GMC Calls for Action to Address Burnout in Trainees and Trainers

Peter Russell

July 27, 2021

The welfare of trainee doctors and those who train them must be central to recovery of the profession after COVID-19, the General Medical Council (GMC) said.

The call came as results of its annual national training survey showed that the pandemic had increased burnout among UK doctors and risked reversing improvements to workload and wellbeing.

Responses from more than 63,000 trainees and trainers suggested that burnout had reached the worst level since polling on the issue was first introduced in 2018.

Burnout and Exhaustion

Overall, 33% of trainees reported feeling burnt out to either a high or very high degree because of their work, compared with around a quarter in previous years.

Three in 5 said they always or often felt worn out at the end of a working day, and 44% felt their work was emotionally exhausting to a high or very high degree.

The pandemic appeared to have also taken a toll on trainers, with 25% of secondary care trainers reporting feeling burnt out to a high or very high degree, up 2% on 2019. The swing was even more marked among trainers in general practice where the level rose 5% to 22%.

Seven in 10 GP trainers (71%) and 49% of secondary care trainers said they always or often felt worn out at the end of a working day.
 

'We Must Not Risk Reversing Gains'

Charlie Massey, chief executive of the GMC, said: "It is not surprising that burnout has worsened during the pandemic, but we cannot expect doctors to continue to operate at this level of intensity. As health services emerge from COVID, pressures will remain, but we must not risk reversing the gains that have been made in recent years."

It was "vital that doctors' training and wellbeing needs are central to service recovery plans", he added.

Training needed to become more flexible to adapt to future pressures, Mr Massey said in a summary of the report. Training environments needed to be supportive, fair, and inclusive, he said. The GMC said it was committed to eliminating discrimination, disadvantage, and unfairness in undergraduate and postgraduate medical education and training by 2031.

Trainee and Trainer Satisfaction Rates

In October 2020, Medscape News UK reported that more than 8 in 10 junior doctors said disruption caused by the pandemic had interrupted their training.

Despite worsening levels of burnout, findings from the latest survey suggested that the quality of training remained high, with 76% of trainees positive about their experience, and 88% satisfied with their clinical supervision.

Results varied between specialities, with only 69% of trainees in medicine and obstetrics and gynaecology posts responding positively. However, the GMC said that could not be attributed to the effects of COVID as it was consistent with previous survey results.

In 2021, 74% of respondents reported that virtual learning environments were being used effectively to support training.

Among trainers, 91% said they enjoyed their role, a figure consistent among all specialities.

'Sobering Reading'

Commenting on the survey results, Dr Sarah Hallett, chair of the British Medical Association's junior doctors committee, said: "Any junior doctor reading these findings will sadly not be surprised about the high levels of burnout among the profession, though it still makes for sobering reading."

She added that "while the pandemic may have exacerbated burnout among the medical profession, it did not create it in the first place" and that the results underlined the importance of "a well-resourced NHS that treats its workforce with dignity", as well as a well-resourced NHS, to "avoid staff stretching themselves so thinly that it leaves them at breaking point".

Dr Rob Hendry, medical director of the Medical Protection Society, described the survey results as "troubling, though sadly not surprising". He said: "It is important that we develop a much deeper understanding of how COVID-19 has impacted on training, workloads, and mental wellbeing, and ensure appropriate support structures are in place for doctors."

Prof Martin Marshall, chair of the Royal College of GPs, said: "A lot of great work has gone into increasing trainee numbers in general practice and we don't want to see this progress regress. This is why we urgently need to see Government address the workload pressures facing the profession by delivering on their manifesto pledge of an additional 6000 GPs to enter the workforce by 2024, as well as initiatives in place to prevent experienced GPs from burning out due to heavy workloads.

"This will help to ensure GP trainers have the time that they need to spend with trainees, and that trainees feel supported."

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