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One in 20 trainees concerned about patient safety

Authors: Helen Jaques 

Publication date:  19 Jul 2012


One in 20 trainees in the UK has concerns about patient safety at the organisation where they train, the General Medical Council’s annual survey of doctors in postgraduate training has found.

Early analysis of the responses from more than 51 000 trainees indicates that the major issues are in the acute specialties, reflecting the pace and intensity of those specialties, the GMC has said.

The fact that 5% of trainees did raise a concern of one kind or another suggests that there may be some “significant issues” around patient safety in the UK, the regulator has said, although it cautions that it is too early to draw any firm conclusions from the patient safety concerns raised by trainees.

The 2012 national training survey also brought to light considerable problems among trainees in feedback, assessment, and handover. However, overall satisfaction with training increased, and trainees were largely happy with their educational and clinical supervision.

Niall Dickson, chief executive of the GMC, said: “These findings tell us that while overall satisfaction with their training is increasing, these doctors have a number of concerns. The issues they raise must be urgently addressed.”

“We need to study the results in more detail, but the early signs are that we are continuing to see pressure on doctors in key specialties, and this cannot be good for them or their patients,” he added.

The GMC’s annual training survey—one of the largest of its kind anywhere in the world—was completed online in April, May, and June this year by 95% of foundation, core, and specialty trainees in the UK (93% in Northern Ireland, 93% in Scotland, and 97% in Wales), the highest response rate since the first survey in 2005.

Respondents’ overall satisfaction with their training this year was 80.4%, up from 78.8% in 2011. Specialty trainees in general practice were the most satisfied group (87.8%), and surgery trainees were least satisfied (76.2%).

Nearly all trainees had a designated educational supervisor and had learning and training agreements with this individual (98.8% and 82.5%, respectively). Four fifths (81.3%) rated the quality of the clinical supervision in their current post as excellent or good, and 94.6% said they were rarely or never clinically supervised by someone they felt wasn’t competent to do so (up from 93.6% in 2011).

However a third (32.7%) of respondents said they rarely or never had informal feedback from a senior clinician and less than two thirds (60.9%) said that they had undergone a formal assessment of their performance and found it useful. Around a quarter weren’t happy with the practical experience they were gaining.

More than one in 10 (15.3%) said they felt forced to cope with clinical problems beyond their competence or experience, with 0.9% saying this happened on a daily basis, 5.5% on a weekly basis, and 9.0% on a monthly basis. Trainees also reported issues with handover before and after night duty, with around a quarter saying that arrangements were informal or not in place.

GMC chief executive Niall Dickson commented: ‘Trainee doctors are delivering much of the frontline care to NHS patients. Making sure they are properly supported and supervised is vital for patient safety as well as for effective training.

Helen Jaques news reporter BMJ Careers

 hjaques@bmj.com

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