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Junior doctors worry about quality of care and long working hours

Many still afraid to voice concerns and concerned by too little time to care for patients properly

Caroline White

Wednesday, 06 August 2014

Over half of junior doctors worry about the quality of care given to patients and struggle to cope with long working hours, reveal two surveys published today as thousands of newly qualified doctors start their working lives.

A Medical Protection Society (MPS) survey of 1,000 junior doctors in foundation years 1 (FY1) and 2 (FY2) found that over half (51%) of FY1s have had concerns about the quality of care in their workplace and almost two thirds (62%) had told a fellow trainee in confidence about it.

But of the 48% of FY2s who had similar concerns about the quality of care in their workplace, 67% had raised the matter with a clinical manager.

Most (82%) of the FY1s had struggled with long hours over the previous 12 months—a 7% increase on the previous year—and over two thirds (68%) had struggled to cope with heavy workloads.

Two thirds of FY1s said they had not had enough time to study, and most (85%) said they worked beyond their contracted hours.

Seven out of 10 FY1s found not having enough time to give patients the care they required difficult. A significant proportion (39%) of all respondents felt that more doctors on the ward would increase job satisfaction.

Despite their concerns over half of respondents (60%) said they chose a career in medicine because they wanted to help people, with only 2% saying that they were motivated by potential future earnings.

Dr Pallavi Bradshaw, medicolegal adviser at the MPS, said that it was encouraging that even after the struggles of their foundation years, two thirds of the doctors surveyed remained enthusiastic about their future career.

But he said that senior doctors and managers needed to promote an open culture to enable trainees to voice concerns about patient safety.

“It is encouraging to see that those in their second year of training feel confident to report such matters. Senior clinicians and clinical managers have a responsibility for creating an open culture and an environment where recognition and discussion of care quality issues is routine,” he said.

In a second survey carried out by the Medical Defence Union (MDU), working long hours emerged as the primary concern for respondents.

Two thirds of junior doctors and medical students (499 out of 704) said this was a worry, and 60% of newly qualified doctors were concerned about the lack of support from more senior colleagues.

Nearly half of junior doctors (126 out of 277) also said that they had struggled to maintain a work-life balance since graduating, with several reporting that they had struggled to book periods of annual leave.

Dr Andrew Collier, Co-chair of the BMA Junior Doctor Committee, said that it was critical junior doctors felt supported and encouraged to speak out about any concerns they had about patient care.

"It's really worrying that so many junior doctors feel they don't have enough time to give patients the care they need and that many have had to raise concerns over the quality of care. This shows that rising workloads are becoming a real barrier to patient care, something which was echoed in a recent BMA survey of doctors.”

He added: “If medicine is to remain an attractive career option, and to protect a generation of young doctors from burnout, we need to get to grips with the recurring problems of excessive workloads, long hours and the chipping away of time for training and development.”

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