In 2011, the first edition of the GMC’s The state of medical education and practice in the UK (SoMEP)was published. Since then, Jacqui Thornton, a freelance health writer whose work has appeared in BMJ, The Lancet and the Sunday Telegraph, has been part of the report-writing team. For this year’s 10th SoMEP she interviewed doctors, to get their real-life experiences to complement the report’s data.

Blog by Jacqui Thornton, health journalist and SoMEP writer

When the first ever SoMEP was published, the GMC was honest enough to admit that while it held a large amount of useful information, it was not routinely analysed and shared. The report aimed to change all that.

The first report was 140 pages. With every subsequent edition there was an initial attempt to slim it down, before we found some exciting new data, cut in various ways, which expanded the length. This year’s edition runs to 168 pages.

Over the years, it has gone from relying on GMC data, to including wider literature and commissioning independent research. Last year an annual ‘barometer’ survey was commissioned, to help demonstrate now and in the future how the profession is coping with everyday pressures.

For some time, we have wanted SoMEP to include the voices of doctors in a more ‘lived’ way. This year, more than ever, we felt it vital to capture their views, while not taking them away from their work. So, I was asked to interview a number of doctors, representative of those on the medical register, to find out how the pandemic had affected their practice, complementing the barometer survey.

I love interviewing doctors. As a national newspaper health editor, and more recently reporting for the BMJ, I am never disappointed by the clarity, intelligence, humanity and humour that marks out my conversations with them. Some are passionate, some self-deprecating, all thoughtful and focussed.

I was not disappointed.  My interviewees shared all of these characteristics, including some more. I was inspired by the doctor in training who proactively led her fellow trainees, becoming a link between clinical directors and colleagues in their first year of training, who offered to train all types of staff on COVID-19 protocols, and who pushed forward on virtual teaching which could be downloaded and viewed at a convenient time.

One trainee doctor in intensive care predicted the highly specialised  nursing staff would become immensely busy and in a practical, matter of fact way took it upon himself to learn some of the tasks so he could give them breaks, while still carrying out, as he puts it, ‘doctor-y’ things. Talking to them, he discovered that nurses have training to deal with doctors – but not vice versa. On reflection, he thinks they should – surely that could only lead to better team working and communication.

The relationship between consultants and trainees was fascinating too. Daily huddles where the medical leads checked in with the wellbeing needs of the trainees were appreciated, even though some consultants were better at it than others – the fact they realised it needed to be done and took it on board was the point.

In primary care it was insightful to hear that the transactional nature of virtual meetings makes staff miss the human contact in surgeries, even though working from home was helpful for GPs.       

Back in secondary care, clinical leaders not used to ‘not knowing’ things had to deal with a lack of evidence because of the novel nature of COVID-19, while still keeping patients’ welfare paramount. A SAS doctor (a doctor who is not in training nor a specialist or GP) was concerned that wellbeing measures at the trust were initially only for trainees when, actually, consultants might have been at higher risk.

This was echoed by the youngest trainee doctor I spoke to, who put it very touchingly. He felt that consultants ‘were feeling stresses that they perhaps hadn’t felt in their careers for a while…. perhaps, that made them feel a little bit close to us….because we feel very out of our depth a lot of the time.’

I was surprised by the level of open emotion shown to me, a stranger. Two interviewees broke down at times.  But all of them – even the two who become emotional – said they were grateful for being able to tell their story; some found it enjoyable, others cathartic. I hope the interviews are well-received, and that they provide additional insight to the 2020 edition of SoMEP.  

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