Junior doctors training in obstetrics and gynaecology are experiencing alarming levels of burnout, which could have a critical impact on patient safety, the General Medical Council (GMC) has warned. The regulator's national training survey reveals that these trainees report more overwork and sleep deprivation than their peers in any other medical field, and they are also more hesitant to escalate concerns about patient care.
Survey Findings
The GMC's analysis, based on responses from 68% of trainee doctors, including registrars, shows that nearly one in three obstetrics and gynaecology trainees felt apprehensive about approaching a senior colleague with a patient issue, compared to one in five across all specialties. Additionally, 70% were at moderate to high risk of burnout, versus 61% overall. One in three reported regular sleep deprivation, compared to one in five among all trainees.
Charlie Massey, chief executive of the GMC, emphasized the gravity of the situation: "Creating environments where staff are supported, listened to and feel able to raise concerns is essential." He told the BBC that when things go wrong in healthcare, it is often due to failures in culture and leadership.
A Personal Perspective
Author Adam Kay, a former doctor who left medicine in 2010 after a traumatic birth incident, said the report "makes for miserable reading" and that "nothing has been done" to improve workplace culture. Kay, who wrote the bestselling memoir This Is Going to Hurt, described his own experience of inadequate support after a stillbirth: "I wasn't particularly well supported after it happened. It was a bit like I said I'd sprained my ankle or something. There was no talk of a debrief. There was no offer of time off or counselling. It's just, you know, get on with it."
He added: "The doctors working on our labour wards are burnt out, bullied, don't feel like they can report problems upstream. It's upsetting to read."
Kay also pointed to staffing shortages as a key issue. "There are fewer staff on the wards than ever. I can't remember the last time I spoke to a doctor in that specialty who wasn't working out what their plan B was, whether that's going part time, moving to another country, or moving to the pharmaceutical industry."
Voices from the Frontline
Dr Miriam Broughton, 27, a second-year resident doctor training to become an obstetrics and gynaecology consultant, shared her experiences. Despite the challenges, she remains passionate about her work: "Being there to deliver someone's baby at the best moment of their life is honestly one of the best things you could ever do. And then also working with people through the hardest moments of their lives and being able to support them is just priceless."
However, she acknowledged the immense pressure: "It could be that there's two or three ladies whose babies need delivering, and then somebody else coming in on maternity triage whose baby isn't moving, and you might also be getting calls from A&E about a lady having a miscarriage who's bleeding really heavily. There's just one of you to manage all those jobs."
Dr Kat Barton, chair of the Royal College of Obstetricians and Gynaecologists (RCOG) National Trainee Committee, said: "Many of us feel overstretched and close to burnout. This reflects staff shortages, working beyond our hours, and knowing that despite our best efforts, the care women receive is being affected." She called for government investment in safe staffing, protected training time, and wellbeing support.
Government Response
A spokesperson for the Department of Health and Social Care (DHSC) said: "In all the investigations carried out in recent years into failings in maternity services, one of the key lessons has been that members of staff must feel empowered to speak up if they have concerns about workload, or patient safety, and their concerns must be acted upon."
The spokesperson added that all NHS trusts now have a Freedom to Speak Up Guardian and that the government is growing the workforce, with a record number of midwives and over 600 added in the past year. The Maternity and Neonatal Taskforce, chaired by the Secretary of State, is working to ensure every maternity unit meets the highest standards of patient safety and care.
The GMC survey also indicated that obstetrics and gynaecology trainees were more positive than average about some aspects of patient safety reporting, such as knowing how to report incidents and near misses. However, the overall picture remains concerning, with burnout and cultural issues posing a significant risk to the safety of mothers and babies.
