Intended for healthcare professionals

Letters Burnout

Tackling burnout in UK trainee doctors is vital for a sustainable, safe, high quality NHS

BMJ 2018; 362 doi: (Published 12 September 2018) Cite this as: BMJ 2018;362:k3705
  1. Judith Johnson, lecturer1,
  2. Chris Bu, foundation doctor year 22,
  3. Maria Panagioti, senior research fellow3
  1. 1University of Leeds and Bradford Institute for Health Research, School of Psychology, University of Leeds, Leeds LS2 9JT, UK
  2. 2Royal Liverpool Hospital, Liverpool, UK
  3. 3NIHR School for Primary Care Research, NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PL, UK
  1. j.johnson{at}

We read the findings of the General Medical Council’s survey on burnout in trainee and trainer doctors with great interest.1 Increasing evidence indicates that doctor wellbeing is a marker of the quality of care delivered to patients. These results therefore raise concerns about patient care. We have shown a consistent link between healthcare staff burnout and patient safety.234 In a recent meta-analysis,5 we examined the association between burnout in doctors and patient safety incidents, low professionalism, and patient satisfaction. We found that the association between burnout and low professionalism was two times higher in trainee and early career doctors than in more experienced doctors. As such, tackling burnout in trainee doctors has strategic importance for the provision of safe, high quality patient care.

Two other meta-analyses have established that interventions to reduce burnout in doctors are effective.67 Unfortunately, these interventions have been developed and evaluated mostly in the United States. We need national research investments to develop and evaluate interventions for enhancing the wellbeing of trainee UK doctors, which take into consideration the distinctive characteristics of the UK healthcare system. We have recently piloted the delivery of a resilience training intervention to obstetric and gynaecological registrar doctors as part of the Yorkshire and Humber Patient Safety Translational Research Centre and mindfulness courses to foundation year doctors in the Royal Liverpool Hospital. Both courses were well received by trainee doctors. Although such programmes should be accompanied by organisational improvements, these early encouraging findings indicate that the wellbeing of trainee UK doctors is subject to establishing a flourishing training environment and an engaging career culture.