Workloads threaten to undermine doctors’ training, GMC finds

Increasingly heavy workloads are eroding the time doctors have for training, a survey of junior doctors conducted by the General Medical Council (GMC) has found.¹

The GMC’s 2016 national training survey, published on Thursday 1 December, had 53 835 responses from doctors in training, from a possible 54 563—a response rate of 98.7%. The regulator found that while most doctors had a positive training experience, there were worries that an increasing workload was a threat to their training.

Of the doctors that responded to the survey, 43% said that their daytime workload was “heavy” or “very heavy,” 2.3% more than in 2012. Doctors in this group had twice as many concerns about patient safety in their post than doctors who said that their workload was about right.

Compared with 2012, they were also six times more likely to be forced to cope with clinical problems beyond their competence or experience on a daily or weekly basis, and were three times more likely to have to leave a local teaching session to answer a clinical call at least once each session.

The GMC’s analysis found that rota gaps were a significant issue for many doctors in training and said that it would “test new questions to help us pinpoint the problems.”

The survey also highlighted concerns about the introduction of a new contract for junior doctors, after 541 respondents shared worries about the new arrangements in England.

The GMC said that respondents’ concerns related to the potential negative impact on patients from proposed rotas, low morale, and mental health issues. They also had longer term concerns relating to an expected increase in doctors leaving training in the UK.

Charlie Massey, chief executive of the GMC, said that he had written to employers to remind them of their obligations to ensure that doctors’ training is protected. “Those responsible and accountable for the delivery of medical education must take steps to ensure the training of doctors remains protected,” he said.

“Medical training is so often a bellwether for the quality and safety of patient care and patients are directly at risk if support and supervision of doctors in training is inadequate.”

Responding to the survey’s findings, Danny Mortimer, chief executive of NHS Employers, said, “Many of the issues highlighted in this report will be mitigated by the new contract of employment for doctors in training.

“The new contract sets out improved requirements on working hours and adequate rest periods, while the new independent Guardian of safe working hours will play a vital role in enforcing them.”