Now is the time to act in tackling burnout in junior doctors

by Sarah Hallett

The pandemic has exacerbated a growing problem, and it urgently needs addressing

Location: UK
Published: Thursday 14 July 2022

In the 2021 GMC national training survey, a third of trainees reported they felt burnt out to a high or very high degree because of their work, a higher proportion than in pre-pandemic years.

The BMA's regular tracker surveys – which we sent out frequently during the pandemic and have continued to send out since – paint an even more devastating picture. 

In April 2022, 62% of junior doctors said they were currently suffering from depression, anxiety, stress, burnout, emotional distress, or another mental health condition, relating to or made worse by their work or study. Of these, around half felt that it had worsened during the preceding month. Worryingly, this is higher than the levels of burnout that were being reported during the peak of the pandemic, where it was around 53%. 

We know that the pandemic did not create this crisis but has exacerbated a growing problem. We have an increasing cohort of junior doctors who have only ever worked in a pandemic NHS, where everyone is tired, fed up and burnt out.

Doctors are graduating with ever-growing student debt – over £80k in some cases. It widens the gap between those whose parents can pay for their university fees upfront and those who rely on funding. Meanwhile, the Government has extended the period over which this is paid back, without consultation.

With the costs of living increasing, many find the NHS bursary is insufficient to cover living costs during their last few years and so have to work while studying for finals. In addition, pay erosion means that the average pay of junior doctors has fallen by almost a quarter since 2008.

Medical school has been an anxiety-ridden time for many new graduates – due to COVID-19, they had to study from home, separated from peer groups, condense many weeks of study into shorter blocks and missed out on electives. Many graduated and joined the workforce early.

Despite widespread rota gaps, most specialty training programmes are now oversubscribed, further adding to the pressure on junior doctors who need to chase points to secure a place in training.

We have had a series of excellent reviews in recent years that point towards answers – the ARCP review, the Foundation Programme Review, the brilliant ‘caring for doctors, caring for patients’ report by Michael West and Denise Coia, the HEE mental wellbeing report. But have we truly listened to the recommendations and done our best to enact them? 

Junior doctors are increasingly demoralised and feel de-professionalised. We want to be treated as adults, as professionals, with autonomy, control, and time to train. We deserve to be paid in accordance with our worth, and certainly not a quarter less than before. It's currently a stressful time, and we must act now, or risk losing doctors forever. 

Since the publication of this column, the GMC has released the results of the 2022 National Training Survey; burnout statistics have worsened yet still, with nearly two-thirds of junior doctors at high risk of burnout. The BMA has just published a response to that survey.

Sarah Hallett is co-chair of the BMA junior doctors committee