Trainee doctors’ workload “major threat” to care

THE workload of trainee doctors is at crisis point and poses a “major threat to high quality hospital care”, the Royal College of Physicians has warned.

Medical registrars face the triple threat of heavy workload, limited training opportunities and an unequal distribution of consultants across the country.

The stark warning comes in the RCP’s new report Hospital workforce: Fit for the future? It is based on the largest surveys of UK hospital doctors and defines registrars as doctors who have completed four to five years of training since medical school and are training to become consultants.

Researchers found 37 per cent of trainees describe the workload of the medical registrar as “unmanageable” while 59 per cent said it was “heavy”. This compares to less than five per cent of general practice registrars who said their own workload was either heavy or unmanageable. It raises concerns that the most talented trainees might avoid careers involving acute medical care.

The report also criticised registrars’ training opportunities as “highly variable” and too often compromised by heavy workload. Only 38 per cent of registrars felt their training in general medicine was good or excellent compared to 75 per cent in their main specialty.

Senior specialist doctors were also found to be unevenly distributed across the country with London having double the number of consultants per head of population compared to the East Midlands.

The RCP called for more doctors to be trained in the skills of emergency, general, acute and geriatric medicine and for the hospital workforce to be reorganised to meet elderly patients’ needs. The role of the medical registrar should also be reassessed with more efficient use of their skills.

Dr Andrew Goddard, director of the RCP’s Medical Workforce Unit, said: “Medical registrars are the unsung heroes of hospital care. But their skills are not being used to best meet patients’ needs. The NHS will soon struggle to provide the best care for patients if this situation is not urgently reviewed.”