Empowered to stand shoulder to shoulder

by Lisa Rampersad and Cristina Costache

Junior doctors Lisa Rampersad and Cristina Costache look back on the experience of working during the 2016 contract dispute. Dr Rampersad describes how she feared involvement with industrial action might imperil her visa renewal, while Dr Costache echoes the feeling of vulnerability felt by many international medical graduates

Location: International
Published: Monday 20 September 2021
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Lisa Rampersad RAMPERSAD: Passionate about representation

In 2016 I started work as a foundation year 1 doctor in the UK during the junior doctor contract dispute.

I had completed medical school, done the professional and linguistic assessments board exams, applied to the foundation programme and gotten a place in North Central London Deanery. As with many other doctors moving to the UK and starting jobs, I signed the junior doctor contract and all the other paperwork in the bundle the HR person handed me and gave them back without a clue as to what the documents held.

Similarly, during the induction week, I signed up to the BMA as everyone else was doing it, and I had heard vaguely about the junior doctor strikes and the threat of a new contract but I didn’t know anything concrete.

As August quickly progressed, we were told about upcoming strike action being organised and, I was intrigued and excited to see what this would look like.

A short while before the strike action the FY1s were called into a meeting and told that we needed to consider the implications of participation in strike action and our obligations as doctors.

We were told that we could be held liable for adverse outcomes for patients if we chose not to fulfil our duties. As a cohort we were confused and a bit offended – we were the most junior of junior doctors, with provisional registration.

We all knew that this could not possibly be true, and knew that, as trainees in the foundation programme, we were protected. Locally trained colleagues who were extremely confident in their own knowledge of the contract dispute bolstered these feelings of outrage at being coerced. But deep inside, I was afraid.

One difference between me and most of my FY1 colleagues was that I was working in the UK on a visa, and I was concerned that being seen to be part of the strike action may be viewed negatively when I applied for renewal of this visa.

A high number of IMGs (international medical graduates), and some UK medical graduates, rely on visas to work, with most being sponsored by the employer (tier 2), with a small percentage from other routes. I was on an unmarried partner visa, which we had spent from October 2014 to January 2016 fighting all the way to a tribunal to get, and I feared the loss of this right to remain.

Because of my concerns I spoke to other IMGs at my trust who had similar thought processes being sponsored by the trust and being afraid of not having contracts renewed if they were seen as difficult. None of us had answers or reassurances of safety and so I looked to our union and the BMA provided.

It was from the BMA that I learnt about trade union activity, and protection from unfair dismissal during industrial action. I also became more informed about what the safety concerns were about the proposed contract and why the membership had voted for industrial action.

With this knowledge I then felt more confident in taking part in the strikes and was ready to do so – the strikes were called off and the contract was imposed, so I never did get to stand on those picket lines.

The passion and fire that rose in me has only grown over the intervening years leading to me becoming involved in the BMA and continue fighting for IMG representation and support, and I’m so pleased to see and be part of the IMG groups in the BMA.

This year, we are again considering industrial action, now, over the lack of a proper pay rise for junior doctors.

COVID has had a significant effect on junior doctors, and the Government’s lack of recognition of our efforts, sacrifices and losses.

Lisa Rampersad is a clinical fellow in general surgery in Brighton


28784 cristina costache COSTACHE: Strongly supports industrial action

I came to the UK in October 2015, straight after graduation, and started my clinical attachment. I followed the strikes, watched the videos, but never got involved because ‘I was not a recognised doctor in the UK yet’ as the GMC took a while to process my registration.

I had no clue who the BMA was, all I knew was that they have a brilliant electronic library – something that I had never had during medical school, that I was looking forward to having access to.

Fast forward and I obtained my GMC registration in February 2016 and was employed one month after that. I was an employed junior doctor for only two strikes, the first one took place on my official second day on the ward and I was told that it is advisable I don’t strike, to not upset anyone.

Myself and my partner at the time, who was in the same situation as me, went to work as usual because, like we were told, we didn’t want to upset anyone. We just started our first job in a country that we really wanted to belong to and to build a career in, so, understandably we didn’t question it.

The nurses and the consultant on call told us to hide in theatre/on the ward so that we don’t end up getting pulled off to other specialties to do ward jobs. It felt pretty scary.

For the second strike we sought BMA advice and we strongly supported to strike alongside our colleagues, because, as we were to learn later on, we had been part of the profession all along. Even though we had different backgrounds, we had equal rights.

It saddens me to realise how many IMG colleagues live with this fear and this feeling of vulnerability: because we are – all some of us have is our job and we are our only source of income and support.

However, our rights should never differ, and a trade union should always have your back. You have the same rights to be part of the team as anyone, to be respected and valued because above everything you worked damn hard to be here – that work wasn’t in vain!

Cristina Costache is a specialty trainee 3 in paediatrics in West Yorkshire