Pandemic driving surge in burnout among trainee doctors and educators, GMC poll shows

One in three trainee doctors and a fifth of trainers feel burned out to a 'high' or 'very high' degree after working through the pandemic, according to a GMC survey that reveals rising strain on clinicians.

A third of trainees said they felt burned out to a high or very degree because of their work, compared to around a quarter in previous years, the 2021 GMC training survey shows. Among trainers, 22% reported feeling burned out to a ‘high’ or ‘very high’ degree - up five percentage points compared with 2019.

The results reflect the intense pressure and stress of medical training during the pandemic, with GMC chief executive Charlie Massey warning that the profession ‘cannot expect doctors to continue to operate at this level of intensity’.

The GMC survey found that three in five trainees 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.

Medical training

Although four in five trainees said they were on course to meet their curriculum outcomes for the year, one in 10 were concerned about progressing through their training.

Close to a third admitted feeling frustrated by their work to a ‘high’ or ‘very high’ degree - and over a quarter said they were not always able to use the time allocated to them to train.

BMA GP committee chair Dr Richard Vautrey called the large increase in GP trainer stress 'incredibly concerning', and called for a renewed effort to protect staff's wellbeing.

Despite trainees and trainers feeling the stress of the pandemic, 76% of trainees rated the quality of teaching as ‘good’ or ‘very good’, while almost nine in 10 trainees (88%) described their clinical supervision as ‘good’ or ‘very good’.

COVID-19 pandemic

Three quarters of trainees (74%) told the GMC that virtual learning environments were being used effectively to support training - backing up last year's survey when trainees noted their support for new and innovative learning methods.

But half of trainees said they had not been provided with effective alternatives through simulation facilities and/or exercises. A total of 55% expect to acquire enough training opportunities to prepare them for their next relevant professional exam.

Responding to the survey results, GMC chief executive Mr Massey 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-19 pressures will remain, but we must not risk reversing the gains that have been made in recent years. The danger is that, unless action is taken, workloads and wellbeing will continue to suffer, and future burnout rates could get even worse.

Doctors' wellbeing

‘As we move on from the pandemic, it is vital that doctors’ training and wellbeing needs are central to service recovery plans. This year’s results should be a blip caused by COVID-19, not part of a new normal.’

He added: ‘The pandemic has caused inevitable disruption, and some training opportunities have been lost. But, thanks to the efforts and hard work of trainers and trainees, where training has been possible the quality has been sustained.

‘We know many trainees remain concerned about their training progression, so we are working hard to ensure training is flexible, fair, and helps prepare doctors to meet current and future patient needs.’

Earlier this month Health Education England (HEE) figures revealed that GP trainee recruitment is on track for a fourth successive record-breaking year after 3,690 doctors accepted GP training positions after the first round of recruitment to 2021.

Primary care resources

Dr Vautrey said: 'It’s positive to see that trainees continue to rate their training and supervision highly, but what is incredibly concerning is the large increase in GP trainers suffering from burnout, with the same group most likely to say their work was emotionally exhausting and others frustrated that there are simply not enough hours in the day to give training the attention it deserves.

'While this is testament to the dedication and importance GP trainers place in ensuring the next generation of GPs get the supervision and mentoring they need, it also underlines the intense and often unsustainable pressure being placed on individual doctors as they try to balance caring for patients, assisting colleagues and looking after their own wellbeing – often while managing the day-to-day demands of running a practice too.

'A renewed effort to protect staff’s wellbeing, while providing practices with the resources they need to meet the growing list of demands they face, will be key as we face the next daunting stage of the pandemic and recovery.'

RCGP chair Professor Martin Marshall said issues of burn out and exhaustion among staff had to be addressed with strong measures. He 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.'

He added: '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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