Author: Elizabeth R

Third Year Medical Student

What is ‘This is going to hurt’ about?

‘This is Going to Hurt’ by Adam Kay is a collection of anecdotes from his time as a junior doctor working in Obstetrics and Gynaecology.

Who is Adam Kay?

Adam Kay was a junior doctor in the UK before switching careers to comedy writing, where he has been involved in programmes such as Mrs Browns Boys and Mitchell and Webb. The book talks about his reasons for going into medical school and also his reasons for changing vocations. Kay uses his skills as a comedy writer to turn his experiences as a junior doctor into a hilarious yet disturbing, eye opening book about working as a junior doctor in the NHS.

Throughout a doctor’s career, they are required to reflect upon their work in order to learn from their mistakes and improve their practice. This reflective writing is saved into a portfolio which gets reviewed regularly. Medical schools have also started bringing this reflective practice into their curriculum so that medical students get used to reflecting upon their experiences.

As a result of this, Kay had years of encounters written down, ready for the best and funniest stories to be read by the general public. In order to protect patient confidentiality, Kay never uses names, instead he uses random initials to describe people.

The review of ‘This is going to hurt’

A life of a junior doctor

Kay explains the pros and cons of being a doctor from delivering babies to breaking bad news. He describes the rush he felt when saving a patient’s life for the first time on a night shift and how he subsequently gained confidence over the years. He also talks about the difficult work life balance of being a junior doctor. This led to almost no social life but, on the bright side, saved him money.

The struggle for a work life balance led to missed Christmases, Stag do’s and dates and ultimately led to the end of a long-term relationship. However, Kay also talks about the camaraderie between health workers and how they make the most of long working hours, especially at times such as Christmas.

The book describes hilarious stories of misunderstandings and mistakes which lead to inevitable hospital admissions. The book depicts stories of strange things stuck in the wrong places and people caught in unusual predicaments. Patients can misinterpret or completely ignore instructions, the consequences of which only get caught later on, when they are forced to attend A&E.

It is hard to imagine how doctors are able to keep a straight face when they come across some situations portrayed in this book. These stories will continuously have you laughing out loud and wanting to tell your friends about the things you have read.

Truly heart-warming

Included in the hysterical anecdotes are stories which are heart-breaking but also truly heart-warming. The stories that particularly stuck to mind were not those of fantastic feats of medicine, but of genuine human connection. Kay explained that some patients just needed somebody to listen to their concerns, to help ease their worries. In many of the cases, Kay did not know the right answer to all of the patient’s questions, but he took the time to listen, a valuable tool which can easily be overlooked.

The book gives an interesting insight into how the NHS works, both positive and negative; from how well teams work together to Kay’s frustration at the bureaucracy between multiple trusts not functioning harmoniously. Kay talks about how multidisciplinary teams work together, each member of the team doing their part in order to effectively deal with different situations.

The support systems for staff are mentioned, where newer doctors are able to ask the more senior doctors for advice. In addition, Kay regularly jibes the at IT system within the NHS, which consistently succeeded in making his life more difficult than it needed to be.

Furthermore, Kay compiled his stories from the times he was working at Christmas to write a short book called ‘The Nightshift Before Christmas’.  It is similar to ‘This is Going to Hurt’ but shorter and centred around the festive period. It is an enjoyable short read which can be read alongside or separate to Kays first book.

Final thoughts

In summary the mix of dark, dry, humour and serious stories provides a sobering picture of how it is to work as a junior doctor in the UK. This book is equally funny and tragic, offering just the right number of laughs to help you through the more tear-jerking stories.

‘This is Going to Hurt’ is a great read for aspiring medical students, providing plenty of thoughts to consider before applying to medical school. Kay gives a unique perspective into the life of a junior doctor which is particularly beneficial for those hoping to follow down that career path, especially for those who do not know of anybody in the medical profession.


1 – Picard, O. and Lee, G., 2013. Medical School Interviews. London: ISC Medical.

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