Trainee SupportDr Ed Pickles

Trainee Support Leaded.pickles@qvh.nhs.uk

Doctors in Difficulty

A trainee in difficulty

• an individual who needs extra support to help them overcome problems threatening completion of their training programme.

• Identifying trainees as ‘in difficulty’ is not to label them, but to initiate certain processes. The aim is to help them complete training successfully.

Causes of Difficulty

• Training environment– mismatches between trainee and trainer– bullying or harassment– excessive workload– commuting

• Personal issues– partner relationship, bereavement, critical family

illness, visa problems

Causes of Difficulty

• Clinical development and examination performance

• Generic professional development

Causes of Difficulty

• Professional behaviour, including drug dependance

• Health concerns & absences, particularly mental health

• Disability

• Bullying / harassment

Signs

• anger, rigidity, absenteeism, failure to answer bleeps

• poor time-keeping or personal organisation • change of physical appearance • lack of insight• clinical mistakes, failing exams• bullying, arrogance, rudeness, lack of team

working • undermining other colleagues

Signs

• defensive reaction to feedback• verbal or physical aggression, erratic or volatile

behaviour• lack of engagement, withdrawing from learning • communication problems • depression or other mental illness • new physical illness or worsening of existing

physical illness

Formal

• Appraisal• ARCP• Examinations• WPBA• Multisource feedback• Clinical governance / incidents• SUIs• Complaints / litigation

Role of Deanery versus Trust• Employer

– performance– grievances– discrimination– whistleblowing– potential disciplinary

matters

– Trainees should be managed in the same way as any other NHS employee.

• Deanery– responsible for providing

high quality training and education.

Sources of Support - immediate

• Educational Supervisor– regular appraisal

• College Tutor – LFG

• Clinical Supervisors– use those you ‘gel’ with

• Trainee colleagues– be nice to each other

• Register with a local GP– Don’t self prescribe

Other Sources - trust

• Clinical Tutor & PGME Manager• Occupational Health– counseling– health advice– employee assistance programme

• Human Resources / Medical Staffing

• Most issues easily managed by you and ES– Written Plans with SMART objectives– Confidential as possible

• Deanery involvement where training may require extension

Support - Deanery

• Educational Supervisor / College Tutor• Training Programme Director• Head of School• Anaesthetic Trainee Support Lead– ed.pickles@qvh.nhs.uk

Deanery Internal Support

• KSS Careers Counselling– Career progression

• Language and Communication Support• Practitioner Health Programme – Confidential Self-referral welcomed for KSS

trainees

External Support

• BMA Counselling Service• Hope4Medics• Doctors’ Support Network• Sick Doctors Trust (dependance)• Medical Women’s Federation• Samaritans• AAGBI / RCOA

Questions?