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This is Going to Hurt: Secret diaries of a junior doctor by Adam Kay

24 November 2017

This medic’s diary is not for the squeamish, says Nick Goulding


LAST summer, I was sitting under the dome of St Paul’s Cathedral at a rites-of-passage ceremony. Fellow academics and 1000 proud family members were applauding the latest cohort of medical graduates being inducted into this most challenging and rewarding of professions.

I wondered how they would cope when faced with their first solo emergency; their first prescribing error; their first death. We trained them in medical science, communication skills, professionalism, and team working, but what about resilience? Within weeks, these fledgling doctors would be face to face with the reality of life on the wards of a hospital. How would they cope?

Adam Kay’s personal diary on the life of a junior doctor is a wake-up call to all medical students who think that their early career will be a breeze. This book will be an uncomfortable read to seasoned health professionals and the general public alike. It may well be categorised as “comedy” in book stores, but hilarity is the bedfellow of heartache in this raw and gritty chronicle.

Gallows humour is often a coping mechanism for those in chronically traumatic circumstances, and that is certainly borne out here. Prepare to be alarmed by the realities of a struggling National Health Service and the demands that it places on its overburdened staff. Witness the depressing decline of the diarist as a functioning human being.

Would I recommend it to my mother as a holiday read? Probably not. Would I suggest it as course (coarse) material for my undergraduate students? Yes, but with a health warning: only a fraction of careers end like this. For the casual reader looking for a succession of belly laughs — you will get a few, but they are mixed with an equal measure of tears. It is not a book for the squeamish. The boundaries of decency are prodded in places, and a few entries in this secret diary should have remained secret.

For me, the greatest value of this book was as a reminder of how vital it is not just to clap and cheer our newly qualified doctors on graduation, but fully support and nurture them on the tough journey ahead.


The Revd Professor Nick Goulding is Professor of Pharmacology and Medical Education at Barts and the London School of Medicine and Dentistry.


This is Going to Hurt: Secret diaries of a junior doctor
Adam Kay
Picador £16.99
Church Times Bookshop £15.30

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