It’s time to fix pay, fix rotas, fix training and fix our outdated contract

A new survey will inform the next course of action for the Northern Ireland junior doctors committee, writes new chair Fiona Griffin

Location: Northern Ireland
Published: Tuesday 25 July 2023

As we go through another changeover period in Northern Ireland, junior doctors have never been more exhausted and despondent.

NIJDC, the BMA Northern Ireland junior doctors committee, is ready to take action to change this.

We have launched a survey to get a clearer picture of the feeling among junior doctors on our pay, working conditions and training to help inform our next course of action. Most importantly, this survey asks what you would be willing to do alongside us to make things change.

At our recent series of workplace listening sessions, the overwhelming message from juniors who attended was that training in Northern Ireland is on life support. 

We are not paid enough for the intensity of our workload. Our rotas are exhausting and limit our access to breaks and annual leave entitlements. We are not getting the high-quality training opportunities needed to develop as doctors. Our contract is outdated and not fit for purpose anymore.

Pay erosion

One of the key areas raised at our listening sessions was how poor our pay is; we are falling behind the other UK nations.

Our calculations show our pay has been eroded by 30.7% since 2008 when compared with RPI inflation. This is a huge loss to our pay and our living standards and fails to reflect the responsibility, training, and sacrifices required of our work.

To make matters worse, the recent DDRB recommendation of a 6% pay uplift, plus £1,250, will not be awarded in Northern Ireland. We are not worth 30% less than we were in 2008 and we are not worth less than doctors in other nations or countries.

Rota gaps and training quality

Exhausting, understaffed rotas and lack of access to adequate training time were highlighted as other common problems across all workplaces. 

This high level of discontent was reflected in the results of the most recent GMC national training survey which was completed by 77% of trainees in Northern Ireland – the largest response rate in the UK.

The survey report painted a depressing but unsurprising picture of junior doctors’ working lives in Northern Ireland. Trainee burnout has risen substantially in the past year alone, with the proportion of juniors at high risk of burnout climbing to 27% – double the increase seen across the rest of the UK. Some 38% of respondents said training and education opportunities were regularly lost due to severe rota gaps, compared to 32% elsewhere in the UK and up from 26% in 2019.

Almost 40% of junior doctors reported that rota gaps were not being sufficiently dealt with, which impacted their education and training. This percentage was significantly higher than in the rest of the UK (29%).

Outdated contract

Junior doctors in Northern Ireland are still on the 2002 contract, which is no longer fit for purpose and does not reflect the reality of training in 2023.

You told us that you do not believe in the fairness of the rota monitoring process and feel trusts are experts in getting the maximum work out of trainees for the minimum banding payment. The protections on work-life balance that trainees now expect are not reflected in the rights the contract gives us. 

All this contributes to training being much less attractive than non-training posts, and even less attractive than working abroad in countries like Australia.

Voting with our feet

It is therefore no surprise that a growing number of junior doctors are reconsidering the training pathway in Northern Ireland altogether. 

The most recent fill rates for the 2023/24 GP training programme intake show that only 99 training posts out of 121 are filled for August 2023. At the time of writing, there have already been 30 resignations from 294 offers for the foundation year one programme, which is a 10% drop-out rate.

It’s time to act

It is time to fix pay, fix rotas, fix training and fix our outdated contract. The future of our profession and our health service depends on it.

It is time for junior doctors in Northern Ireland to act. Learn more about what we are doing to address this.


Fiona Griffin is chair of the BMA Northern Ireland junior doctors committee