Is being a doctor more stressful than other jobs?

Induction and support

Police constables initially patrol with an experienced officer for many months in a system similar to an apprenticeship; as a new patrolling officer you are rarely on your own. Likewise as a Royal Marine you work within a troop of 30 men, some of whom will have served for more than 10 years. In both careers, there is a larger body of colleagues with knowledge and experience around you, and they are simply more available than the average senior doctor. In medicine you become acutely aware that by seeking help you are adding to a colleague’s workload.

Personal responsibility

We were no strangers to responsibility through our other jobs, with potential for injury and loss of life if mistakes were made. There was, however, a degree of protection in systems and protocols with clear boundaries about what was and was not our responsibility. Being a doctor is more challenging in this respect—there is less team working, and decisions taken are often our individual responsibility.

Working patterns

Since the age of 18 we have both worked nights, weekends, and bank holidays in jobs with long hours and no guaranteed finish time. But we have never been as tired or as physically and mentally stretched as when doing junior doctor on-calls. In previous jobs the antisocial hours were part of the shift pattern and you were not expected to work 12 days in a row unless you chose to do so. Additionally, antisocial hours were not necessarily busier than standard shifts; our experience in medicine is that on-call shifts often have a more intense caseload, with considerably reduced staffing and solitary working adding to the stress.

Leave

Although there was potential for leave to be cancelled in the police and military, it was rare, and the administrative processes were more efficient. Getting time off in medicine is a frequent source of stress and anxiety—we all know of doctors rostered to work on their wedding day who desperately try to make the swaps themselves. It is also rare that rotas are published in a timely way, and changing posts adds to this uncertainty. Rota gaps in medicine are now so common that leave arrangements lack flexibility, further affecting quality of life for NHS doctors.

Changing job and location

Although military personnel have no final say in where they are sent, there aren’t many jobs that require you to move as frequently as a doctor. As a police officer you may be moved to another station, but generally this would be within the same area and certainly not at the other end of the country. Likewise, there is no enforced change of role and department every four months as happens in medicine, something that contributes to an almost permanent awareness of our conscious incompetence alongside a nagging anxiety about our unconscious incompetence.

Multiple conflicting demands

This is probably the biggest and most challenging difference. We both experienced extremely busy periods in our previous careers, but we were generally able to finish the job. As doctors we are invariably interrupted; attempting to complete one task while continuing to receive and prioritise multiple bleeps. Extra staff are either not available or are busy and we are often forced to decide on the “least bad” option based on incomplete information and with potential for disastrous consequences if it goes wrong.

We are pleased and proud to be doctors and feel fortunate that we were able to come into medicine later than most. We’ve both done some interesting and difficult jobs in the past, but this is the toughest by far. Some work stress is inevitable but other professions seem to do more to minimise the impact on their frontline staff. Surely we in medicine should take similar care?