Letters MTAS

Mental health of applicants seems to be deteriorating

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39254.905764.1F (Published 28 June 2007) Cite this as: BMJ 2007;334:1335
  1. Gregory J Lydall, locum staff grade in addictions1,
  2. Amit Malik, chair, psychiatric trainees committee2,
  3. Dinesh Bhugra, dean2
  1. 1Ware, Hertfordshire SG12 9DZ
  2. 2Royal College of Psychiatrists, London SW1X 8PG
  1. grogl{at}doctors.org.uk

    We are surveying the impact of Modernising Medical Careers (MMC) and the Medical Training Application Service (MTAS) on the mental wellbeing of junior doctors.1 The preliminary results from the 790 online anonymous responses to date are disturbing and require an urgent response.

    Overall, 395 (50%) respondents were women, 636 (80%) held UK/EEA passports, and 527 (67%) were aged 25-29.

    Most worryingly, 165 (21%; 95% confidence interval 18% to 24%) respondents agreed or strongly agreed with the statement: “I have been having more thoughts of ending my life than usual”—an increased level of suicidal risk in an already vulnerable professional group.2

    Most trainees (740, 94%) admitted to higher than usual stress levels over the past six months, 759 (96%) attributing it to MTAS/MMC compared with 411 (52%) attributing it to financial problems.

    Respondents agreed, or strongly agreed, with disturbances in their sleep (523, 66%), appetite (330, 42%), and energy levels (571, 72%). A large proportion agreed to experiencing anhedonia (526, 67%), less enjoyment of sex (352, 45%), tearfulness (508, 64%), irritability (699, 88%), and a sense of future hopelessness (402, 51%). They also reported physical (399, 51%) and psychological (679, 86%) anxiety symptoms. Considerable numbers admitted to increased consumption of alcohol (279, 35%) but not recreational drugs (20, 2.5%).

    The results also imply that the past six months might have had a negative impact on patient care. Compared with their usual clinical practice, 240 (30%) admitted that they made more mistakes at work, 342 (43%) that they cared less about patient care, and 673 (85%) that they enjoyed work less. In addition, 177 (22%) had taken more sick leave than usual. But only 64 (8.1%) had sought professional help for their difficulties.

    The Royal College of Psychiatrists has set up support mechanisms for affected psychiatric trainees. It will present the findings of the completed survey to all the medical royal colleges so that they can consider establishing appropriate support mechanisms for trainees in their specialty. The college also intends to explore the regular monitoring of the mental health of junior doctors.


    • Competing interests: None declared.


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