More than half of junior doctors have taken time out of training, with many doing so due to concerns for their own health and struggles over future decisions, according to a first-of-its-kind survey by the BMA that provides in-depth insight into their career choices.
More than 2,000 junior doctors1 took part in the research, which asked respondents about their attitudes towards and experience of breaks in clinical training.
According to the BMA’s research, a common motivation for those who took breaks was uncertainty over career speciality, with respondents saying time out allowed them space for decision making. A significant number also said “health and wellbeing” was a key driver for taking a break from the “treadmill” of training.
The study also revealed differences in motivation between male and female junior doctors, with men more likely to a take deanery-approved out of programme break to work in a non-training post at home or abroad, work as a locum or travel, while women were more likely to take time off for maternity than men were to take paternity leave.
Key findings of the BMA research include:
• 56 per cent of respondents said they had taken a break in training, with the majority of these (28 per cent) taking this after Foundation Year 2 (FY2) – a trend increasingly known as “F3”;
• The most common reason given for those who had taken breaks was to go abroad (26 per cent), followed by maternity/paternity leave (24 per cent);
• A significant number (19 per cent) said they had taken a break for “health and wellbeing” reasons, with doctors undecided on their speciality (31 per cent) and those training for general practice (28 per cent) most likely to have done so for this reason;
• A sizeable number said they had worked as a locum (21 per cent) and taken a non-training service post in the UK (19 per cent);
• Of those respondents who were working (or had worked) in a non-training post outside the UK during a break, more than three-quarters (78 per cent) had chosen Australia or New Zealand as their destination;
• For those who had taken a break for reasons other than health and wellbeing, family or caring responsibilities, the most common motivations centred around future career decisions, with 38 per cent saying they took time out to decide upon their preferred speciality, 21 per cent to improve their chances of securing their preferred training post and 19 per cent to experience other specialities;
• Among ‘other’ responses, many doctors said they wanted to fulfil wider interests, travel and experience working in another country and that they needed a break from the “treadmill” of training or risk “burnout”;
• Those who took breaks found them overwhelmingly beneficial, with 83 per cent saying it supported them in their decision on preferred speciality;
Within the survey, respondents were also given the opportunity to expand on their answers and offer personal accounts of their experience of breaks in training:
“Given the workload across all specialties in the NHS and increasing pressures in the face of poor funding, poor staffing and very low morale, I still feel regular breaks out are essential for doctors' wellbeing. This helps to prevent burn out and allows us time to tend to the other important aspects of our lives which can get so neglected when working full time/training.” - CT/ST3 grade doctor in training
“It has given me the time and thinking space to take a step back and ensure the decision I am making [regarding] my future training is the right one for me. My foundation years were a slog of ‘just getting through’ a lot of heavy service provision posts. They did not provide me with adequate experience in the speciality I was interested in, to enable me to make an informed decision re applying to speciality training.” – doctor in a non-training post
“Clearly it was a big step to go back to work after (in my case) nearly 10 years. I have had very little support from my previous Deanery (lost training records etc) and, having followed an unconventional path, I have had to start from scratch from a training point of view… I do think that when people leave the programme there should be an exit interview at which people are given advice about how to keep in touch, maintain their skills and keep the door open to return. Otherwise skills and talent will be lost forever.” – doctor in a non-training post
Responding to the survey’s findings, Dr Jeeves Wijesuriya, BMA junior doctors committee chair, said:
“Each year, more junior doctors are opting for a break from clinical training and this research from the BMA offers a real insight into both why they are making these decisions, and what they are doing with this time away from training.
“With many saying they needed more time to decide on their speciality after completing their foundation years, we must work with education providers to consider the underlying reasons for junior doctors wanting to take a step back before committing to a certain career path. Further, with work-life balance and the ability to take future breaks key factors in career decisions for today's junior doctors, it is evident that workforce planning must take into account this need for greater flexibility.
“Current data suggests that the majority of those who took breaks in the past have returned to training, however, there is no guarantee that this will continue to happen, and our research shows that the process of re-entering training can be fraught with difficulties. It is therefore vital employers provide the necessary support to ensure a seamless return to work. The commitments laid out by HEE in last year’s Supported Return to Training project are a step in the right direction.
“As junior doctors, we experience unsustainable pressures in the NHS on a daily basis. Working conditions in the health service appear to have significant impact on where junior doctors see themselves working at the completion of their training, with workload and staffing levels major factors. It is concerning that a significant number of junior doctors said they took a break for health and wellbeing reasons, while describing heavy workloads and low morale during their training. The NHS is in the midst of a recruitment and retention crisis, and the government must urgently work with the BMA and other organisations to address these systemic issues, to ensure a workforce and health service fit for the future.”
Notes to editors
The BMA is a trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.
- The BMA surveyed 2,164 junior doctors in September and October 2017.
- Read the full report “Trends in the career choices of junior doctors” here