Challenges to well-being for general practice trainee doctors: a qualitative study of their experiences and coping strategies

Abstract

Purposes of the studyTo identify the challenges to well-being experienced by general practice postgraduate trainees and to explore how the trainees respond to those challenges.Study designQualitative focus group study with doctors in their final year of general practice training (n=16). The participants in the study were recruited from one training scheme in South West England. Data were thematically analysed.ResultsParticipants reported challenges to well-being relating to dysfunctional relationships with colleagues and patients, their workload, a perceived lack of support at work and also physical environmental challenges. They identified response strategies focused on cognitive processing, physical self-care, focusing on their professional purpose, building supportive relationships and adapting their working environment where possible. Additionally, there were factors that could support trainee well-being, including personal factors such as adaptability and self-awareness, but also external and organisational factors, such as culture, supportive colleagues and organisational adaptability in relation to workload management. The importance to trainees of the idea of being a ‘good doctor’ arose repeatedly in the data, as did the importance of the organisational environment. Participants reported finding their training placements in secondary care environments particularly challenging.ConclusionThis research highlights the strategies that general practice trainees use in response to challenges, but also that the responsibility for maintaining well-being cannot be borne by individuals alone. This study identifies that supportive approaches by healthcare organisations and educators are vitally important to general practitioner trainees’ well-being.

Determinants of well-being and their interconnections in Australian general practitioners: a qualitative study

“…Similar to our results, they identified the importance of team support, taking breaks, variety of and control over their work, on an internal level; and wider governmental and public support, resources and funding on an external level 40. British GP trainee focus groups (n=16) discussed the benefits of supportive professional relationships (ie, supportive trainers), control over workload and barriers to well-being of ‘not being valued’, and work-life imbalance 55. The European General Practice Research Network interviewed 183 GPs across eight countries, and described factors that promote job satisfaction: freedom to organise and choose their practice environment; professional education; and establishing strong patient–doctor relationships 56.…”

“… 40 British GP trainee focus groups (n=16) discussed the benefits of supportive professional relationships (ie, supportive trainers), control over workload and barriers to well-being of ‘not being valued’, and work-life imbalance. 55 The European General Practice Research Network interviewed 183 GPs across eight countries, and described factors that promote job satisfaction: freedom to organise and choose their practice environment; professional education; and establishing strong patient–doctor relationships. 56 Interestingly, patient–doctor relationships and professional education were not mentioned in our cohort.…”

Factors affecting the UK junior doctor workforce retention crisis: an integrative review

“…Breaks 36 38–40 43 48 54 : There is often insufficient time during shifts to eat, drink, use the toilet, and rest. If taken, breaks are disrupted frequently due to lack of cross-cover.…”

“…Team connection 36 40 42–45 48 55 58 62 63 73 74 77 : Team relationships are affected by lack of stability in specialty and location. Hierarchies within the medical team and wider multidisciplinary team can also create barriers to cohesive working.…”

“…Compromised patient care 36 39 41 44–46 48 53 54 : Many of the themes identified result in a feeling that it is impossible to build necessary doctor–patient relationships, empathise, and do one’s job effectively, resulting in patients not receiving an adequate standard of care. This can lead to stress and guilt, along with frustration and concern about the damaged state of the NHS and the impacts of restructuring and inadequate funding.…”