Employers must tackle high level of burnout among trainees, says GMCBMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3018 (Published 09 July 2018) Cite this as: BMJ 2018;362:k3018
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We read the GMC survey findings on burnout in trainee and trainer doctors with great interest. This is the first time that such a large cohort of doctors has responded to burnout inventory questions in the UK. The response rate in trainee doctors was also remarkably high (96%). As such, these findings accurately reflect the experience of UK trainee doctors and mark a significant step forwards in our understanding of doctor wellbeing.
There is increasing evidence that the wellbeing of doctors is a marker of the quality of care delivered to patients. These results therefore also raise cause for concern in relation to patient care. Our previous studies have shown a consistent link between healthcare staff burnout and patient safety[1-3]. In a recent meta-comprehensive analysis accepted for publication in JAMA: Internal Medicine, we specifically examined the association of burnout in doctors with patient safety incidents, low professionalism and patient satisfaction. Of particular concern in relation to the GMC survey results is our finding that the association between burnout and low professionalism was two times higher in trainee and early career doctors compared with more experienced doctors. As such, addressing burnout particularly in trainee doctors has strategic importance for the provision of safe, high quality patient care. Despite this, national evidence on the impact of burnout on the career of doctors and the quality of patient care is very limited.
Two recent meta-analytic reviews have established that interventions which deliver organisational improvements to the healthcare system as well as resilience training interventions which are time-protected and financially supported by the healthcare organisations are very promising for mitigating signs of burnout in doctors [5,6]. Unfortunately, these interventions have been developed and evaluated mostly in the US. National research investments are needed to develop and evaluate interventions for enhancing the wellbeing of trainee UK doctors taking into careful consideration the distinctive characteristics of the UK health care system. We have recently piloted the delivery of i) a resilience training intervention in obstetric and gynaecological registrar doctors as part of the Yorkshire and Humber Patient Safety Translational Research Centre and ii) mindfulness courses in foundation year doctors in Royal Liverpool Hospital following the award of successful institutional funding. Both courses have been well-received by trainee doctors. Although such programmes should be accompanied by organisational improvements, these early encouraging findings suggest that the wellbeing of trainee UK doctors is subject to establishing a flourishing training environment and an engaging career culture.
Judith Johnson; University of Leeds and Bradford Institute for Health Research
Chris Bu; Royal Liverpool Hospital
Maria Panagioti; NIHR School for Primary Care Research, NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Manchester Academic Health Science Centre, University of Manchester
1. Johnson J, Louch G, Dunning A, et al. Burnout mediates the association between symptoms of depression and patient safety perceptions: A cross-sectional study in hospital nurses Journal of Advanced Nursing. 2017;73(7):1667-1680.
2. Hall LH, Johnson J, Heyhoe J, Watt I, Anderson K, O’Connor DB. Exploring the impact of primary care physician burnout and wellbeing on patient care: A focus group study. Journal of Patient Safety. 2018;in press.
3. Hall LH, Johnson J, Watt I, Tsipa A, O’Connor DB. Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review. PloS One. 2016;11(7):e0159015.
4. Panagioti M, Geraghty K, Johnson J, et al. Effects of physician burnout on patient safety, professionalism and patient satisfaction: a sytematic review and meta-analysis. JAMA internal medicine. 2018;in press.
5. Panagioti M, Panagopoulou E, Bower P, et al. Controlled Interventions to Reduce Burnout in Physicians: A Systematic Review and Meta-analysis. JAMA Internal Medicine. 2017;177(2):195-205.
6. West CP, Dyrbye LN, Erwin PJ, Shanafelt TD. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. The Lancet. 2016;388(10057):2272-2281.
Competing interests: No competing interests