THE SATURDAY PROFILE/Junior Doctors: Non-consultant hospital doctors are threatening strike action because having finally achieved decent pay for long overtime hours, they now find their employer wants to include night/weekend work on the roster to avoid paying those rates, writes Chris Dooley
He is 29 and single. He works an average of 77 hours a week and earns €85,000 a year. He smokes. He drinks too much. He has an unhealthy diet. He is highly motivated but doesn't show it. He is very, very tired.
He is the typical Irish male junior doctor.
Some believe he is an endangered species, and may soon be visible only in foreign habitats. Most of his friends have emigrated already.
He is thinking about going on strike, an action taken this week by his colleagues in Waterford and Tullamore.
As a result, he has been reading about himself in the newspapers. About how he works impossibly long hours but makes €45,000 a year in overtime alone. It's true, but reading about it doesn't help his disposition. His resolve to support the strike is strengthened.
One of the most noticeable things about him, but only from close observation, is that he is driven to succeed.
A non-Irish colleague says the Irish junior doctor, male and female, is like a duck in a pond. The calm exterior masks the furious paddling under water.
"An Irish hospital doctor will be highly motivated but will hide it as much as possible. He will be trying his best while making it look like he is really not trying at all."
This may be to do with a simple unwillingness to put his head above the parapet, or perhaps it goes back to the particularly strong bonds that medical students develop at university, which curb overt competitiveness.
Life-long friendships are formed from an early stage and sealed over drinks in pubs such as Hartigan's in Leeson Street, a favoured Dublin hang-out for young meds studying around the corner at UCD in Earlsfort Terrace.
Students like to drink, but none does so with more dedication than a medical student. Nowadays, the young doctor's on-call duties play havoc with his social life, but the house he rents with five other doctors is known locally as "the party house".
The house has been rented by doctors for as long as the neighbours can remember. As one lot moves out following six or 12 month assignments, another moves in. Only one of the doctor's housemates is married, and he last saw his children the weekend before last. All that moving and those all-night shifts make a regular family life impossible.
At 29, he has invested too much time into his medical career, for too little money, to think of getting out. Like many of his colleagues, however, he is filled with doubt about his choice of profession.
In a survey carried out by his union, the Irish Medical Organisation, 42 per cent of non-consultant hospital doctors - as the junior doctor prefers to be known - said they would not choose medicine if they were to start their careers again.
Bullying, the threat of physical assault, racism and sexual harassment also concerned a significant number of non-consultant hospital doctors. Nearly half of his colleagues are non-nationals, and 37 per cent are women. Taking Irish junior doctors in isolation, the majority - 55 per cent - are women. Of even greater concern to doctors in the same survey was the "over optimistic expectations" of some patients and politicians promising resources they cannot deliver.
In recent years, more of the available resources have been finding their way into the doctor's pay packet than had been the case. Three years ago, a senior house officer with four years' experience earned less than £25,000 (€31,750) a year in basic pay.
For the first 10 hours of overtime he received one-and-a-half times the basic rate, but for all hours after that he received a half-time rate of £5 an hour before tax.
That system was abolished two years ago when the State's 3,000 junior doctors agreed a new, vastly improved structure in which overtime rates rise as more hours are worked.
As a registrar with six years' experience, the typical 29-year-old earns a basic €40,000 as well as overtime which averages at €45,000 across the system. A senior registrar at the top of the scale earns a basic €59,000.
So why is he willing to go on strike when the pay has never been so good? While his union representatives talk repeatedly about training, money is undoubtedly a factor.
Having worked long overtime hours for peanuts, he now finds that his employer wants to make night and weekend work a part of his basic roster so it can avoid paying the newly agreed rates.
He is also genuinely concerned about training. Less day-time work means less time working under the direction of specialist consultants. In other countries, such as the US, a more intensive training regime sees medical graduates rise to consultant status more rapidly than in Ireland.
In Ireland, non-consultant hospital doctors far outnumber consultants and it is they who are most visible on the wards. In the US, it is the other way around. A typical hospital might have four specialists to one junior doctor.
Perhaps that's one of the reasons the Irish doctor, having completed the 15-odd years it takes to reach consultant level, knows the post he is aiming for could well go to a colleague who emigrated years ago to receive his training abroad.
The lack of loyalty to those who stay at home is just one of the topics that comes up in canteen conversations with colleagues, or at the snack bar vending machine where supper is frequently enjoyed.
When the conversation moves to sport, as it does in most workplaces, it is usually to rugby or golf. "I know it's a cliché but you don't hear much talk about GAA," observes a junior doctor who spoke to The Irish Times.
Like himself, most of our typical junior doctor's colleagues went to rugby-or hockey-playing schools and come from professional backgrounds. The few who don't tend to stay quiet about it.
Keeping quiet, in fact, was part of the junior doctor's lot until the recent past. "Consultants' posts are very scarce and everyone is vying for them, so nobody wanted to be identified as stepping out of line," says one.
Something has changed, however. The typical junior doctor has asserted himself. He is not just tired. He is tired of being taken for granted.