Progression and Retention of Psychiatric Trainees in Wessex

AIMS: To explore factors influencing the progression and retention of Psychiatric trainees in training posts within the Health Education England Wessex region. Specifically: To understand what trainees value most in their training; to determine the degree to which trainees feel supported and valued in their training; to determine self-reported burnout measures in trainees; to understand factors that have a negative impact on training experience; to understand factors that are important to trainees when considering future job roles. METHODS: Online questionnaire survey, capturing both qualitative and quantitative data, open to all Wessex Psychiatric trainees and doctors who had left or completed a Wessex Psychiatry training scheme since 1.1.2018. Responses were collected between 7.6.2021 and 31.7.2021. The survey included a burnout scale, questions about how supported and valued trainees felt during training, and questions regarding career intentions. This project received approval from the Health Research Authority (IRAS 296985). RESULTS: 50 participants completed the survey and were included in analysis. 38% were at risk or high risk of burnout. Trainees felt more supported and valued by individuals such as clinical supervisors (70% felt well or very well supported and valued) than by organisations (41% felt well supported and 34% felt well valued by their Trust and Deanery). Trainees rated ‘work-life balance’ as the thing they valued most in training (64%). Poorly resourced services, trainee workload, lack of role models, experiences of aggression, and defensive practice of seniors were cited as reasons trainees considered leaving Psychiatric training. The three most important factors cited by participants when considering a consultant post were ‘Position available with flexible working’(62%), ‘Position available within a supportive team of colleagues’ (54%) and ‘Positive experience working in the Trust as a Trainee’ (46%). 81% of higher trainees wished to work less than full time in a consultant position once they had completed training. CONCLUSION: Flexible working arrangements and work life balance need to be considered in workforce planning. Measures to reduce burnout in psychiatric trainees need to be pro-actively explored by employing Trusts and Deaneries. Mentoring schemes, facilitation of peer support, and clear processes for how to raise concerns regarding supervision are recommended to enhance support for trainees. Junior doctor awards, improved feedback between Trusts and junior doctors and engagement of the Trust board with junior doctors are proposed to improve the sense of value trainees feel. Positive experiences as a trainee are likely to improve retention of local trainees into the local consultant workforce.