‘You can't be a person and a doctor’: the work–life balance of doctors in training—a qualitative study

Abstract

ObjectivesInvestigate the work–life balance of doctors in training in the UK from the perspectives of trainers and trainees.DesignQualitative semistructured focus groups and interviews with trainees and trainers.SettingPostgraduate medical training in London, Yorkshire and Humber, Kent, Surrey and Sussex, and Wales during the junior doctor contract dispute at the end of 2015. Part of a larger General Medical Council study about the fairness of postgraduate medical training.Participants96 trainees and 41 trainers. Trainees comprised UK graduates and International Medical Graduates, across all stages of training in 6 specialties (General Practice, Medicine, Obstetrics and Gynaecology, Psychiatry, Radiology, Surgery) and Foundation.ResultsPostgraduate training was characterised by work–life imbalance. Long hours at work were typically supplemented with revision and completion of the e-portfolio. Trainees regularly moved workplaces which could disrupt their personal lives and sometimes led to separation from friends and family. This made it challenging to cope with personal pressures, the stresses of which could then impinge on learning and training, while also leaving trainees with a lack of social support outside work to buffer against the considerable stresses of training. Low morale and harm to well-being resulted in some trainees feeling dehumanised. Work–life imbalance was particularly severe for those with children and especially women who faced a lack of less-than-full-time positions and discriminatory attitudes. Female trainees frequently talked about having to choose a specialty they felt was more conducive to a work–life balance such as General Practice. The proposed junior doctor contract was felt to exacerbate existing problems.ConclusionsA lack of work–life balance in postgraduate medical training negatively impacted on trainees' learning and well-being. Women with children were particularly affected, suggesting this group would benefit the greatest from changes to improve the work–life balance of trainees.

Today's doctors: What do men and women value in a training post?

“…If this is the case, it will have significant implications for medical workforce planning, retention and recruitment. As more early‐career doctors in many countries are women, 26,35,36 and if more male early‐career doctors now wish to achieve a better work‐life balance in their training posts and jobs, specialties, which have been traditionally male‐dominated and perceived to have long hours and inflexible working patterns, may struggle to recruit 28,36‐40 . Career breaks may become more common for both genders as these appear to be increasingly related to a wish to improve work‐life balance 19,38,41,42 …”

Education and service: how theories can help in understanding tensions

“…It appears to be contributing to resident and trainee dissatisfaction and an increasing pattern of residents and trainees wishing to take time out of training, quit training or move into medical jobs without patient contact. [13][14][15][16][17][18] Responses to the challenge of tension between education and service have been diverse. These have included calls for the transformation of medical education, such as shifting from traditional ward teams to more education-oriented services, 19,20 and alternative pedagogic methods, such as simulation-based education.…”

Medical Doctors and Leadership Positions in Abuja, Nigeria: A Gender Perspective

“…Women are typically saddled with the work of keeping the home and when this is added to that of the office including the long hours spent in the hospital can be quite challenging. The work load is worse among those with children (Rich et al, 2016). A study among 96 trainees and 41 trainers involved in the United Kingdom postgraduate medical training reported that female trainee doctors suffered more from work-life imbalance and tended to chose specialties that appeared more favourable to achieving a work-life balance (Rich et al, 2016).…”

“…The work load is worse among those with children (Rich et al, 2016). A study among 96 trainees and 41 trainers involved in the United Kingdom postgraduate medical training reported that female trainee doctors suffered more from work-life imbalance and tended to chose specialties that appeared more favourable to achieving a work-life balance (Rich et al, 2016). Also, female doctors are more likely to develop burnout syndrome compared with their male counterparts (Amoafo et al, 2015).…”