Are junior doctors a burden or an asset for managers?:
Richard Vize argues that junior doctors make a vital contribution and we need to listen to them in order to deliver high-quality care
Junior doctors are often more associated with increasing death rates than raising standards in the public's mind, and have seemed more tolerated than embraced. But attitudes towards this vital and substantial section of the NHS workforce are changing.
As the next intake of junior doctors prepare to take their first steps on the ward in August, the General Medical Council has published its annual survey of UK doctors in postgraduate training. With more than 51,000 of the 54,000 eligible doctors responding, it could hardly be more authoritative.
While there was a high degree of satisfaction with much of their training, around one in 20 raised concerns about patient safety. Acute services accounted for many of these problems, which the GMC said may indicate "some significant issues across the UK".
Overall 5.4% reported receiving at least some training from someone they did not regard as competent to do so. One in seven said they were forced to cope with clinical issues beyond their abilities, and for more than 400 doctors this was a daily problem.
Surgical training received the lowest satisfaction score of any speciality. Feeling bullied or harassed was a rarity, but was still experienced regularly by 1.1%.
In Britain, the professions doggedly maintain their hierarchies from one generation to another. A pupil barrister or junior doctor has no room for doubt about their lowly status or the relative weight they can expect to be attached to their views and judgments.
But – slowly – junior doctors are beginning to get the support and respect they deserve. The higher death rate caused by the arrival of junior doctors on the wards – known as the "killing season" – is being addressed by NHS medical director Sir Bruce Keogh. This year's intake will spend a minimum of four days shadowing before being let loose on patients.
Trials have indicated that this approach could cut errors in the early days by around half. Mentoring is hardly a new or difficult concept and is straightforward to organise. What does it say about medical and managerial culture in the NHS that many hospitals have allowed the killing season to become an accepted part of trust life – and death – and left it unchecked, year after year?
The intensity of junior doctors' clinical training would seem to leave little time for anything else, but a small and growing number are pursuing leadership training as well. They realise that being a first-class doctor increasingly depends on being able to lead a high-performing team, rather than just on personal excellence.
As the King's Fund noted in its recent report Leadership and engagement for improvement in the NHS, some training pairs doctors with managers, to break the frustrating cycle of each understanding and respecting too little of each other's contribution. The London Deanery's Paired Learning Scheme, for example, links senior registrars with managers so they can share expertise in improving services. The idea originated in the experience of a junior doctor – paediatrician Dr Bob Klaber noticed managers and junior doctors rarely spoke and knew little of each other's work.
King's Fund research among junior doctors on leadership programmes uncovered palpable determination to make a difference, but some were still being stymied by managers and senior doctors who did not value what they had to offer.
UK consultants often work in the same trust for many years, and put down deep roots. It is easy to see in such a culture that not everyone will welcome the insights about weaknesses in practice or opportunities for improvement from a junior member of the team.
As the NHS searches for efficiencies, quality and patient centred care, junior doctors have a vital contribution to make. They are a talented, energetic but much underused resource.
Managers should see their development as a key measure of the trust's success. The attitudes that will ensure they have the best possible foundation for their careers – teamwork, being open to challenge, seeing every patient contact as an opportunity to learn, valuing the contribution of every individual – are exactly the attributes that secure high-quality care. Guardian Professional.
Junior doctors are often more associated with increasing death rates than raising standards in the public's mind, and have seemed more tolerated than embraced. But attitudes towards this vital and substantial section of the NHS workforce are changing.
As the next intake of junior doctors prepare to take their first steps on the ward in August, the General Medical Council has published its annual survey of UK doctors in postgraduate training. With more than 51,000 of the 54,000 eligible doctors responding, it could hardly be more authoritative.
While there was a high degree of satisfaction with much of their training, around one in 20 raised concerns about patient safety. Acute services accounted for many of these problems, which the GMC said may indicate "some significant issues across the UK".
Overall 5.4% reported receiving at least some training from someone they did not regard as competent to do so. One in seven said they were forced to cope with clinical issues beyond their abilities, and for more than 400 doctors this was a daily problem.
Surgical training received the lowest satisfaction score of any speciality. Feeling bullied or harassed was a rarity, but was still experienced regularly by 1.1%.
In Britain, the professions doggedly maintain their hierarchies from one generation to another. A pupil barrister or junior doctor has no room for doubt about their lowly status or the relative weight they can expect to be attached to their views and judgments.
But – slowly – junior doctors are beginning to get the support and respect they deserve. The higher death rate caused by the arrival of junior doctors on the wards – known as the "killing season" – is being addressed by NHS medical director Sir Bruce Keogh. This year's intake will spend a minimum of four days shadowing before being let loose on patients.
Trials have indicated that this approach could cut errors in the early days by around half. Mentoring is hardly a new or difficult concept and is straightforward to organise. What does it say about medical and managerial culture in the NHS that many hospitals have allowed the killing season to become an accepted part of trust life – and death – and left it unchecked, year after year?
The intensity of junior doctors' clinical training would seem to leave little time for anything else, but a small and growing number are pursuing leadership training as well. They realise that being a first-class doctor increasingly depends on being able to lead a high-performing team, rather than just on personal excellence.
As the King's Fund noted in its recent report Leadership and engagement for improvement in the NHS, some training pairs doctors with managers, to break the frustrating cycle of each understanding and respecting too little of each other's contribution. The London Deanery's Paired Learning Scheme, for example, links senior registrars with managers so they can share expertise in improving services. The idea originated in the experience of a junior doctor – paediatrician Dr Bob Klaber noticed managers and junior doctors rarely spoke and knew little of each other's work.
King's Fund research among junior doctors on leadership programmes uncovered palpable determination to make a difference, but some were still being stymied by managers and senior doctors who did not value what they had to offer.
UK consultants often work in the same trust for many years, and put down deep roots. It is easy to see in such a culture that not everyone will welcome the insights about weaknesses in practice or opportunities for improvement from a junior member of the team.
As the NHS searches for efficiencies, quality and patient centred care, junior doctors have a vital contribution to make. They are a talented, energetic but much underused resource.
Managers should see their development as a key measure of the trust's success. The attitudes that will ensure they have the best possible foundation for their careers – teamwork, being open to challenge, seeing every patient contact as an opportunity to learn, valuing the contribution of every individual – are exactly the attributes that secure high-quality care. Guardian Professional.
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