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Over half of junior doctors have taken time out

Quarter go abroad, quarter take childcare leave, and a fifth do it for ‘health and wellbeing’

Louise Prime

Thursday, 01 March 2018

Well over half of junior doctors have taken time out of their training, often after their foundation year two (FY2), the BMA has reported. Its latest survey revealed that the most common reasons cited for taking a break were to travel overseas, to take maternity or paternity leave, or simply as a health and wellbeing break. Health Education England said it has also been reviewing the problem for trainees of difficulties arising from late rota notification – and particularly in GP training, where GP out-of-hours shifts are allocated rather than chosen by the trainee, many trainees are given less than four weeks’ notice of their shifts rather than the recommended minimum of six weeks’ notice.

The BMA’s survey of junior doctors in September and October 2017 found that of the 2,164 respondents:

  •  56% said they had taken a break in training, with most (28%) doing so after FY2 – a trend increasingly known as ‘F3’.
  • Of those who had taken breaks, the most commonly cited reason was ‘to travel for personal interest’ (26%), followed by maternity/paternity leave (24%).
  • Nearly a fifth (19%) said they had taken a break for ‘health and wellbeing’ reasons; doctors undecided on their speciality (31%) and those training for general practice (28%) were most likely to have done so for this reason.
  • A fifth had worked as a locum (21%) and taken a non-training service post in the UK (19%).
  • 78% of those working (or who had worked) in a non-training post outside the UK had chosen Australia or New Zealand.
  • The most common motivations among those who had taken a break for reasons other than health and wellbeing, family or caring responsibilities centred around future career decisions – 38% took time out to decide upon their preferred speciality, 21% to improve their chances of securing their preferred training post and 19% to experience other specialities.
  • Among ‘other’ responses, many doctors said they wanted to fulfil wider interests, travel and experience working in another country and that they needed a break from the ‘treadmill’ of training or risk ‘burnout’.
  • Those who took breaks found them overwhelmingly beneficial, with 83% saying it supported them in their decision on preferred speciality.
The report also looked in detail at doctors undertaking less than full-time (LTFT) training. This option was more often chosen by women and those caring for dependents, but there was also a smaller group without caring responsibilities who said that maintaining their LTFT status was important to them. LTFT trainees were more likely than full-timers to report being more satisfied with their training, but most also said they thought their decision was viewed negatively by those responsible for their training.

Health Education England and the BMA issued a joint statement pointing out that doctors feeling valued and supported as they train is key to guaranteeing high quality care and rebuilding workforce morale. HEE deputy medical director for education reform Professor Sheona MacLeod, commented: “One of the 10 targeted issues that have come under review by the Enhancing Junior Doctors’ Working Lives group, made up of the BMA, HEE, GMC, NHS Employers and the Academy of Medical Royal Colleges, was that of difficulties arising from late rota notification. In response, the Code of Practice was developed to ensure trainees are informed of their final rota with six weeks’ notice. However, in GP training, where GP out-of-hours shifts are allocated rather than chosen by the trainee, many trainees are given less than four weeks’ notice of their shifts.

“The BMA and HEE strongly encourage systems that allow GP trainees to choose out-of-hours shifts flexibly themselves, but where this is not possible trainees must be given at least six weeks’ notice of their out-of-hours shifts in line with the Code of Practice. Where this has not been achieved, trainees are encouraged to contact their training programme director or their local HEE out-of-hours lead so that HEE can monitor compliance and investigate further if necessary.”

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