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Heavy workloads continue to get in the way of doctor training, warns GMC

Work volumes continue to be a barrier for medical trainees to receive their training, the GMC has warned.

Initial analysis of the GMC’s annual annual training surveys found that over half of doctors (53%) in specialty or GP training work beyond their rostered hours at least weekly.

Although this was a slight improvement on the previous year (when 58% said they worked beyond their hours) the GMC said workload issues ‘remain a persistent and troubling issue’.

The survey, which was answered by over 53,000 doctors in training (98%), also found that over a fifth (22%) are left short of sleep on weekly or daily basis due to their working schedule.

It also revealed that ‘an increasing number’ of medical students ‘are taking a break of at least a year after finishing foundation training’ although 93% return to training within five years.

GMC said stressed this was only the initial analysis of its surveys of trainees and their educators, which contain over 100 questions and was also completed by nearly 25,000 trainers (54%).

Other findings to date included:

  • 41% of trainees decscribed their workload as heavy or very heavy, down from 43% in 2016, while 70% of trainers said the same;
  • There was a hike in trainees saying days were subtracted from their study leave to attend compulsory training, from 27% to 44%, although GMC said it had no explanation as to why this was;
  • Fewer than half of trainers (44%, same as in 2016), said they were ‘always able to use the time allocated to me in my role as an educator specifically for that purpose’;
  • Around half (53%) said there was enough time allocated in their work plan to carry out their role as educator, which was similar to the year before.

GMC chief executive Charlie Massey said: ‘Workload issues, and the impact they can have on doctors’ education and training, remain a persistent and troubling issue. Tiredness and fatigue can impair decision-making, and so can impact on patients as well as the doctors themselves.

‘Our early findings suggest some trainees have experienced improvements in workloads since last year. This is welcome, and it’s important that we acknowledge the work being done, across all four UK nations, to deal with these pressures.

‘However, it is too early to determine whether it is the start of a longer-term trend. We know from our wider conversations with trainees that the situation for them continues to be very challenging.’

The GMC said it would continue to analyse the surveys, which were open between March and May this year, and report in more detail later this year on findings about ‘training environments and training pathways across specialties (including general practice), countries and regions’.

It comes as Pulse revealed last month that Health Education England (HEE) budget cuts are affecting training available for qualified GPs and trainees – with courses being cut due to the squeeze, and trainees having to train each other in one area of the country.

These were the first reported cuts since Pulse revealed Health Education England was facing a 30% squeeze to its runninb budget and had been offering GP trainers voluntary redundancy.

It also comes as Pulse reported that HEE was spending funds taken from education programmes on the training of support roles, such as physician associates.

BMA junior doctors committee chair Dr Jeeves Wijesuriya said: ‘These findings provide another opportunity for politicians to listen to doctors and take action. It is unacceptable for both patient care and doctors’ wellbeing that more than half of those surveyed say they are working beyond their rostered hours, and one in five say working patterns regularly leave them short of sleep.

‘The pressure of working in an NHS at breaking point, with chronic NHS underfunding and staff shortages puts doctors at greater risk of fatigue and burnout.’