probably lots of good reasons not to go into medicine. But I dont think, in the long term, salary is one of them.

ttmd

dissed doc wrote: »

The main difference between on-call as a junior doctor, and doing late nights as a lawyer/investment banker/whateverbusiness is

a) someone might die, tonight and by being present you can stop that because tomorrow is too late

and

b) someone might not make enough money tonight unless you stay in really late and type up some powerpoint presentations, but they will also make plenty of money tomorrow, so no harm done.

It's not "responsibility", it's about what actually *matters* in life, and not about magic fiat money moving around an accountant's desk.

The way you can tell if being an lawyer/banker/whatever is valued, then ask yourself

a) do people take out insurance to make sure that there are plenty of lawyers/bankers/whatevers available when they need them

I think you find the answer is no, they don't. No one ever really says "you know what, I can't move because my cancer has eaten awya at my lungs but I could really do with a banker. Good thing I took out banker isurance so I can do some investing - pity I cancelled the health insurance but who needs that eh?".

This is a bit unfair. I get one is a power point presentation and one is human life. But lets say for instance you are in a field with a huge level of attrition. You make a bad fist of that presentation/contract/whatever, and you will be out that door. Or lets say to you are negotiating trying to keep the company afloat, it might have a huge corresponding effect on a large amounts of staff or colleagues - it effects your family, their family - so on.

It is not fair to say that this person does not feel a huge drain of pressure on them? I think it shows a lack of empathy to belittle their concerns and worries.

p_holmz

drkpower wrote: »

Just so we can compare like with like, a trainee solicitor (post-LLM, post (most) FE1s) is really more comparable with a medical student in their clinical years rather than an NCHD. An intern/SHO is comparable to a solicitor with 1-3 years PQE."

Sorry to bring this back but to resolve career related arguments, it is important you compare like with like and above point is incorrect.

A medical student in their Clinical years can only be compared to a 2nd or 3rd year LLB Student (Both being undergrads). A trainee Solicitor will be comparable to an NCHD both still under training and ultimately reporting to a partner/consultant. FE1, MBA, POST LLMs, Phd will be comparable to SHO, Research yrs, Phd and HST years.

With this in mind, a Consultant in a hospital, Executive management in FTSE company and Partnership in a law firm are considered career pinnacles in their respective sectors. Only years of hard work and overtime, extra qualifications above the minimum and determination will get one to these levels. AND IT TAKE YEARS OF COMMITMENT.

So comparing the salary of a hospital consultant with the salary of a middle manager or a scientist who graduated last year is misleading. It is understable a doctor would sit and think he would have been an actuary and a Director "years ago" if he hadnt studied medicine. But the same number of ppl in Banks and Law firms will be looking at Consultants with envy for earning 200K. Both fail to consider how many years it took them to get there and how many ppl failed on the way there.

Given all that, if you cannot find satisfaction in your current job role, you can try somewhere else but you gonna still need to put in the same level of hard work to succeed anywhere else.

No one makes 200K- 300K just sitting on their a$$ 9-5. Unless u play the lotto of course....

opinion guy

p_holmz wrote: »

No one makes 200K- 300K just sitting on their a$$ 9-5. Unless u play the lotto of course....

Bank exectives do did

p_holmz

opinion guy wrote: »

Bank exectives do did

They still do mate. They are having to "fight hard" for their bonuses but they still get their nice salaries. Bail out or no bail out.

http://www.independent.ie/national-news/bailedout-aib-to-pay-top-staff-euro40m-bonus-2454086.html

opinion guy

Grrrrr.......**shakes fist**.......:mad:

ttmd

p_holmz wrote: »

drkpower wrote: »

Just so we can compare like with like, a trainee solicitor (post-LLM, post (most) FE1s) is really more comparable with a medical student in their clinical years rather than an NCHD. An intern/SHO is comparable to a solicitor with 1-3 years PQE."

Sorry to bring this back but to resolve career related arguments, it is important you compare like with like and above point is incorrect.

A medical student in their Clinical years can only be compared to a 2nd or 3rd year LLB Student (Both being undergrads). A trainee Solicitor will be comparable to an NCHD both still under training and ultimately reporting to a partner/consultant. FE1, MBA, POST LLMs, Phd will be comparable to SHO, Research yrs, Phd and HST years.

With this in mind, a Consultant in a hospital, Executive management in FTSE company and Partnership in a law firm are considered career pinnacles in their respective sectors. Only years of hard work and overtime, extra qualifications above the minimum and determination will get one to these levels. AND IT TAKE YEARS OF COMMITMENT.

So comparing the salary of a hospital consultant with the salary of a middle manager or a scientist who graduated last year is misleading. It is understable a doctor would sit and think he would have been an actuary and a Director "years ago" if he hadnt studied medicine. But the same number of ppl in Banks and Law firms will be looking at Consultants with envy for earning 200K. Both fail to consider how many years it took them to get there and how many ppl failed on the way there.

Given all that, if you cannot find satisfaction in your current job role, you can try somewhere else but you gonna still need to put in the same level of hard work to succeed anywhere else.

No one makes 200K- 300K just sitting on their a$$ 9-5. Unless u play the lotto of course....

The difficulty of most white collar careers in this country nowadays is thoroughly depressing.

karlitob

DessieMG wrote: »

With the proposed changes in the HSE by Labour and Fine Gael and talk of capping public sector wages at 200,000 would this mean that consultants and GP's would be hit, does his mean that it would be less financially advantageous to do medicine since it is a very demanding job and requires you to make a lot of sacrifices?

Are you kidding?

E200k - Less financially advantageous. They're docs, not gods! And there are a lot of very demanding jobs that don't pay anywhere near as much. Like any job - there are people whoa re good at it and not so good at it.

My advice - pick a job you want to wake up every morning and do.

karlitob

opinion guy wrote: »

No. It isn't.

Funny video though.

Yes it is. Interns start on E32,000 a year, SHO's go up to $0,000. The earn their bucks from spending 80 hours in the hospital a week. I would begrudge anyone to get paid for the work they do.

They earn time + a quarter overtime. A nurse wouldnt piss on time a quarter. Most hospitals now want time for first 15 hours overtime worked. And a few dublin hospitals arent paying for some overtime.

I would agree that some interns are ****e at getting their work done sooner and should not be paid overtime but in general, its cos its busy, very busy.

Also, junior docs dont have job security. They work on 6 month contracts and if they're good enough then they get on schemes which can rotate from 2 - 3 to 5 years depending on level.

I'm not a doc but i work in a hospital.

docbroc

karlitob wrote: »

Yes it is. Interns start on E32,000 a year, SHO's go up to $0,000. The earn their bucks from spending 80 hours in the hospital a week. I would begrudge anyone to get paid for the work they do.

I must admit as an SHO i earned an awful lot of $0,000.

opinion guy

karlitob wrote: »

Yes it is. Interns start on E32,000 a year, SHO's go up to $0,000. The earn their bucks from spending 80 hours in the hospital a week. I would begrudge anyone to get paid for the work they do.

They earn time + a quarter overtime. A nurse wouldnt piss on time a quarter. Most hospitals now want time for first 15 hours overtime worked. And a few dublin hospitals arent paying for some overtime.

I would agree that some interns are ****e at getting their work done sooner and should not be paid overtime but in general, its cos its busy, very busy.

Also, junior docs dont have job security. They work on 6 month contracts and if they're good enough then they get on schemes which can rotate from 2 - 3 to 5 years depending on level.

I'm not a doc but i work in a hospital.

When you add in overtime they do earn 50k.
They are supposed to earn time and a half for all overtime now. Hospitals seem to feel they have free reign to redefine contracts however they see fit.

drkpower

p_holmz wrote: »

Sorry to bring this back but to resolve career related arguments, it is important you compare like with like and above point is incorrect.

A medical student in their Clinical years can only be compared to a 2nd or 3rd year LLB Student (Both being undergrads). A trainee Solicitor will be comparable to an NCHD both still under training and ultimately reporting to a partner/consultant. FE1, MBA, POST LLMs, Phd will be comparable to SHO, Research yrs, Phd and HST years.

Sorry to bring it back too, but the above point is incorrect;).

A solicitor is not qualified until after they complete their traineeship, just as a doctor is not qualified until after they graduate (subject to the restrictions vis-a-vis intern yr.).

Qualified solicitors, just like NCHDs, continue to be supervised by and ultimately report to partners. Indeed, in bigger firms, 'junior' solicitors will be subject to far closer supervision that 'junior' doctors.

A trainee solicitor is essentially undergoing the practical side of their solicitor education; just as a medical student in their clinical years is undergoing the practical side of their medical education.

While there are clearly differences, the closest comparison (and I say this, having gone through both careers), in medicine, to a trainee solicitor, is a medical student in years 5/6 and the closest comparison, in law, to an intern/SHO, is a solicitor with 1-3 years PQE.

drkpower

opinion guy wrote: »

This is something I don't understand. As a doc you're going to be runnign around all the time from place to place, drama happening, adrenalin going etc etc. **** that will to some extent, keep you awake - to a point I add. I can never understand how someone in a sitting down profession can do an allnighter. How does one sitting at a desk for 24 hours not fall asleep. OR how would one do accountancy math at 4am having not slept. Without physical stimulus I don't get it. (and even then I don't get it)

When someone at a desk job is doing an allnighter, it is usually in the context of a major deal closing, or an ongoing major trial. In such cases, the adrenaline level is also quite high, so it does help to get you through the late nights.

Although, the physical stimulus and nature of the work of an NCHD, does tend to make allnighters 'easier'.

Bella mamma

karlitob wrote: »

Yes it is. Interns start on E32,000 a year, SHO's go up to $0,000. The earn their bucks from spending 80 hours in the hospital a week. I would begrudge anyone to get paid for the work they do.

They earn time + a quarter overtime. A nurse wouldnt piss on time a quarter. Most hospitals now want time for first 15 hours overtime worked. And a few dublin hospitals arent paying for some overtime.

I would agree that some interns are ****e at getting their work done sooner and should not be paid overtime but in general, its cos its busy, very busy.

Also, junior docs dont have job security. They work on 6 month contracts and if they're good enough then they get on schemes which can rotate from 2 - 3 to 5 years depending on level.

I'm not a doc but i work in a hospital.

I don't know anyone who is not being paid time + 1/2 for all rostered overtime Mon - Sat, and double time on Sundays/BHs since around mid-Jan last year (or was it mid-Feb? It's all a blur.........)

Anyone?

(I won't even mention unrostered overtime :mad:)

karlitob

I'll revert to you on that.

My figures are from an SpR friend (SHO nearly 2 years ago) who ranted about it at the time.

My point is that the basic pay and for basic hours of an intern are **** and they deservedly earn their money for the 60/70/80 hours work that they put in a week.

As for trainee solicitors, the fact that you work all those hours for nothing to line the pockets of partners is not a good thing. Its not a system we should strive to copy. Within reason, people should get paid for the work that they do and there's nothing wrong with that.

The obscene monies earned at the top of the profession is sickening and should not happen. Consultants and Partners etc should not earn such monies.

opinion guy

karlitob wrote: »

I'll revert to you on that.

My figures are from an SpR friend (SHO nearly 2 years ago) who ranted about it at the time.

My point is that the basic pay and for basic hours of an intern are **** and they deservedly earn their money for the 60/70/80 hours work that they put in a week.

As for trainee solicitors, the fact that you work all those hours for nothing to line the pockets of partners is not a good thing. Its not a system we should strive to copy. Within reason, people should get paid for the work that they do and there's nothing wrong with that.

The obscene monies earned at the top of the profession is sickening and should not happen. Consultants and Partners etc should not earn such monies.

32k a year is not "****", and neither is what they get paid for their hours. But this doesn't change the fact that they shouldn't be working those hours (well I don't mind 60/70/80hours a week.....what I do mind is individual shifts that re longer than 16 hours with no proper breaks - bad for patients and bad for the doctors)

This seems relevant:
http://www.ncbi.nlm.nih.gov/pubmed/21464347

karlitob

opinion guy wrote: »

32k a year is not "****", and neither is what they get paid for their hours. But this doesn't change the fact that they shouldn't be working those hours (well I don't mind 60/70/80hours a week.....what I do mind is individual shifts that re longer than 16 hours with no proper breaks - bad for patients and bad for the doctors)

This seems relevant:
http://www.ncbi.nlm.nih.gov/pubmed/21464347

580+ points on the leaving cert, 6 year medical degree (which is in fact 3 degrees), a one year internship and to be good enough to get on an SHO scheme for E32000 IS "****". Cop onto yourself. Graduate nurses start off on E32000. The average industrial wage s E30k approx. SHOs are worth way more than average since they have proved themselves way more than average. You need a reality check. SHOs deserve every penny they get. As do Reg's and SpRs (good ones anyway) but GPs and Consultants do not deserve the money they get.


I never mentioned that they 'should' work 60/70/80 hours. I merely stated they were working that. The EWTD is obviously not in place and should be. Nad how can you be ok with 80 hours per week and not ok with 16. How can they work up to 80 within working 16 hours per day.

And we didnt need you to search through pubmed for us to know that longer working hours are bad for your health. Besides the confidence intervals are too wide

ttmd

Just one thing I think people should take into account - if you have qualified for medicine here as an undergraduate, I think its very good value in terms of an education.

Most of the schools here are highly regarded, and I would bet that students are paying relatively little for an education that costs a lot to deliver.

Don't take this as an endorsement that anyone should get treated badly when they qualify though.

spagboll

strike strike strike! do it for me guys! my 23 year friend cleaner in a hse hospital makes more than an intern!

jmn89

ttmd wrote: »

Just one thing I think people should take into account - if you have qualified for medicine here as an undergraduate, I think its very good value in terms of an education.

Most of the schools here are highly regarded, and I would bet that students are paying relatively little for an education that costs a lot to deliver.

Don't take this as an endorsement that anyone should get treated badly when they qualify though.

It does seem bizarre that the government will invest so much in our medical education and then make the enviornment so inhospitable as to make emigration the only viable option for a reasonable lifestyle. I'm in final year at the moment and it seems that I'm one of the few not planning to emigrate at least temporarily after internship. The NCHD crisis will deepen.

opinion guy

jmn89 wrote: »

It does seem bizarre that the government will invest so much in our medical education and then make the enviornment so inhospitable as to make emigration the only viable option for a reasonable lifestyle. I'm in final year at the moment and it seems that I'm one of the few not planning to emigrate at least temporarily after internship. The NCHD crisis will deepen.

Worse than you think. I was talking to a bunch of foreign doctors from eastern europe yesterday - every one plans to leave when their contract runs out to get away from the workign conditions here!

p_holmz

Sometimes I am inclined to think this problem lies with Doctors themselves. They are simply victims of their own passion (passion being the oath of patient care).
It seems to me that each NCHD looks after their own only and Consultants look after themselves too. Evidence suggests this! A consultant came out the other day running his mouth on how current SHOs are lazy and how they need to work long hours to learn. Why? How can a human being be made to work 60-80 hours a week! No other sector I know of will allow this. We all hear about public sector staff goin on strikes and Aer Lingus as well... The effect of the strike is disastrous but it sends out a message to management that these workers are no fools...

Doctors may not have to go this far but they definitely need to get to together and get some action. Even if it means simply walking out after their shifts!

opinion guy

p_holmz wrote: »

Sometimes I am inclined to think this problem lies with Doctors themselves. They are simply victims of their own passion (passion being the oath of patient care).
It seems to me that each NCHD looks after their own only and Consultants look after themselves too. Evidence suggests this! A consultant came out the other day running his mouth on how current SHOs are lazy and how they need to work long hours to learn. Why? How can a human being be made to work 60-80 hours a week! No other sector I know of will allow this. We all hear about public sector staff goin on strikes and Aer Lingus as well... The effect of the strike is disastrous but it sends out a message to management that these workers are no fools...

Doctors may not have to go this far but they definitely need to get to together and get some action. Even if it means simply walking out after their shifts!

Well a more critical concern is how can human beings concentrate, much less learn after 36 hours or more of continuous work ? Answer they can't. The learning stuff is Bs. The truth is the consultants want things to stay as they are as to fix it means to hire more docs taking money away from their departments.

ericm84

Hey all,

Been following these threads with interest for a while (but now I have a question...im a newbie so apologies if this doesn’t come out right!!). I've read a lot about 80+ hour weeks for NCHD’s and 72 hour unbroken shifts. I was just wondering how this breaks down....

i.e. can anyone give an average week's work breakdown for interns, sho's and regs?

As a comparison/example, my sister works at an SHO level in a large uk hospital and while her hours are bad they dont seem anywhere as crazy as the shifts irish nchd's work........and her house mates (all docs) while they work hard they aren't really doing the same tough hours as irish docs and all seem to love their jobs (and all got places on their preferred training schemes when they finish FY2).

A typical week for her would be:
On call 1 in 5 (with the following day off)
Weekend on call 1 in about 4 (usually 1pm sat-1pm sunday, or friday night/sunday and then off monday)

Mon:
7.45 - 9am: Ward round
9:30 am - 1pm: outpatient clinic
2-5: out-patient clinic
(On call example but the day of the week changes each week)
5pm - 7am (Tues) on-call: Usually is on site till about 11pm-12am. Then she normally gets to sleep from about 1-6 and up then to prepare for ward rounds at 7.45 -9am (Tues). Then heads home and has the next day off so

Tues:
7.45 - 9am: Ward round
9-1(2)pm: Minor surgery cases
2-5:30pm: Cover for absent colleagues (so could be on call, clinic, surgery etc.....)

Wed:
7.45-9am: ward rounds
9-1pm: out patient clinic
2-4.30pm: teaching/lectures and team presentation

Thurs:
7.45 - 9am: Ward round
9-1(2)pm: Take over dept on call responsibilityl
2-7ish: Surgery cases

Friday:
7.45-9am: Ward round
9-1(2)pm: Minor ops
2-5.30pm: Take over dept on call responsibility till hand over to person on-call overnight


Sat: Off
Sun: Off

Works out about 50 hours a week......(obviously worse when working weekends and granted some days when she's been handing over the on call stuff she has been in till 7/7.30). Her housemates seem to work similar hours (although one is on a rotation that has 1 week of nights which sounds horrible!)

Also, her consultants seem (for the most part) fairly sound people who are happy to teach.

Now, is it MUCH worse than this in ireland?? How do shifts compare??

dissed doc

ericm84 wrote: »

Now, is it MUCH worse than this in ireland?? How do shifts compare??

My recollection is:

Monday

0700hrs: wake up
0745hrs: Start work, ward round
1100-1700hrs: clinic, wards, duties

if on Call (see Tuesday):

Tuesday:

1730hrs: leave work
1800hrs: fall asleep in car
1830hrs: wake up
1900hrs: fall asleep


The shifts are usually (from my experience, many years ago) aroudn 32hrs in a row, no rest, and no protected sleeping time and pretty much running around wards with blood bottles and ECG units. You can relax at home the evening the following day.

For weekends, it's ~ 56hrs in a row, but that was only ever 1 in 4 for me (1 in 3 usually with holidays for others).

Average is e.g., 32 + 10 + 10 + 10 = 62-65hrs for a MOnday - Friday with one on call

With two midweek on calls: 32 + 10 + 32 = 74-78hrs

With a weekend (no midweek calls - unlikely if on 1 in 4) = 10 + 10 + 10 + 10 + 10 + 56 (to Monday evening from Saturday morning) = ~106-110hrs (in a single week).

it was 10 hrs a day because you were on roudns from 8am and never left until at least 6pm (clinics always run over, and if theatre is running, as an intern or SHO you are on the wards until things are settled).

Sid_Justice

karlitob wrote: »

580+ points on the leaving cert, 6 year medical degree (which is in fact 3 degrees), a one year internship and to be good e

Bachelor of Obstetrics isn't a real degree and shouldn't be implied to be one.

karlitob

Sid_Justice wrote: »

Bachelor of Obstetrics isn't a real degree and shouldn't be implied to be one.

Well the point is that medics/surgeons deserve what they earn since they have worked so hard to get it.

But since you're off the point - why is it not a real degree and the other two are?