UK-trained doctors face a greater risk of burnout during the pandemic

Trained doctors are at greater risk of burnout now than during the pandemic, with some describing how they have struggled with inconsistent workloads and inadequate support.

Recent figures published by the General Medical Council (GMC) in its national training survey of junior doctors and their trainers reveal the proportion of trainees who feel they are at “high or moderate risk” of burnout. 63%

This is higher than in 2020 and 2021 during the epidemic, when the figures were 43% and 56% respectively, although there was a slight decrease in the previous year.

Mike Greenhalgh, co-chair of the British Medical Association’s (BMA) junior doctors committee, said: “The burnout figures from the GMC are alarming but sadly not surprising – they are and with the increasing trend of doctors taking time out of training, or choosing to. jobs abroad and outside the NHS. ”

The GMC survey – the largest annual survey of UK doctors – asked 74,000 doctors about their workplaces, quality of training, health at work and workload. It found 32% of emergency medicine trainees are at high risk of burnout, the highest of any specialist.

The report said: “The results of the survey are still very worrying. “A third of those trained in emergency medical services [are] rated as at high risk of burnout, suggesting that unsustainable workplace pressures have become the norm in this particular setting.”

The warnings about the pressures facing trainees come as the health secretary, Wes Streeting, hopes to tackle the problem with junior doctors. The Government and the BMA, the doctors’ union, have agreed a revised pay deal for the lowest paid doctors in England worth around 22% over two years. Members will then vote to accept the deal.

Victoria Selwyn, 27, who is a junior doctor, said that apart from a better salary, it is necessary to take care that the participants feel tired, as well as better support. He said he is well trained, but nothing can fix a junior doctor who takes care of “two or three hundred patients” with one registrar on seven floors of the hospital.

He described trying to stabilize patients who were deteriorating at night until his registrar was available. “Everybody’s straight … and these nights, your bleep is always going off,” he said. “Your job ends up being multi-tasking and you’re trying to differentiate yourself in a million different ways. You’re wondering how you’re meant to get through and put patients first. You feel like you’re having a lot of fun.”

He said there were challenges of staff shortages during his training, and many of his colleagues needed time off from fatigue.

Selwyn added that it can be frustrating that after such intensive training it was often difficult to find work in the chosen specialty. He hopes to train in psychiatry and believes that more training activities will help create a better career plan for junior doctors.

Michael West, professor of work and organizational psychology at Lancaster University, said: “If you were to invent the worst possible job at the beginning of a person’s career, the job of a junior doctor would be it.” .”

West, co-author of the GMC’s 2019 report Caring for Doctors, Caring for Patients, says a lack of independence, poor working conditions and a culture of guilt have contributed to a “toxic cocktail” for junior doctors. He said: “It is difficult to work well and treat each patient as a person.”

More than 9,000 junior doctors start working in hospitals every year across England, Wales, Scotland and Northern Ireland. Most take time off during the first two years of employment or later, and a large number complain of stress and overwork.

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after the news release

Nathan Robinson, 28, said he took a six-month break from stress when he started as a junior doctor in the summer of 2021. He said there was a “disagreement” between how medical students thought about their work and the reality of first jobs.

Robinson said that although the work is difficult, it is very difficult because of the lack of support and the culture of blame when things do not go well. “I didn’t know what I was getting into,” he said. “Is it going to require workers? Is someone going to die?”

Once in his second year of hospital training, he was the only doctor in his emergency department dealing with “adults” – patients who came in with moderate to serious health complaints. beauty. He said he was examining “patient after patient” with no time to stop and think. “We forget sometimes there’s a life on the line,” he said. “You work 150% all the time, but nobody appreciates it.”

Robinson said there was no support or learning after the transition was too difficult. He said: “I would go home, sit down and think: ‘Well, what happened?’ “The next day, it’s like everything that happened yesterday is a clean slate. No debrief. There is nothing.”

A survey of 10,000 medical students in British Medical Journal last year found that one in three UK medical students planned to leave the NHS within two years of graduating – either to practice abroad or to leave medicine altogether.

Some trainees say frustration and dissatisfaction has been increased this year by the new delivery system of their hospital training programme. While many find a place they love, others are asked to move hundreds of miles from where they live.

Professor Colin Melville, director of medicine and director of education and standards at the GMC, said: “Our analysis shows that the risk of fatigue is significantly associated with overwork, lack of or interrupted exercise time. , and feeling unsupported.”

An NHS spokesman said: “The findings from this report highlight the continued need to support the training and working life of doctors and the importance of recognizing the risk of burnout in doctors in training and the doctors who train them. We know that more needs to be done and so we are strengthening our workplace health services and reviewing our mental health and treatment for staff to ensure that everyone working in the NHS has the right support they need .

A spokesman for the Department of Health and Social Care said: “The deal put in place for doctors will increase pay for junior doctors and see the BMA, NHS England and the government work together to improve standards, including to examine the current circulation system.”