Work pressures negatively impact training

WORK pressures are preventing many junior doctors from taking part in valuable training opportunities, a problem which could spark a specialty recruitment crisis.

The warning has been issued by the Joint Royal Colleges of Physicians Training Board (JRCPTB) following a survey of core medical training (CMT) doctors.

They say there is a danger that, unless fundamental problems are addressed urgently, trainees will be put off applying for core medical training (CMT) “with a resulting knock-on effect which would compromise medical specialty recruitment.”

Nearly a third of all UK CMT doctors (those who have completed their two-year foundation training) responded to the survey. The JRCPTB said feedback suggests they are spending so much time on the wards that they are missing out on training opportunities such as attending outpatient clinics and formal teaching sessions.

Ninety per cent of the CMT doctors who responded to the survey said that service provision took up 80 to 100 per cent of their time, leaving little time for training. A similar percentage (89 per cent) said outpatient clinics provided either valuable or very valuable training, but 81 per cent said work pressures often prevented them from attending. A similar number were unable to attend formal training sessions due to work demands.

This lack of opportunities is damaging trainees’ confidence, the JRCPTB said, and impacting their readiness to take on more responsible medical roles. Almost half of respondents said CMT had not prepared them to move on to their next role as a medical registrar with a similar number calling for CMT to be extended from two to three years.

Many trainees said their experiences of CMT put them off acute medical specialties, with one doctor saying: “It feels more like a service post than a training post.” Another said: “Current CMT is not a training programme. I feel completely disillusioned by it and this is why I have changed to GP.”

Other concerns raised in the survey include the amount and quality of consultant feedback and the length and frequency of meetings with educational supervisors. Most trainees wanted longer and more frequent meetings.

Medical director of the JRCPTB Professor Bill Burr said: “There is a clear message here that there is a need for urgent action to address the problems which are in part due to excess demands being made on too few doctors who are inadequately supported.”

The report’s joint author Dr Fiona Tasker said more clinical staff are needed on the wards to help junior doctors take advantage of training opportunities.

She said: “There are many dedicated supervisors who contribute to training core medical trainees and prepare them to take on the role of the medical registrar.

“However, not enough time is allocated to most consultants for this important teaching/mentoring role, and protected time to deliver training opportunities both on and off the wards should be factored into consultant job plans."

Link

Survey of core medical trainees in the UK 2013

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