‘Junior’ doctors: what’s in a label?

junor doctor

Image: ITV News

When is a junior doctor not a junior doctor?

The answer is not ‘When they grow up’, but ‘When they work in the UK’, according to England’s chief medical officer.

The ‘junior’ descriptor was flagged last week by an Oxford professor as being ‘unjust, progressively inaccurate and detrimental to self-esteem.’ Chief medical officer Dame Sally Davies agreed with him that hospitals should consider updating their nomenclature for doctors who have only recently graduated.

However, the online response from the not-senior-doctors themselves has been less supportive.

Some noted that delineations in levels of medical responsibility already do exist, for very good reason, so obscuring them with a more cryptic title helps nobody. Tell it like it is!

The ‘junior’ debate is merely the latest in the endless series of quandaries about naming groups of people. If there is one, universal rule about labelling for any population that is a minority or vulnerable, it is this: after a decade or so, the name gets on the nose.

I recall being amazed as a medical student when I discovered ‘spastic’ referred to muscle tone. Hard to believe it had once been an acceptable description for a disparate group of people whose care needs were defined by reduced mobility.

In my schoolyard, of course, the term was pure insult, and had been replaced by the far kinder ‘disabled’. Kinder for a decade or so, until that descended into the same sociological mire, to be superseded by ‘person with a disability’.

This term is now souring, morphing into ‘person living with a disability’, or ‘other-abled’. The only sure bet is that even the most sensitive term currently used will become outdated over the next decade. In the near future, those who don’t understand the history of language will shake their heads at how disrespectful we must have been, back in 2017.

I have a fascination for word usage, and the evolution of language that delineates humans provides endless entertainment. (If you are reading this in 2027, my apologies to all non-humans for the typecasting.)

I don’t rail against change, by any means. Political correctness, after all, serves a social purpose. We embrace new language once the vulnerable group feels the previous terminology has become demeaning.

If the group currently called junior doctors decides the label is derogatory, I’ll gladly run with the herd. After all, I am already comfortable with LGBTIQ; people of Muslim faith; Aboriginal and Torres Strait Islander peoples; and survivors of family violence.

All those names – here, substitute any minority group – have undergone constant evolution. Their predecessor used 10 years ago is now inaccurate, 20 years ago is outdated, and 30 years ago is undeniably an insult.

Even those conservatives who decry political correctness only ever rant about the latest change—they wouldn’t dream of going back three decades.

Some progressives mount the opposite argument; perhaps we should somehow avoid specification altogether because it is discriminatory.

But the practical need for delineation always wins out. Some doctors have recently been let loose on patients; others have been around for years. It helps to know which is which.

‘Junior’ is not yet on the nose, but it soon will be. Scoff if you will, but the Oxford professor will be proven right – he is merely an oracle.

After him will march a vanguard of a few sympathisers, then a groundswell of change, then general adoption, and finally ‘junior’ will be consigned to the sharps bin.

That’s all good; everyone will be happy to have finally updated the label. Just in time for the next cycle.

An edited version of this article was first published in Medical Observer, Oct 2017

About Dr Justin Coleman

Justin is a GP working in Aboriginal health in Brisbane, Australia. He is also a medical writer, editor and blogger. Further details at https://drjustincoleman.com/
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