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Feature Medical Training

The firm: does it hold the answers to teamworking and morale?

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l4105 (Published 10 June 2019) Cite this as: BMJ 2019;365:l4105

Rapid Response:

Re: The firm: does it hold the answers to teamworking and morale?

Having graduated only in 2015, I have never experienced 'the firm'. I would, however, like to suggest that smaller hospitals and DGHs may be closer to a happy medium.

From my experience as a foundation trainee my initial year was based in a rural DHG. All the FY1s lived on site in hospital accommodation as well as some of the rotating registrars and FY2s. No long commute! We knew each others rotas so if you'd been on a long shift someone else would make you dinner or run an errand for you. We still had a mess fully stocked with snacks and a fund for tea, coffee and a few nights out, we also put on a biannual dinner and dance. Consultants and senior registrars took a keen interest in our training and well being and would notice when things weren't quite right, possibly because there was a weekly pub quiz in which to socialise after work.

This system was not perfect but it felt cohesive and fun and supportive. When I moved on to a bigger city hospital I felt much more of a transient cog in a big machine where you could just turn up do the list of jobs handed over and leave. It felt lonely and isolating.

My experience of some specialties, such as psychiatry, do largely maintain a consultant led team with a junior and senior trainee (this experience is limited) where, as a junior I did feel more valued, included and a more fulfilling sense of continuity. Is it possible in the more pressured specialties integrate more of this within the working time directive constraints? I suppose that is the million pound question.

Competing interests: No competing interests

02 July 2019
Chloe Durrell
Clinical Fellow
Aberdeen