What should we call Junior doctors?
Updated recommendations, July 2023
Following publication of my report in April 2022, there have been further discussions, so I have updated the recommendations.
- All Doctors should be clearly identified as a Doctor (or Surgeon).
- Where a level of expertise is needed, eg for the rota, these broad ranks
- Foundation Year 1
- Consultant or Specialist
- The term ‘Junior doctor’ and ‘trainee’ should not be used. Where it is
essential to know the Doctor is on a training programme:
- ‘Doctor in Postgraduate Training’ OR:
- ‘Postgraduate Doctor’ OR:
- ‘Postgrad Doctor’
- Surgeons should consider using the title ‘Dr’. This reinforces their role as medically qualified and reduces the use of historical titles (Mr/Ms/Miss/Mrs/Mx) that are gendered and related to marital status. This will require good support for those committed to a surgical career from their surgical department without requiring the historical title.
- The term ‘Junior Doctor’ originally applied to doctors in postgraduate training programmes. There should be awareness that there are now more doctors not in training programmes than in postgraduate training programmesii. SAS doctors (specialist, associate specialist and specialty doctors) are on permanent contracts with national terms and conditions of service. SAS doctors are experienced and senior doctors who have at least four years of full-time postgraduate training, two of which have been in their relevant specialty. There are also large numbers of Locally Employed Doctors (LE Doctors); for example, a doctor may be “on the SHO rota” but may not be in a training programme.
- Every effort should be made to ensure the name and role as a Doctor is clear, including name badges, lanyards, theatre caps, introductions and signatures.
- Patients and other staff should be included in any communication effort to ensure respect for these Doctors.
I was invited to report on what we should call junior doctors. I convened a working group, with a range of invited speakers, to give their views. A survey had almost 2000 responders. Everyone (88% of survey responders) agrees that the term ‘junior doctor’ is demeaning. 47% also thought ‘trainee’ should also be avoided. The educational labels that started in 2007 are poorly understood. It is not a simple re-branding exercise. There are many problems. The term means different things to different people. There are almost as many doctors working in similar roles who are not in training posts as doctors who are in training posts. There are multiple other roles in healthcare that can be confusing. People tend to guess if they are not sure or don’t want to cause embarrassment. This can be a safety problem, if other staff do not realise the seniority of an opinion giver.
I have some solutions! It will require a suite of terms, not just one. Some old terms (eg “Registrar”) should come back.
My report has no legal power to change practice. I am reliant on everyone: the public, staff, doctors and organisations that manage them, to share my report and start some changes. Thank you.
Prof Scarlett McNally BSc MB BChir FRCS(Tr&Orth) MA MBA FAcadMEd
Consultant Orthopaedic Surgeon Twitter @scarlettmcnally