Exams are eroding anaesthetic trainees’ work-life balance, college warns

Authors: Abi Rimmer 

Publication date:  15 Dec 2017

Professional examinations are eroding trainees’ work-life balance, the Royal College of Anaesthetists has said.

In a report on the welfare and morale of anaesthetists in training, the college said that trainees felt that exams were stressful and not always relevant to contemporary clinical practice.[1]

“Anaesthetists in training who struggled with exams felt there was inadequate support from the college, resulting in repeated unsuccessful attempts and increasing demotivation,” the report said.

Trainees also felt under pressure to sit exams when they were poorly prepared, the report said, and some felt that the cost of exams and revision courses were prohibitive.

The college’s findings were based on a survey of 3977 anaesthetists in training conducted by the college between December 2016 and January 2017. In total, 2312 responses were received, representing 58% of anaesthetists training in the UK.

The survey found that 85% of respondents were at high risk of burnout and 64% felt that their job had negatively affected their physical health.

The survey also highlighted the problems trainees had with getting proper nutrition and hydration while working shifts. Two thirds (62%) of trainees said that they had worked through a full shift—up to 13 hours—without a meal and 75% had worked through a shift without sufficient hydration.

In addition, most (95%) respondents said that they had stayed on at work after their shift had finished and 26% had stayed on for more than two hours.

The survey also highlighted the issue of rota gaps in anaesthetics, with trainees being asked to fill gaps in their hospital an average of six times each month.

In response to the findings, the college said that doctors should reflect on how well they look after themselves and how they support each other. “Traditional ‘heroic’ models of working relentless hours, and unbounded selflessness, exchanges short term altruism for long term risk of burnout and adverse consequences for physical and mental health,” the report said.

It also said that senior doctors should make an effort to learn about the lifestyle problems affecting their younger colleagues. “Current anaesthetists in training have worked their professional lives without early exposure to the support networks of the hospital residence, the doctors’ mess, and the clinical firm,” it said.

The college called for employers to provide rest and catering facilities for all clinicians working on-call, and for rotas to be designed to allow trainees to develop personally and professionally.

Liam Brennan, president of the Royal College of Anaesthetists, said the findings in the report were a “clear wake-up call.”

“We are calling on the government and senior NHS leaders to work with us to change the workplace culture for doctors of all specialties,” Brennan said. “Patient safety is of paramount importance to all anaesthetists. Directly or indirectly, all of the findings in this report have some impact on our ability to consistently meet our patients’ needs.”


  1. Royal College of Anaesthetists. A report on the welfare, morale and experiences of anaesthetists in training: the need to listen. December 2017. [Link] .

Abi Rimmer The BMJ

Cite this as BMJ Careers ; doi: