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News NHS Crisis: Voices from the Front Line

Training is in tatters as doctors prioritise urgent care and discharges

BMJ 2023; 380 doi: (Published 16 January 2023) Cite this as: BMJ 2023;380:p116
  1. Elisabeth Mahase
  1. The BMJ

Training of junior doctors has been hit by the ongoing NHS crisis, with trainees feeling “demoralised” because “burnt out” consultants don’t have the time or capacity to teach and training is continually cancelled.

One internal medicine trainee, who wished to remain anonymous, told The BMJ they had decided to quit their training as they had not had a session in months. “Our teaching gets cancelled every time the hospital is in critical. There’s no procedural teaching—we must stay on the ward and do TTOs [medicine discharge forms] because we must prioritise discharges.”

The trainee said that no consultants in their area signed up to do PACES (practical assessment of clinical examination skills) teaching because they are “all so understandably burnt out.” Their PACES exam was then cancelled because of a lack of examiners. “This is not ‘training’ any more. I am service provision, and it’s why I’ve decided to leave,” they said.

Such experiences are not unique. Mike Greenhalgh, co-deputy chair (education and training lead) of the BMA’s UK Junior Doctors Committee, said he knew “several people personally” who have either left medicine or left medicine in the UK because their training sessions had repeatedly been cancelled and they had just been spending their time keeping the service ticking over.

Greenhalgh, a trauma and orthopaedic registrar in the north west of England, said, “This is certainly the worst I’ve ever seen the NHS. Consultants and colleagues who’ve been around for longer than I have …

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