Millions will face surgery delays unless anaesthetic workforce grows, college warns

Dear Editor,
We read the recent BMJ article titled “Millions will face surgery delays unless anaesthetic workforce grows, college warns” with great interest and echo the concerns of the Royal College of Anaesthetists. This problem is not however exclusive to anaesthesia and exists in many specialties, with the NHS experiencing a workforce crisis long before the COVID-19 pandemic. Consultant posts are unfilled across the United Kingdom yet specialty training remains a bottleneck in most training programmes due to the lack of ST1 and ST3 posts available. The current training crisis is likely to compound the problem, with many trainees requiring extensions to their specialty programs due to loss of training opportunities during the pandemic. A recent audit of surgical trainees in the United Kingdom found that training cases have reduced by over 50% during the COVID-19 pandemic. If training and career progression is not maintained then we are likely to see an increase in the number of clinicians leaving training programmes.

The pandemic has been a catalyst for rapid change and development in teaching methodology which must continue, to maintain a high standard of training throughout and beyond the pandemic. Many have adapted remarkably to the loss of face-to-face training opportunities, inspiring the creation of novel virtual learning resources. Recent innovations in medical education have often been driven by trainees resulting in the generation of innovative and imaginative learning resources, in a time where increased flexibility of training is required. The adaptation of postgraduate examinations has been more of a challenge for both trainees and training institutions but one that is necessary to enable continued career progression.

The provision of good quality training will require a conscious buy-in by all stakeholders and trainees must seek every opportunity for learning and make use of novel resources. Trainers must plan for the delivery of medical education despite the demands of the pandemic, and training institutions have a responsibility to assist both of these groups. After all, if we do not invest in training today, we will find ourselves in a worsening workforce crisis in the near future.

Additionally, rates of physician burnout increasing. It has therefore never been more important to support the wellbeing of doctors. Awareness of the impact of burnout on doctor and patient health has grown significantly but there are many barriers remaining which prevent physicians accessing support and advice services. Good resources are often poorly advertised to those who would benefit from their services, and so it is the responsibility of all to ensure that doctors are regularly signposted towards wellbeing initiatives and services.

We agree that increased specialty recruitment is vital if we are to meet growing clinical demands but we feel that maintaining the training and wellbeing of clinicians already in specialty programmes must be given equal consideration in order to maintain the existing workforce.