In the United Kingdom, a resident doctor, known until 2024 as a junior doctor, is a qualified medical practitioner who is either engaged in postgraduate training or employed in a non-training post. The period of being a resident doctor starts when they qualify as a medical practitioner following graduation with a Bachelor of Medicine, Bachelor of Surgery degree and start the UK Foundation Programme. It culminates in a post as a consultant, a general practitioner (GP), or becoming a SAS doctor (Specialty, Associate Specialist, or Specialist doctor). The term resident doctor currently incorporates the grades of foundation doctor, core trainee (in some specialties, such as surgery, medicine, and psychiatry), and specialty registrar. Before 2007, it included the grades of pre-registration house officer, senior house officer and specialist registrar. During this time, resident doctors will do postgraduate examinations to become members of a medical royal college relevant to the specialty in which they are training, for example membership of the Royal College of Physicians for doctors specialising in internal medicine, membership of the Royal College of Surgeons for doctors specialising in surgery or membership of the Royal College of General Practitioners for doctors specialising in family medicine. Doctors typically may be resident doctors for 8–20 years, and this may be extended by doing research towards a higher degree, for example a Doctor of Philosophy or Doctor of Medicine degree. In England, there are around 71,000 resident doctors.
Replacement of the term "junior doctor" There had been controversy about the historical term "junior doctor", with many organisations and individuals voicing concern that it created misconceptions about their work and did not do justice to the skills and experience acquired by these doctors, many of whom have been working for several years. The British Medical Association (BMA) voted to discontinue the term "junior doctor" from all forms of communication at their 2023 annual representative meeting (ARM). The motion was presented to the BMA Representative Body by Dr Sai Pillarisetti, a foundation year doctor. After a debate and vote of members, it was passed in full and made BMA policy. References to junior doctors in BMA policies and communications are due to change to "resident doctors" from September 2024. An independent report for Health Education England (HEE) authored by Prof Scarlett McNally found more than 75% of those surveyed found the term "junior doctor" inappropriate, and almost half thought "trainee" should be avoided. The report recommended a shift towards "postgraduate doctors" instead. In December 2023, then Health Secretary Victoria Atkins faced criticism for using the term "doctors in training" as an alternative to "junior doctor" in a TV interview on BBC Breakfast. This was followed by a spokesperson for the Department of Health and Social Care stating they respected the profession's decision to move away from the term "junior doctor". In July 2024, as part of a deal between the BMA and the UK government to settle a long-running dispute about junior doctors' pay in the NHS in England, it was announced that the term "junior doctor" would be changed to "resident doctor" within the English NHS. This deal was accepted by the BMA on 16 September 2024, and the name change took effect on 18 September 2024. A similar agreement was made between BMA Scotland and the Scottish government covering NHS Scotland in October 2024, with this agreement coming into effect in November 2024. Separately, the Northern Ireland executive agreed to start using the term "resident doctor" in Health and Social Care (Northern Ireland) from the same date as in England, while the Welsh government agreed to start using the term in NHS Wales from November 2024.
Working hours In Europe and the US, there has been some reduction of the working hours of doctors who are in postgraduate training, in line with recommendations and legislation aimed at improving patient safety and doctors' working conditions. In 1991, the government, the NHS and the British Medical Association (BMA) agreed a package of measures on working hours, pay and conditions which was called the New Deal for Junior Doctors. The doctors' duty hours, which were felt to be excessive, were reduced to a maximum average of 56 hours' actual work and 72 hours' on call duty per week, although the change was not enforced until 1 December 2000. The European Working Time Directive (EWTD) sets out minimum health and safety requirements for the organisation of working time. The EWTD required the average working week to fall to 48 hours or fewer by 2009. The shortening of resident doctors' working hours had implications for how training programmes are organised, especially for specialties such as surgery, where there was a tradition of maximising the hours of experience. Most studies that have looked at a reduction of resident doctors' working hours have found either a beneficial or neutral impact in terms of measures of patient safety, clinical outcomes and postgraduate training. The reduction in number of hours worked by resident doctors is one of the factors leading to blurring distinctions between them and other clinical professions, such as nurse practitioners who also perform complex tasks.
Migration An Organisation for Economic Co-operation and Development survey in December 2015 showed that 35.4% of NHS doctors, 34,000, were born abroad compared with 5% in Italy, 10.7% in Germany and 19.5% in France. The UK was the second highest exporter of doctors, second only to Germany, with 17,000 British doctors working in other OECD countries. These figures are for all doctors in the NHS, not just resident doctors. According to the Career Destination Report published by the UK Foundation Programme Office in 2019, an increasing number of UK resident doctors are seeking to take up work abroad. A report by the General Medical Council described a number of "push" and "pull" factors, including seeking a better work-life balance and wanting to take advantage of other opportunities abroad. Most doctors who complete foundation training do eventually return to specialty training in the UK within three years.
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