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Working patterns for doctors in training leave one in five unable to sleep

More than half of doctors in training work beyond their rostered hours at least once every week, the General Medical Council’s (GMC’s) latest UK-wide workforce training survey has found.

The survey also revealed that one in five doctors in training reported that working patterns would regularly leave them short of sleep due to the high stress of the job.

The organisation polled 53,000 doctors in training and a further 24,000 senior doctors who act as trainers, and found that the situation for doctors in training is becoming increasingly difficult, with high demand and stretched staff.

Despite this, the GMC was told that overall satisfaction with teaching quality remained high. These findings follow a similar staff survey from March that found that even under enormous pressure, staff satisfaction remained high.

“Workload issues, and the impact they can have on doctors’ education and training, remain a persistent and troubling issue,” said Charlie Massey, chief executive of the GMB. “Tiredness and fatigue can impair decision-making, and so can impact on patients as well as the doctors themselves.”

Though this year’s survey indicated slight improvements from last year, Massey emphasised that it was not a big enough change to signal a wider, long-term trend just yet.

“It is too early to determine whether it is the start of a longer-term trend,” he added. “We know from our wider conversations with trainees that the situation for them continues to be very challenging.

“In the meantime, it is important that education providers do what they can protect the quality of training and the wellbeing of doctors, using the results of this year’s surveys to target their efforts.”

Education opportunities lost due to gaps in rotas

For the first time, the GMC’s survey also asked questions about rota design and whether it impacted on the training that doctors received.

In total, 31% disagreed or strongly disagreed with the statement that education and training opportunities were rarely lost due to gaps in work rotas.

“The results do reflect the concerns that have been raised previously by doctors in training, and they suggest rota issues are affecting some doctors’ access to education and training,” Massey continued.

“We know frontline health services are under huge pressure at the moment, but education providers must do their utmost to make sure rotas provide doctors with sufficient access to learning opportunities and to minimise the adverse effects of fatigue and workload.”

The BMA’s Junior Doctors Committee chair, Jeeves Wijesuriya, argued that the results backed up previous BMA warnings that rota gaps are a threat to patient safety as well as the quality of training doctors receive.

“These findings provide another opportunity for politicians to listen to doctors and take action,” he stated. “It is unacceptable for both patient care and doctors’ wellbeing that more than half of those surveyed say they are working beyond their rostered hours, and one in five say working patterns regularly leave them short of sleep.

“The pressure of working in an NHS at breaking point, with chronic NHS underfunding and staff shortages puts doctors at greater risk of fatigue and burnout.

“The BMA is ensuring employers better protect training time and improve rostering for trainees, specifically those working less than full time and we have worked with the GMC on a seven-point plan to improve work-life balance, focus on outcomes rather than time spent training, and support doctors with specific needs.”

And CEO of NHS Employers Danny Mortimer commented: “This highlights the work that employers and senior medical professionals must still do to improve the safe working and effective education of junior doctors.

“The 2017 contract improves protections for the working hours and training of junior doctors. Doctors have been moving on to these new arrangements, and they are starting to work with the consultant medical staff responsible for their training and work to address the requirements of the new contract.”

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