Monday 15-12-2025 - 12:00

 

Written by Michelle Ngugi

Lancaster Medical School Department Representative 2025/2026 & 5th Year MBChB student

 

 

 

A Final Year Student's Reflection on NHS Placements During Prolonged Industrial Action.

 

 

Industrial action has become a regular part of NHS life. Since March 2023, repeated junior doctor strikes have affected how hospitals run and, in turn, how medical students are trained. For those of us in clinical years, this has meant dealing with ongoing uncertainty around placements, often with little warning and limited clarity. 

As a final year medical student at Lancaster, I have had several placements disrupted by strike action in different ways. Sometimes this has meant placements being cancelled altogether. Other times, placements have technically gone ahead, but in a form that looks very different from what was originally planned. By this stage of training, placements are meant to be hands-on and confidence-building. When they are disrupted, the impact is not just logistical, but educational. 

One example that stands out happened at the start of a paediatrics placement in my third year. Just before 10pm the night before the placement began, I received a high-priority email saying that the first week had been cancelled due to strike action. The reason for the cancellation was understandable. What was harder to accept was how late the information came. When cancellations come this late, many students have already planned travel, accommodation, and other commitments around the supposed placement the following day. With clearer systems in place, it feels likely that this could have been communicated earlier, even if plans were still subject to change. 

Experiences like this have not been isolated. Communication around strike-affected placements has often arrived late and been framed as urgent, with little explanation of what students should do next. Messages can feel reactive, rather than part of a wider plan. This leaves students trying to interpret expectations themselves, often without reassurance about how missed time or altered placements will be treated academically. 

Cancellations, however, are only part of the picture. Even when placements go ahead during strike periods, the quality of the learning experience can be significantly reduced. Students may be told to attend as usual, only to find that teams are extremely short-staffed and focused entirely on service provision. Doctors are doing their best under difficult circumstances, but teaching, supervision, and feedback are understandably deprioritised. It is not uncommon to spend long stretches of the day waiting around, unsure of who to speak to or how to be useful. 

In these situations, attendance becomes more about being seen than about learning. While students may technically be present, the educational value of the day can be very limited. At times, it has felt as though this distinction has not been fully recognised when placements are deemed to be running as normal. There is a difference between a placement that exists on paper and one that offers meaningful learning, and that difference matters. 

What has been particularly difficult is the sense that there is no consistent framework guiding these decisions. Industrial action has been ongoing for nearly 3 years, yet responses still feel ad hoc. There does not appear to be a clear set of criteria for when a placement should be cancelled, adapted, or paused on educational grounds. As a result, similar situations can be handled very differently across placements, adding to a sense of unpredictability. 

A more structured approach would help. This could include clearer expectations around what constitutes an educationally viable placement during strikes, earlier communication wherever possible, and explicit reassurance about how disruption will be considered in attendance matters. Even when certainty is not possible, knowing that there is a process in place would make a significant difference. 

This is not about criticising individual clinicians or placement teams, who are under immense pressure and doing what they can. It is about recognising that prolonged disruption requires systems that are designed for it. Without those systems, the burden of uncertainty falls disproportionately on students. 

Medical education relies on trust and communication. When information arrives late or expectations are unclear, that trust is weakened. As industrial action continues to shape the NHS, a more proactive and structured approach to managing placements would help ensure that students are supported not just in theory, but in practice.