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PRACTICE: Yvonne Steinert The "problem" junior: whose problem is it? BMJ 2008; 336: 150-153 [Full text]

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Managing Trainees in Difficulty

Kelwyn D Williams   (21 January 2008)

Sometimes it's the system rather than the learner

Udoka C Onyeaso   (24 January 2008)

Managing Trainees in Difficulty 21 January 2008
Kelwyn D Williams, Consultant Psychiatrist 18 Denmark Road, Gloucester GL1 3NW Send response to journal: Re: Managing Trainees in Difficulty	Helpful though this paper is, practical advice for managing doctors in difficulty has just been published by the National Association of Clinical Tutors (2008). It provides a comprehensive diagnostic framework for formulating problems and suggests appropriate management options. The approach used is systematic and consistent and makes reference to the National Clinical Assessment Service. I would commend this resource to UK medical educationalists as first port of call. National Association of Clinical Tutors. Managing Trainees in Difficulty 2008 Competing interests: None declared
Sometimes it's the system rather than the learner 24 January 2008
Udoka C Onyeaso, ST4 inPaediatrics RCH Treliske TR1 3LJ Send response to journal: Re: Sometimes it's the system rather than the learner	I agree with a lot of the points raised in this well written article but need to highlight that often the problem is with the system. This is particularly true of specialist settings like NICU where the nursing staff are vastly more experienced than the fledgling juniors in a lot of aspects of care of the patient group. There is a subtle bullying associated with an underhanded unhelpfulness at play, undermining the well-intentioned junior doctor.This erodes their confidence and morale and sets off a cycle of underperformance-a self- fulfilling prophecy. I think mentors and supervisors need to be more vigilant in identifying these situations and supporting their juniors appropriately. Competing interests: None declared