I worked a 1:2 for 7 years with a series of absentee landlords, many of
whom frankly took the p*ss - I remember one particular charmer who asked
if I minded covering Thursday night. The rota was M/Th one week, T/W/F/S/S
the other. He left thing Tuesday morning and returned the following
Monday! I made him take it as A/L - well it was deducted from his
This was in the days of the old contract, and one of the reasons I left
was that a dermatologist 10 years older than me could be taking home half
as much again with no on-call...
To answer the question, people coming through the ranks now simply will
not look at a 1:2, so you have to look at a better rate. The catch with
most rotas is of course that you are expected to do internal cover, which
turns a 1:3 into a 1:2.4 or so. There comes a minimum staffing, however
small the department, and I am inclined to agree with Adrian on 1:4.