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Junior doctors’ training under threat from heavy workloads, the GMC warns

Increasingly heavy workloads are eroding the time doctors have for training, according to the GMC.

The 2016 national training survey, which canvassed opinions from around 55,000 doctors in training, shows that many trainees are working under such pressure that its threatening the training they need to become the next generation of GPs and consultants.

Over half of doctors in training reported that they regularly work beyond their rostered hours, and up to 25% said their working patterns left them sleep-deprived on a weekly basis – a worsening trend in recent years.

Overall, more than 43% of doctors reported their daytime workload as ‘very heavy’ or ‘heavy’, an increase since 2012. Key specialties – including emergency medicine, acute internal and general internal medicine, respiratory medicine, and gastroenterology – reported even higher workloads which have grown worse in the past five years.

The survey found that doctors with excessive workloads were more likely to have to leave teaching sessions to answer clinical calls.

Other implications of too-heavy workloads include doctors in training being forced to cope with clinical problems beyond their competence and having inadequate handovers with colleagues.

The GMC’s analysis also found that rota gaps were a significant issue for many doctors in training.

The GMC’s Chief Executive, Charlie Massey, said: “We know the very real pressures our healthcare services are under and appreciate the challenges organisations involved with the training of doctors are facing, but it is vital training is not eroded.

“Those responsible and accountable for the delivery of medical education locally must take appropriate steps to ensure the training of doctors remains protected. Medical training is so often a bellwether for the quality and safety of patient care and patients are directly at risk if support and supervision of doctors in training is inadequate.”

The GMC also surveyed 23,000 trainers with many saying they lacked sufficient time to fulfil the role as well as they would like. One in three said they didn’t have enough time to deliver training.

Massey added: “We have clear standards about protecting doctors’ training, and valuing trainers, that we expect education bodies and providers to meet. Where our standards are not met, we can and we will take action.”

Dr Pete Campbell, BMA junior doctors committee chair, said: “We cannot accept a situation where vital training time is being sacrificed in the face of rising pressures on services. This is a short-sighted approach that is already having an impact on the quality of patient care. We need to maintain a highly trained medical workforce if the NHS is to continue to deliver a world class service for patients, and protecting and valuing training time is absolutely vital to achieving this.”

2012 versus 2016

The percentage of doctors in training reporting their daytime workload as ‘very heavy’ or ‘heavy’ in the GMC’s 2016 national training survey included: emergency medicine (78.4%), gastroenterology (63%), respiratory medicine (61%), general internal medicine (60%) and acute internal medicine (59.7%).

In 2012, the equivalent figures were emergency medicine (72.38%), gastroenterology (60.18%), respiratory medicine (56.65%), general internal medicine (50.45%) and acute internal medicine (46.55%).

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