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Trainee doctors suffering from burnout as demands on hospital medicine increase

A quarter of trainee doctors are suffering from burnout with their NHS hospitals characterised by poor handovers, inadequate inductions and gaps in rotas.

That’s the conclusion of a GMC report on junior doctors, which challenges employers to safeguard their well being, education and development.

One in six doctors in training said handover arrangements did not always ensure continuity of care between different clinical departments, and one in three said handovers were not used as learning opportunities.

Inductions also varied, with more than 4,000 trainees (8.1%) reporting that they didn’t get an explanation of their role and responsibilities at the start of their most recent post.

And over half of doctors in training – almost 53% – told the GMC that they received less than the recommended six weeks’ notice of their rota. Around one in 10 had only a week’s notice or even less.

Dr Jeeves Wijesuriya, BMA junior doctors committee chair, said: “To see such a large number of junior doctors burnt out is deeply concerning, but no surprise given the intense workload pressures experienced by trainees, and as reported in this survey.

“These statistics lay bare the real-terms impact of poor planning; if a doctor is working in an understaffed department, not getting a rota until two weeks before they are due to begin a new role and even when they do start they are receiving no proper induction, this is bound to be detrimental to their well being and affect how they feel about the quality of their training.”

The GMC review is based on its annual national training survey, which collates the views and experiences of more than 70,000 doctors in training and senior doctors who act as trainers.

Wijesuriya added: “Burnout affects so much more than quality of training, and as this report notes, heavy workloads can have patient safety implications. With a high proportion of junior doctors working beyond their rostered hours and as many as half of trainees in some specialties regularly feeling short of sleep, high quality patient care cannot be guaranteed.

“That more than two-thirds of trainees feel forced to work beyond their clinical competence at times makes for stark reading – and the potential risk that this poses should be obvious.

“There is still a lot of work to be done in improving both the training that junior doctors need to guarantee the quality and resilience of our future NHS, and the quality of working life that they so deserve.”

Doctors in emergency medicine reported the highest rates of burnout. Nearly 74% of emergency medicine trainees rated the intensity of their workload as either ‘heavy’ or ‘very heavy’, and they reported feeling short of sleep while at work more than any other specialty.

Other specialties where trainees reported higher than average workloads and tiredness were surgery, medicine, obstetrics and gynaecology, and paediatrics.

The GMC has commissioned a UK-wide review, led by Dame Denise Coia and Professor Michael West, into the causes of poor well being faced by doctors.

Charlie Massey, the GMC’s Chief Executive, said: “Handovers, inductions and well-organised rotas are indicators of workplaces where teamwork and positive cultures are fostered, and where trainees feel well supported. But where these aspects run less well doctors more commonly report poor experiences.

“Proportionally more doctors who feel unsupported at work with high workloads tell us they experience exhaustion and burnout. That can erode the quality of their training as well as potentially putting patients at risk. These warning signs must not be ignored.”

Read the full GMC report Training Environment Report

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