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Everybody needs a break. Even consultants.
Consultants are at risk from burn out. This isn’t a controversial statement, it’s a factual one. The evidence to support it grows stronger every year. Last year The Royal College of Physicians updated their report NHS Reality Check and asked half of all substantive consultant physicians about the current state of their wellbeing. 2,372 (32%) responded to the survey and painted a picture of an NHS staff nearing crisis point. Increasing workload pressures have left many doctors in an untenable position and 40% of consultants describe themselves as never or only sometimes in control of their workload. 49% describe their workload as excessive always or most of the time and 47% are working excessive hours always or most of the time. Troublingly, 49% report that work has affected their relationship with their partner and 47% their relationship with their children.
The RCP also examined the frequency of six symptoms that have been recognised to suggest someone may be at risk of burnout, based on the Maslach Burnout Inventory:
Twenty-three percent of consultants experience two or more of the six features of burnout almost always or most of the time. 14% experience three or more always or most of the time.
Despite morale falling to new lows year on year, doctors are finding it increasingly difficult to broach the subject of a sabbatical with their health board or practice. Managers’ attitudes are often that they should be seen as a gift and not an entitlement, putting clinicians in a difficult position when they attempt to raise the subject and negotiate. There’s some suggestion that rising financial pressures might be leading employers to look at sabbaticals as luxuries that the NHS simply can’t afford, and potentially pushing staff into an early retirement that they might not have otherwise taken. This short-sighted view is holding back the medical profession from being enriched by the range of new skills and experiences that taking a sabbatical can give to weary consultants. If you’re feeling like you’ve lost your enthusiasm for your career, having a period away could see you return feeling refreshed and reinvigorated.
You might also look into a sabbatical if you have a passion for a particular aspect of medicine that you haven’t had a chance to pursue yet. Many clinicians use their career break to take a course in something related to medicine or undertake a piece of research with a view to writing a book about their findings. Thrill seekers might even consider working abroad doing humanitarian work or working somewhere like Everest base camp! The opportunities are endless and can enrich your career, making you a better doctor with invaluable, unique experiences and skills. Doctors report returning to work feeling a renewed sense of purpose and are often inspired by the work they did during their sabbatical. With so much to gain from taking time out of your career, more consultants should push for a sabbatical period and exercise their rights to enrich themselves and the profession.
For many years my particular interest has been in postgraduate medical education, which has included roles for the Royal College of Physicians and the Wales deanery, and presenting at international conferences, including Canada and Europe. Between May and August 2013 I went to Auckland University Hospital on a sabbatical to review postgraduate medical education and trainee and doctor support. It was fascinating to note what was similar to and different from the United Kingdom. Most of my time was spent looking at doctors’ performance and assessment and discussing how revalidation was being rolled out in the UK. I was invited to New Zealand for my expertise—but I learned so much from that experience—for example, I was impressed by the value placed on junior doctors with on-call meals provided as well as fully funded study leave and all fees. The culture in the health service was very positive.
It was a fantastic experience. I’ve learned from having a sabbatical that it can refresh you and give you a different perspective on practice. I returned to reality, training consultants about appraisal, reflection and revalidation but I felt energised and was enjoying my work more than I had for many years.
To anyone considering taking a sabbatical, I would say, ‘Don’t hesitate.’ It’s a wonderful opportunity to do something that may be related to your specialty, rather than going on extended annual leave, and it also gives you the opportunity to meet fascinating people and make life-long friends. I would urge any consultants considering a sabbatical to take full advantage of the opportunity, you won’t regret it!
The BMA can offer guidance in how to pursue a sabbatical, including a service for members where trained professionals look over your contract with a fine toothcomb ensuring you know your rights and what you’re entitled to.