Junior doctors urged to work within their competence

Medical graduates preparing to start working life as foundation year doctors are reminded to practise within their level of competence.

UK-wide medical defence organisation MDDUS is issuing the reminder as thousands of newly qualified trainees begin their role as doctors on the first Wednesday in August.

Concerns have been raised that the huge staff change-over threatens patient safety, with research suggesting mortality rates rise by as much as eight per cent during the transition period.

The GMC’s latest annual National Training Survey of 51,000 junior doctors has also revealed a number of areas of concern. The survey found that, while 80 per cent of trainees say the quality of their training is good, 15 per cent said they felt forced to cope with clinical problems beyond their competence.

MDDUS senior medical adviser Dr Anthea Martin says: “Starting life as a junior doctor is a daunting experience. There is a steep learning curve when medical students make that transition from student to doctor.

“Many feel they are being thrown in at the deep end and the nature of medicine means that it is inevitable doctors have to learn on the job.

“It is worrying that so many junior doctors responding to the GMC’s survey have felt forced to cope with clinical problems that are beyond their competence as this can put patients at risk. Newly qualified medics should not feel pressurised into working outwith their capabilities.

“It is important they do not feel afraid to seek help and advice from colleagues and supervisors. By asking questions, they are reducing the risk of stress and ensuring patient safety is not compromised. Given the correct support, juniors will become more confident and assured in the tasks they perform.”

Dr Martin has welcomed a new compulsory NHS work shadowing scheme, launching next year, that aims to tackle the issue by requiring junior doctors to spend at least four days shadowing a senior colleague before taking up their first job.

“The introduction of work shadowing will undoubtedly go a long way to help trainees settle into their new role,” adds Dr Martin.

She says that while it is rare for MDDUS to receive calls from junior doctors concerned that they have been asked to work beyond their capabilities, it does happen. “It is more likely that the doctors themselves fail to recognise the limits of their expertise and competence.

“When this happens, patients are placed at risk and this increases the possibility of a complaint or clinical negligence claim,” adds Dr Martin. “This can have further ramifications such as onward referral to the GMC or disciplinary action. If in doubt, juniors should always seek advice and support from senior or more experienced colleagues.”

Supervising doctors are reminded of their responsibilities towards trainees taking on new roles. The GMC survey also revealed that 33 per cent of trainees said they rarely or never had informal feedback from a senior clinician on how they were doing in their post.

GMC guidance Leadership and Management for all Doctors provides advice for those whose responsibility it is to ensure newly qualified doctors are given the support they need. It states that doctors with extra responsibilities “must understand the extent of their supervisory responsibilities, give clear instructions about what is expected and be available to answer questions or provide help when needed.”

Dr Martin concludes: “Supervising doctors should support juniors wherever possible. This extends beyond the initial shadowing period and includes ensuring new doctors have the skills and training to be able to carry out their roles safely.”

Ends

For further information contact Richard Hendry on 0845 270 2034 or 07976 272266, or email rihendry@mddus.com.

Note to editors

MDDUS (The Medical and Dental Defence Union of Scotland) is a medical and dental defence organisation providing access to professional indemnity and expert medico- and dento-legal advice for doctors, dentists and other healthcare professionals throughout the UK. For further information on MDDUS go to www.mddus.com.

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