It basically means “not a consultant”. The traditional medical culture is one of toxic infantilism which is really hard to convey until you’ve experienced it. The powers that be have renamed us so many times. We used to be called house officer, senior house officer, registrar then consultant. Then the new training pathways came in in the early 2000s and this creeping culture of making us sound as junior as possible. Senior house officer was officially outlawed for fear it gave nursing staff and others a mistaken impression that the doctor was in any way senior. Replaced with core trainee, or junior grade and now they’re suggesting “central doctor”. I wish I could make it make bleeping sense but I can’t. Meanwhile someone can do a degree in sport science, 2 years training to be a physician associate and start on £44k 9-5 no on calls. And people wonder why doctors are mad.
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It’s about skills more than education. The university education for nursing, medicine etc is specific skills based programmes Focused at a specific job. I don’t begrudge tradesmen getting a decent wage, I can’t do their job so I need to pay them for their skills and expertise. Nurses and doctors are no different. You can’t easily replace a nurse or a doctor, just like retraining electricians etc takes considerable time and not everyone is up to the job. It’s about skills.