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Enhancing the working lives of doctors in training

We are involved in a wide range of initiatives to improve the experience of doctors in training

Doctors in training

We recognise that many doctors in training feel undervalued and morale can be low. We are keen to help recognise and respond to this challenge and are involved in a wide range of initiatives to improve the experience of doctors in training and improve their working lives.

It is, however, important that this work is inclusive and provides the whole system with advice about changing the culture of how we work together in the NHS.

We are undertaking various pieces of work, including delivering greater flexibility to and improving the working lives or doctors in training. You can read about this work via the tabs on the left, or listed below.

In addition, we are also:

  • looking at rotations so that, where possible in terms of delivering the curriculum and while ensuring that doctors are fairly distributed for patient care, trainees do not have to rotate more than necessary so that they can establish a relationship with a single organisation
  • driving up quality of support for junior doctors, through introducing our Commissioning for Quality Framework. This will include in the culture and educational leadership, and in supporting and empowering both trainees and educators to ensure consistent and high quality learning environments.

We have conducted a major, year-long review of appraisal and assessment, aiming to improve training for doctors. The review followed feedback from trainees that the process was stressful, burdensome and did not always provide them with the support or feedback they needed. It found that the process was applied inconsistently depending on geography or specialty. In addition to reviewing the process, it was also an opportunity to draw out where processes are working most effectively and to spread this good practice. 

We have updated our policy on cross cover by doctors in training (found in related documents). While it is the professional duty of all doctors to help patients in need, any diversion of junior doctors from their usual professional responsibilities should be regarded as exceptional and should not risk adversely affecting their training progress.

We have extended whistleblowing protection for junior doctors, providing a new legal route directly against ourselves, if required, for trainees who raise concerns and believe that we have caused detriment to them as a consequence. We have now placed this into our contracts with local employers a provision that protects junior doctors making patient safety disclosures.

In partnership with BMA and NHS Employers, we have agreed a revised Code of Practice for postgraduate medical training which sets out the information that recruiting organisations and employers should provide to doctors and dentists at each stage of the recruitment process and subsequent rotations.

This agreement means that all postgraduate medical and dental trainees will benefit from an extra four weeks’ notice on placement and rotas – meaning that trainee placement information should be provided a minimum of 12 weeks in advance and to make sure rotas are shared a minimum of 8 weeks before the trainee start date. This will better enable trainees to make necessary preparation and remove the need for them to take annual leave during fixed periods in each rotation.

We’ve agreed with the BMA that, for the first time, doctors with a medical condition, disability or caring responsibilities are guaranteed special consideration in the allocation of offers. Under this agreement, applicants with a medical condition or disability for which they need to work in a particular location, and those who are carers for someone who is disabled, will be pre-allocated to their required region if they score highly enough to achieve an offer.

We have introduced a formalised swapping process across all specialties, except for academic programmes, open to applicants once they have accepted offers. Agreed with the BMA, this process gives a further opportunity for juniors to train in their preferred region by applying to swap with a fellow applicant or into a vacant place, where there is a position available.

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