A new report by the Association of Surgeons in Training (ASiT) sheds light on the non-financial costs of surgical training to reveal concerning impacts on trainees’ physical and mental wellbeing.
The survey, based on feedback from 459 UK surgical trainees, vividly describes the challenges faced by those pursuing a career in surgery.
Alarmingly, half of the respondents said they are contemplating practising in another country due to the non-financial costs associated with surgical training.
The UK’s NHS is grappling with challenges post-COVID-19, with record-high surgical waiting times and low public satisfaction.
Trainee doctors, especially in surgical training, face heightened risks of burnout due to long training periods, financial burdens, and poor work-life balance, as highlighted by the 2023 GMC National Training Survey and the UK Surgical Workforce Census Report.
Addressing these issues, the NHS Long Term Workforce Plan prioritises staff retention, emphasising wellbeing, work-life balance and a supportive working environment. This reflects the importance of a healthy workforce, which not only affects doctors’ quality of life but also impacts patient safety.
In the ASiT report, a staggering 76.8% of respondents reported that surgical training harmed their physical health, with 84.3% reporting adverse effects on their mental health.
Staffing levels, rotational training and rota patterns were identified as significant contributors to trainees’ quality of life.
The majority of respondents indicated their training negatively affects their romantic relationships (81.5%), relationships with family (77.0%), and friendships (82.0%).
A significant 89.3% reported missing important family events due to clinical commitments, with 62.2% missing out due to non-clinical commitments related to career progression.
ASiT’s report also includes a series of recommendations aimed at addressing these issues:
• A minimum notice of one year for any changes to the recruitment process.
• Assignment of a base hospital for trainees, with rotations not exceeding a 60-minute commute.
• Higher specialty trainee rotations should be assigned in two blocks at the time of offer acceptance for ST3-ST5, with a review and assignment at ST6-ST8.
• Mandatory self-development time should be incorporated into all core and higher specialty trainee rotas.
• Trainees requesting annual or study leave with more than six weeks' notice should be accepted regardless of assigned duties.
• Free accommodation and food should be available for overnight workers.
• Trusts should be fined for not providing rotas within minimum time guidance.
• Fines should be imposed for unfilled rota gaps.
• An external, independent reviewer should conduct exit interviews following each placement.
Miss Roberta Garau, Association of Surgeons in Training- President
The report is the first of two summarising the findings from the survey, with a second report focusing on the financial costs of surgical training set to be published soon.
The findings underscore the urgent need for reforms to address the non-financial challenges faced by surgical trainees, ensuring a more supportive and sustainable environment for the next generation of surgeons.
