Sir, the proposed new contract for junior doctors is an issue which has implications not just to doctors but also to dentists as well. The contract, which Jeremy Hunt (Secretary of State for Health) is intending to impose from August 2016 will force junior doctors to work anywhere from 7 am – 10 pm Monday to Saturday. This previously stood at 7 am – 7 pm Monday to Friday with time worked outside of these hours paid at a 'banded' rate. The change means the hours classified as 'normal' will increase by 50% and therefore reduce the amount of 'banded' extra pay given for working unsociable hours by up to 30% for doctors (depending upon the speciality). To clarify – the term junior doctor is a loose term. It can be used for anyone fresh from medical school (Foundation Doctor Year 1) to a Senior Speciality Trainee (ST7+), a difference of about 9 years.

An oral & maxillofacial surgery trainee must obtain both a medical and dental degree. Fees are currently at £9,000 a year for university level education and with a minimum of 8 years in university (5 years for dentistry and 3 for medicine or vice versa) the least a student must fund is ≥£47,000 (including available study bursaries – IF awarded).

Furthermore, the second degree does not qualify for a student loan and therefore the fees must be paid for upfront increasing the financial burden. The fees don't stop there, the personal cost of training for compulsory courses and post graduate qualifications is rising and placing further strain.1 Another area of concern is that of the locum pay cap. The Department of Health wishes to cap what is paid to locums, which is considered to be the financial lifeline of any 'second-degree' student. Pay protection is another matter of concern that is likely to be phased out with the new 'junior doctor' contract.

This allows a trainee who has spent sometimes 2-6 years post primary dental/medical qualification working as a speciality doctor/dentist or otherwise to continue on this level of pay as a foundation doctor, rather than face a massive pay cut of up to 40% and fall to the bottom of the pay pyramid. All of this with annual retention fees causes an immense financial strain on the new crop of oral and maxillofacial trainees.

It is with a heavy heart that, as a third year medical student, I seriously consider my position in a second degree at the mercy of the Department of Health and its decisions. This will push the speciality to the brink and plunge me deeper in debt – which may force me to leave training. Most trainees have their origin in dentistry and with the British Dental Association (BDA). As an organisation the BDA must join the growing body of professional organisations and voice concern over the new contract, as we trainees are facing a questionable and bleak future.