Thursday 15 August 2013

New doctors need more support as they begin their careers

New doctors need more support as they begin their careers A third of junior doctors are reconsidering their career choice after just a year on the wards.

Over the coming weeks about 6,000 new junior doctors will start life on the wards. It is a tough and daunting experience, as they put into practice all the training they have received over the past four or five years.
Predictably, there is negative press coverage around this time, based on research from the Dr Foster unit and the department of acute medicine at Imperial College London. The article, published four years ago, did show a small increase in deaths at the start of August – but the findings did not demonstrate a causal link between the rise in mortalities and the influx of new doctors.
Since that research was first published, junior doctors have become better prepared for the transition from medical student to junior doctor: training is far more patient-focused at medical school, and there is a period of pre-job shadowing, dedicated induction programmes and close clinical supervision. But there is no doubt that this is a challenging time for both junior doctors and senior colleagues.
We conducted a survey of about 350 junior doctors who are just completing their first year on the hospital wards, which produced some interesting findings. It was encouraging to see that more than two thirds had chosen a career to help people, but disheartening that a third were re-considering their career choice due to their early experiences. After years of dedicated study, it is a telling sign of the major stresses placed on the shoulders of young doctors so early in their careers.
We must do more to support junior doctors. Though the profession clearly has a role to play, so too do NHS managers. They have the power to provide appropriate resourcing and support on the ward, which can affect morale. As our survey shows, three quarters of respondents said that they had struggled with long hours. A similar number had difficulty with heavy workloads, and more than a third had felt isolated.
When asked what they had found most challenging when dealing with patients during their first year, 73% of junior doctors said they didn't have enough time to give patients the care they required, and nearly half were working beyond the maximum working hours stipulated by European law.
Managers have an important role in providing a safe learning environment. They should be accessible, and receptive to concerns, queries and new ideas. They will have a pivotal role in delivering Sir Bruce Keogh's vision, set out in his recent review into the quality of care and treatment provided by 14 hospital trusts in England.
I share his belief that junior doctors should not just be seen as the clinical leaders of tomorrow, but the clinical leaders of today. We must harness their enthusiasm and support them to become a valuable and respected member of the team.
Junior doctors are at the frontline of patient care, they understand the challenges faced by both patient and management and are, therefore, a valuable source of intelligence. They are capable of providing real insights and seeing things that affect patient safety.
The NHS has come under sustained fire and we need to nurture it back to health. Junior doctors represent the present and our future, and have a core role in restoring pride in our healthcare system, which we often forget is the envy of many countries.
So spare a thought for the thousands of young doctors who have embarked on a lifetime of dedicated hard work and study, and whose actions are a matter of life and death.
Dr Pallavi Bradshaw is medicolegal adviser at the Medical Protection Society. Guardian Professional.
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