Book Review: This is Going to Hurt by Adam Kay

If you are interested in applying to medical school and keep up with the medical field on social media, you probably have already heard of the sensation that is This is Going to Hurt. Winner of a record four National Book Awards, amongst which the Zoe Ball Book Club Book of the Year, and New Writer of the Year, a non-fiction book written by former Obstetrics & gynaecology registrar, Adam Kay, it is definitely required reading if you want to break the ice with pretty much anyone in the medical world right now.


The book includes tales of his days from the beginning of his foundation years all the way through to specialist training. It is written in the form of what can only be described as the diary of a junior doctor, scribbled in secret after endless days, sleepless nights and missed weekends, and reviewed by Stephen Fry as “painfully funny”.

Kay’s account of the days spent on the wards is indeed laugh-out-loud funny, with vivid descriptions of constant tsunamis of bodily fluids, eye-opening accounts of what our current health service is like, but most importantly - the firsthand experience of someone in the phase we all, excited or fearful, eventually get to and have to get through - a junior doctor. 

What I liked about the book

Well, first things first, This is going to hurt is an impossibly funny book. Either that, or after a couple of years spent in med school, you start to find the amusing side of all things odd at best and gruesome at worst that doctors encounter on the wards. Granted, the book at times is not for the faint-hearted and can grotesquely depict the misfortunes that some patients present to the hospital with. On the other hand, the narrative remains light-hearted even in the most impossible of times for our main hero, retaining the same upbeat and positive vibe all throughout, and even when you’re feeling empathetic towards some of the things a junior doctor needs to endure, you can’t help but laugh a bit with it, too.

“Yes, I haven’t slept in 32 hours, yes, everything is on fire and yes, I have no idea what I’m meant to be doing right now, but it’s all okay and the adventure continues” - is the general mood that the story goes in for the majority of the book. Despite the endless predicaments that our hero finds himself in time and again, the occasional story of a successful delivery, especially if previously expected to be a particular challenge, turns everything back around and gives you a sense of fulfillment, that yes, it surely must be all worth it, after all.

Another thing that I really enjoyed about this book was the raw honesty, with which some of the situations in which junior doctors often find themselves in, have been described. There was no glamorising or sugar-coating of the situation, the fact of the matter is, you will end up working 97-hour weeks, your personal and social life will suffer as a consequence, there will be times, more often than not, where your whole existence will be consumed by your job.

While it is your institution’s task, whether that’s the med school you attend or the hospital you end up working at, to advocate for a healthy work-life balance, it seems that the dire years you will spend working as a junior doctor are almost a certain kind of rite of passage that everybody goes through eventually. This book honours that reality and in a way, especially if you’re in your early years of medical school or have not yet applied to one, i.e. you are not completely familiar with the realities of the clinical environment and routine, it can serve as a no-holds-barred account of what is looming round the corner in just a short few years for you too. 


What I didn’t like about the book

You may have already read the book or perhaps watched an interview with its author, in which case you already know of the unexpected turn it takes just before it ends. Throughout the entirety of the book, despite the humour with which all stories are depicted time and again, we are still able to sneak a peek into the challenging reality of the day-to-day life of a junior doctor, from the long exhausting hours, through the jokeful and very eloquent suggestion that the hospital parking meter earns more per hour than the staff, all the way to ungrateful patients and helpless medical situations, we see it all.

Even equipped with this prior knowledge and understanding that builds up throughout the book, it’s not enough to prepare you for what comes around the corner - the author experiences a heavy patient loss, which ultimately triggers his decision to resign from his post and leave medicine for good.

While I think it is particularly important that awareness is continually raised for the sometimes impossible challenges doctors face and the incredible resilience they need to be equipped with in order to deal with them, as well as the toll it can too often take on their mental health, I couldn’t help but feel the conclusivity of the author’s decision.

As someone in their early years of medicine and certainly still very impressionable by anything said and done by higher authority professionals in medicine, I felt hopeless gut punch upon finishing the book that something like this would probably happen to me too and when it did, I was probably not anywhere near prepared to deal with it and started worrying about quitting before I had even begun my medical practice.

While not necessarily something I didn’t like about the book and appreciate that it was just one man’s account of one’s own personal experience, it did leave me concerned and I think spending some more time exploring other alternative avenues that not every tragedy needs to end in giving up, would have brought back the reader’s hope, especially if one on the path of becoming a physician. 


In conclusion, This is going to hurt was a loud, funny, heartbreakingly sad and a very real account of one doctor in the beloved but beleaguered NHS, and I would absolutely prescribe this book to anyone in their early medical training. While I loved that it remained realistic and honest at all times, I think it’s important to remember that it was exactly what it says it is - an account of one doctor in the NHS.

While many of the logistic challenges presented might still be around by the time you qualify and begin your practice, and most certainly the challenges that have to do with exhaustion, mental health and life and death decisions will always be around, this book is not a one-size-fits-all recipe of what it would be like for every junior doctor out there.

We are continuously improving, not only in our technology advancement, drug development or approach to patients, but we are being more and more open in talking about the struggles, both mental and physical, of being a doctor. Ensuring such a widespread awareness amongst both medical professionals and the public too, is vital to our ability to cope with adversity in a safe and productive way. 

We hope you have found this review helpful. Once you have read the book, come back and leave a review and tell us what you think! As you are preparing for medical school applications, if you have any questions, email us at

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