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Enhancing Junior Doctors' Working Lives

The Enhancing Junior Doctors’ Working Lives programme was established in March 2016, to address a range of issues that were having a significant negative impact on the quality of life of doctors in postgraduate training.

Led by Health Education England (HEE), it is a cross-system collaboration to drive and deliver system improvements and meaningful change to postgraduate medical training.

We have worked collaboratively with system partners in the Academy of Medical Royal Colleges, the GMC, NHS Employers and the BMA as well as individual Medical Royal Colleges and the devolved nations to address those issues and provide trainees and stakeholders with yearly updates on our progress.

NEW! 2022 Progress Report

This year’s Enhancing Junior Doctors' Working Lives report, the sixth progress report to be published, is a summary of achievements over the past year. The report is a useful resource for doctors and educators and helps NHS Trusts and practices see how the system is working to support doctors.

What are some of the key messages from this year’s report?

How HEE is focusing on providing flexibility in training and enabling a medical career to be more tailored to the individual, for example through allowing all doctors in training to apply to train less than full time for any reason, and the recognition of experience completed outside of training programmes.
The ‘F3 Phenomenon’ exploring the reasons why Foundation doctors are choosing not to progress directly into specialty training.
Reviewing medical rotations to consider flexible start dates, staggered changeover dates and the geographical boundaries of rotations.
How recruitment processes have been adapted following the pandemic.
The investment of £26 million into the COVID-19 training recovery programme.
Individualised opportunities such as the Population Health Fellowship.
How HEE is engaging with doctors in postgraduate training, for example via the National Trainee Engagement Forum.

Read the full 2022 progress report here.

The F3 phenomenon: Exploring a new norm and its implications

In February 2022, we published a new report called "The F3 phenomenon: Exploring a new norm and its implications". Over recent years we have seen an increase in the number of junior doctors choosing to take a break from training following completion of the Foundation Programme. This is often to work in a non-training post and the vast majority have returned to training at a later date. As this report identifies, there are numerous factors in why doctors choose to take this break, and the reasons are shaped by the interaction between different personal and professional circumstances.

This programme of work, run jointly with the Royal College of Physicians was commissioned in order to build our understanding of what has been referred to as “the F3 phenomenon”, and what it means for individual doctors and for postgraduate training.

This report confirms what we have observed; taking a break from training post foundation is becoming increasingly common. The increased understanding the report brings will help us in the HEE Medical Education Reform Programme to ensure doctors are adequately supported in their careers and attracted into training programmes through our work to individualise training and to increase training flexibility.

Read the F3 report here.

We have also produced 3 helpful videos which you can watch on YouTube:

The F3 phenomenon

Making the most of the F3 year

Mentorship and supervision in F3

A mapping document produced by the National Leadership Fellows highlights initiatives from across the country to enhance junior doctors' working lives. It does not aim to be a fully comprehensive document as we are all continuously working on initiatives, but it gives an overview of activity across the country, highlighting good practice that can be replicated elsewhere in the country and also where there may be gaps.

In April 2019, The Royal College of Pathologists provided an update to the above report.

New national arrangements for the payment of relocation and expenses for doctors in training have been agreed and are in force from 1 November 2020. Read more here.