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For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions" /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="It has never been more important to ensure doctors in training feel supported. Abi Rimmer hears from four experts on how to achieve this Anna Melvin, postdoctoral research fellow for Care Under Pressure 3, University of Exeter, says, “Life as a trainee can be challenging, with unfamiliar working environments, inadequate inductions, continuous assessment and examinations, relocations or long commutes, and a lack of belonging. Therefore, trainees often feel undervalued, lacking control, and disillusioned with medicine, especially in the context of the long journey to being a doctor. “All of this affects their wellbeing, learning, career choices, and retention. Life can be made better for trainees in many ways, but key is creating a sense of connection. “Connection means positive working relationships and a sense of belonging to a team. It is an important psychological nutrient for human wellbeing and growth—when trainees feel known and valued, their wellbeing and learning are supported. Trainees are also better able to contribute to work and are more likely to want to return to work in such environments. “The nature of team working in the NHS means, however, that trainees often experience disconnection on their placements. As they are only there for short periods of time, it is difficult to get to know people. Additionally, permanent staff are often unwilling to invest in them, as they will soon be gone. “Creating a sense of connection can seem difficult in busy and pressurised …" /> <meta name="DC.Contributor" content="Abi Rimmer" /> <meta name="article:published_time" content="2023-08-15" /> <meta name="article:section" content="Careers" /> <meta name="citation_title" content="How can we make life better for doctors in postgraduate training?" /> <meta name="citation_abstract" lang="en" scheme="teaser" content="<p>It has never been more important to ensure doctors in training feel supported. <b>Abi Rimmer</b> hears from four experts on how to achieve this</p>" /> <meta name="citation_journal_title" content="BMJ" /> <meta name="citation_publisher" content="British Medical Journal Publishing Group" /> <meta name="citation_publication_date" content="2023/08/15" /> <meta name="citation_mjid" content="bmj;382/aug15_2/p1783" /> <meta name="citation_id" content="382/aug15_2/p1783" /> <meta name="citation_public_url" content="https://www.bmj.com/content/382/bmj.p1783" /> <meta name="citation_abstract_html_url" content="https://www.bmj.com/content/382/bmj.p1783.abstract" /> <meta name="citation_full_html_url" content="https://www.bmj.com/content/382/bmj.p1783.full" /> <meta name="citation_pdf_url" content="https://www.bmj.com/content/bmj/382/bmj.p1783.full.pdf" /> <meta name="citation_issn" content="1756-1833" /> <meta name="citation_journal_abbrev" content="BMJ" /> <meta name="citation_doi" content="10.1136/bmj.p1783" /> <meta name="citation_pmid" content="37582580" /> <meta name="citation_volume" content="382" /> <meta name="citation_article_type" content="Other" /> <meta name="citation_section" content="Careers" /> <meta name="citation_author" content="Abi Rimmer" /> <meta name="citation_author_institution" content="The BMJ" /> <meta name="twitter:title" content="How can we make life better for doctors in postgraduate training?" /> <meta name="twitter:card" content="summary" /> <meta name="twitter:description" content="It has never been more important to ensure doctors in training feel supported. Abi Rimmer hears from four experts on how to achieve this Anna Melvin, postdoctoral research fellow for Care Under Pressure 3, University of Exeter, says, “Life as a trainee can be challenging, with unfamiliar working environments, inadequate inductions, continuous assessment and examinations, relocations or long commutes, and a lack of belonging. Therefore, trainees often feel undervalued, lacking control, and disillusioned with medicine, especially in the context of the long journey to being a doctor. “All of this affects their wellbeing, learning, career choices, and retention. Life can be made better for trainees in many ways, but key is creating a sense of connection. “Connection means positive working relationships and a sense of belonging to a team. It is an important psychological nutrient for human wellbeing and growth—when trainees feel known and valued, their wellbeing and learning are supported. Trainees are also better able to contribute to work and are more likely to want to return to work in such environments. “The nature of team working in the NHS means, however, that trainees often experience disconnection on their placements. As they are only there for short periods of time, it is difficult to get to know people. Additionally, permanent staff are often unwilling to invest in them, as they will soon be gone. “Creating a sense of connection can seem difficult in busy and pressurised …" /> <meta name="og-title" property="og:title" content="How can we make life better for doctors in postgraduate training?" /> <meta name="og-url" property="og:url" content="https://www.bmj.com/content/382/bmj.p1783" /> <meta name="og-site-name" property="og:site_name" content="The BMJ" /> <meta name="og-description" property="og:description" content="It has never been more important to ensure doctors in training feel supported. Abi Rimmer hears from four experts on how to achieve this Anna Melvin, postdoctoral research fellow for Care Under Pressure 3, University of Exeter, says, “Life as a trainee can be challenging, with unfamiliar working environments, inadequate inductions, continuous assessment and examinations, relocations or long commutes, and a lack of belonging. Therefore, trainees often feel undervalued, lacking control, and disillusioned with medicine, especially in the context of the long journey to being a doctor. “All of this affects their wellbeing, learning, career choices, and retention. Life can be made better for trainees in many ways, but key is creating a sense of connection. “Connection means positive working relationships and a sense of belonging to a team. It is an important psychological nutrient for human wellbeing and growth—when trainees feel known and valued, their wellbeing and learning are supported. Trainees are also better able to contribute to work and are more likely to want to return to work in such environments. “The nature of team working in the NHS means, however, that trainees often experience disconnection on their placements. As they are only there for short periods of time, it is difficult to get to know people. Additionally, permanent staff are often unwilling to invest in them, as they will soon be gone. “Creating a sense of connection can seem difficult in busy and pressurised …" /> <meta name="og-type" property="og:type" content="article" /> <meta name="og:image" property="og:image" content="https://www.bmj.com/sites/default/files/highwire/bmj/388/8457.cover-source.jpg"/> <meta name="twitter:card" content="summary_large_image"><meta name="twitter:image" property="twitter:image" content="https://www.bmj.com/sites/default/files/sites/defautl/files/attachments/bmj-article/2023/08/cc_trainee_dr_connections.jpg"><meta name="twitter:title" content="How can we make life better for doctors in postgraduate training?" /><link rel="alternate" type="text/plain" title="Full Text (Plain)" href="/content/382/bmj.p1783.full.txt" /> <script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"How can we make life better for doctors in postgraduate 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clearfix"> <div class="panel-display" > <div class="hero"> <div class="hero-wrapper"> <div class="hero-content" style="position: relative; left: 0px; top: 35.5px;"> </div>  </div>  </div>  <div class="row"> <div class="left-content col-xs-12 col-sm-8 col-md-8 col-lg-8"> <article> <div class="panel-pane pane-highwire-article-citation" > <div class="pane-content"> <div class="highwire-article-citation highwire-citation-type-highwire-article node1086233" data-node-nid="1086233" id="node-1086233--21034544622" data-pisa="bmj;382/aug15_2/p1783" data-pisa-master="bmj;bmj.p1783" data-apath="/bmj/382/bmj.p1783.atom"><cite class='highwire-cite highwire-citation-bmj-article-top'> <span class='highwire-cite-article-type'>Careers</span> <h1 class="highwire-cite-title" id="page-title">How can we make life better for doctors in postgraduate training?</h1> <span class='highwire-cite-journal'>BMJ</span> <span class='highwire-cite-published-year'>2023</span>; <span class='highwire-cite-volume-issue'>382</span> <span class='highwire-cite-doi'> doi: <a href="https://doi.org/10.1136/bmj.p1783">https://doi.org/10.1136/bmj.p1783</a></span> <span class='highwire-cite-date'>(Published 15 August 2023)</span> <span class='highwire-cite-article-as'> Cite this as: <span class="italic">BMJ</span> 2023;382:p1783 </span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs pane-panels-ajax-tab-tabs" > <div class="pane-content"> <ul class="tabs inline panels-ajax-tab"><li class="first"><a title="Article Tab - Article" href="/content/382/bmj.p1783" class="panels-ajax-tab-tab" data-panel-name="jnl_bmj_tab_art" data-target-id="highwire_article_tabs" data-entity-context="node:1086233" data-trigger="" data-url-enabled="1"><span>Article</span></a><a title="Article Tab - Article" href="/panels_ajax_tab/jnl_bmj_tab_art/node:1086233/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li><a 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class="panels-ajax-tab-wrap-jnl_bmj_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view "><span class="highwire-journal-article-marker-start"></span><div class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="last" id="contrib-1"><span class="name">Abi Rimmer</span></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address>The BMJ</address></li></ol></div><div class="teaser"><p id="p-1">It has never been more important to ensure doctors in training feel supported. <strong>Abi Rimmer</strong> hears from four experts on how to achieve this</p></div><div class="section other1" id="sec-1"><h2 class="">Create a sense of connection</h2><p id="p-2">Anna Melvin, postdoctoral research fellow for Care Under Pressure 3, University of Exeter, says, “Life as a trainee can be challenging, with unfamiliar working environments, inadequate inductions, continuous assessment and examinations, relocations or long commutes, and a lack of belonging. Therefore, trainees often feel undervalued, lacking control, and disillusioned with medicine, especially in the context of the long journey to being a doctor.</p><p id="p-3">“All of this affects their wellbeing, learning, career choices, and retention. Life can be made better for trainees in many ways, but key is creating a sense of connection.</p><p id="p-4">“Connection means positive working relationships and a sense of belonging to a team. It is an important psychological nutrient for human wellbeing and growth—when trainees feel known and valued, their wellbeing and learning are supported. Trainees are also better able to contribute to work and are more likely to want to return to work in such environments.</p><p id="p-5">“The nature of team working in the NHS means, however, that trainees often experience disconnection on their placements. As they are only there for short periods of time, it is difficult to get to know people. Additionally, permanent staff are often unwilling to invest in them, as they will soon be gone.</p><p id="p-6">“Creating a sense of connection can seem difficult in busy and pressurised working environments, but small things can make a big difference—for example, regular team coffee breaks, team meetings, or protected time for teaching. These enable people to get to know each other, create opportunities for learning and social connection, and help break down hierarchies so senior doctors seem more approachable. Therefore, trainees feel part of the team, valued as individuals, and more comfortable in the working environment.</p><p id="p-7">“While trainees might only be in a team for a short time, efforts to integrate them can make a big difference to their own experiences, and also those of the team and ultimately patients.”</p></div><div class="section other2" id="sec-2"><h2 class="">Consider marginalised groups</h2><p id="p-8">Mashal Iftikhar, core psychiatry trainee year 3 in north London, says, “One of the biggest lessons I have learnt from organising a wellbeing programme for junior psychiatrists with my colleague Hannah Campling is the importance of including trainees at the margins.</p><p id="p-9">“Trainees who have a disability, are single parents, have young families, are the sole breadwinner, are from overseas, or come from an ethnic minority background face additional barriers to improving their wellbeing. In tackling these factors, we improve life for all trainees.</p><p id="p-10">“Firstly, wellbeing is political. Organising yoga sessions will have little impact when trainees are struggling to meet their basic needs. Trainees with significant visa fees or childcare costs, those working less than full time, and those with no generational wealth will be struggling the most. These trainees are overwhelmingly female, and from working class and ethnic minority backgrounds. The fight for full pay restoration cannot be replaced with online mindfulness.</p><p id="p-11">“Secondly, there is no wellbeing without community. One of the most joyous outcomes of our in-person programme has been the forming of deep connections and solidarity between trainees, galvanising them to organise together on matters affecting them in the workplace—from rest spaces and locum rates to pregnancy and breastfeeding support. Give trainees the opportunity to get to know each other outside of handover and they’ll take care of the rest.</p><p id="p-12">“Thirdly, time is money and energy. By organising funded wellbeing events in protected time during working hours, we include trainees whose health would otherwise exclude them from staying after work or who can’t afford extra childcare.</p><p id="p-13">“Finally, remember the principle ‘nothing about us without us.’ Who are the trainees in your region? What are the challenges they face? What would help make their life better? You’ll never know unless you ask.”</p></div><div class="section other3" id="sec-3"><h2 class="">Create a supportive culture</h2><p id="p-14">Partha Kar, diabetes and endocrinology consultant, Portsmouth Hospitals NHS University Trust, says, “One of the fundamental problems as regards to how we look after our trainees is our inability to see them as adult colleagues simply at a different point of a journey we all are on. The infantilising word ‘junior’ seems to have become part of the fabric of the NHS.</p><p id="p-15">“Making life better for our trainees is all about the small comforts—a place to sit, rest, and take breaks; a place to have regular meals; and a locker to store their stuff away and have some privacy.</p><p id="p-16">“In the Portsmouth diabetes centre we pride ourselves on how we look after our trainees, even though we are aware that they’ll move on to other things. This involves never forgetting those basic, small comforts and, most importantly, a door that is never shut.</p><p id="p-17">“Trainees deserve designated time for teaching, time for administration, and a core commitment to the fact that their job is for training—not simply for service provision.</p><p id="p-18">“Throw in a culture of “We will always have your back”—whether that be giving leave as needed for personal circumstances or protecting trainees from unreasonable requests or bullying—and you create a sought after place to be a part of.</p><p id="p-19">“It’s never too difficult to have a smile on your face, place a hand on a shoulder, or simply pause in the corridors, however busy life is. The end result is a happy workforce and the creation of a pipeline for the department—with individuals steeped in the same philosophy.”</p></div><div class="section other4" id="sec-4"><h2 class="">Ask trainees what they need</h2><p id="p-20">Hannah Campling, specialty trainee year 4 general adult psychiatry higher, north London, says, “Over the past year I’ve been leading a wellbeing programme for junior psychiatrists working in north London. I have been doing this as part of my special interest day—this is important as I want to model boundaries between work and home.</p><p id="p-21">“I have learnt some key points for making life better for trainees during this time. Firstly, wellbeing for junior doctors needs to be run and informed by other junior doctors. Only they can understand what trainees need and want.</p><p id="p-22">“Wellbeing programmes do not replace the need for fair and better pay for junior doctors. We need to acknowledge this in our communications and advertising.</p><p id="p-23">“Junior doctors need to feel supported by their seniors to attend wellbeing events and this means creating protected time, with support from medical education departments and HR.</p><p id="p-24">“A wellbeing programme run by trainees also needs to be sustainable so that when trainees rotate the programme continues. Ways of doing this include securing a budget for the programme and creating a committee of trainees rather than relying on one person.</p><p id="p-25">“Measure outcomes of the programme with quick and simple surveys. This makes it easier to secure a budget if you can show the positive impact the programme is having on staff morale, retention, and so on.</p><p id="p-26">“Our wellbeing programme has successfully run a range of events in the past year, including karaoke, nature walks, a roller disco, and a mindful drawing session. I’d love to hear from other junior doctors who would like to set up a similar scheme where they work.”</p></div><div class="section fn-group" id="fn-group-1"><h2>Footnotes</h2><ul><li class="fn-other" id="fn-1"><p id="p-27">You can find out more about the Care Under Pressure research programme here: <a href="https://sites.exeter.ac.uk/careunderpressure">https://sites.exeter.ac.uk/careunderpressure</a></p></li><li class="fn-other" id="fn-2"><p id="p-28">To learn more about Hannah Camplin’s programme you can contact her at <a href="https://twitter.com/HtotheLO">@HtotheLO</a></p></li></ul></div><span class="highwire-journal-article-marker-end"></span></div><span id="related-urls"></span></div></div> </div> </div> </div> </div> </div> </div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-article-trendmd" > <div class="pane-content"> <div id="trendmd-suggestions"></div> </div> </div> </article> </div> <div class="right-nav col-xs-12 col-sm-4 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