Following qualification at medical school (= passing the finals exam), students may apply for a provisional registration and license to practice as a doctor in the UK. All such licenses are granted by the UK doctors' regulatory body, the General Medical Council (GMC). A provisional license entitles the holder to practice medicine only under supervision by a fully licensed practitioner. Full registration is obtained upon satisfactory completion of an approved, supervised apprenticeship of one year duration which must contain at least 4 months each of Hospital Medicine and Hospital Surgery.
Out of these regulations were born the 'Junior House Jobs', equivalent to the US internship. Although the stipulation is only for 4 months, in practice 99.9% of UK graduates undertake two 6 month contracts, one in Medicine and the other in Surgery. Accreditation for such posts towards full registration is granted by the local regional Medical School. Although clearly intended to oblige the new doctor to get a broad practical grounding in the bread and butter of medicine, the staffing requirements of the hospitals has historically forced considerable bending of this intent, so that it is entirely possible for a doctor to become fully registered having done six months of Neurology and six months of Neurosurgery, having never seen either an appendicitis or an asthma attack.
A Junior House Officer (JHO) typically works an average of 72 hours a week, based on a full 40 hour working week and cover for every 4th night and weekend. Such a regular rota results in a regularly repeating four week working cycle of 104, 56, 72 and 56 hours respectively with the longest continuous shift being 56 hours (9am Saturday until 5pm Monday).
Basic starting salary for a House Doctor is £18585 annually for the basic 40 hour week, but each post is then allocated to one of several pay bands depending on the amount of additional on-call duties worked and their intensity. Band supplements (as a proportion of basic salary) are then:
Band 1A– 50%, Band 1B– 40%, Band 1C– 20%
Band 2A– 80%, Band 2B– 52%
Band 3– 100%
Band FA– 25%, Band FB– 5%, Band FC– Pro-rata.
Thus, a House Doctor on a busy 1:5 rota may work an average of 26 additional hours each week, for which they receive an additional £14868 annually before deductions. Malpractice Insurance for this period is nil: the State pays any costs.
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