Kay began his medical training as a House Officer in 2004 with the United Kingdom's National Health Service after attending Dulwich College and Imperial College School of Medicine. This event motivated Kay to respond to this accusation by releasing This is Going to Hurt, which illustrates his own experiences as a junior doctor. Around this time in 2015, junior doctors entered contract disputes with the NHS leading the Secretary of State for Health and Social Care, Jeremy Hunt, to accuse junior doctors of being greedy.

Five years after his resignation, Kay was officially removed from the medical register which prompted him to dispose of all the medical files he had been storing, leading him to review his reflective journal. It was recommended to Kay to write this diary as a 'reflective practice' in which he could log any interesting clinical experiences he experienced throughout his training. This is Going to Hurt is mostly composed of diary entries Adam Kay wrote during his medical training under the National Health Service. Kay accomplishes this by incorporating humour into his personal anecdotes that depict his life as he progresses through his medical training, and his eventual resignation from this career. Kay's book discusses political issues in the health care system of the National Health Service in the United Kingdom and societal conflicts between the general population and neglected doctors. It is a collection of diary entries written by Kay during his medical training from 2004 to 2010. This is Going to Hurt: Secret Diaries of a Junior Doctor is a nonfiction book by the British comedy writer Adam Kay, published in 2017 by Picador.

Adam kay this is going to hurt