Steve Loasby, Research Manager at the GMC, discusses how induction is an important tool that can affect a doctor’s wellbeing, workplace environments and patient care.

At the GMC, we have many sources of data at our disposal: registration records, anecdotal feedback from doctors and policy makers, and insights from our regularly commissioned research projects. All help shape our thinking.

But we heard that sometimes inductions were taking place at inconvenient times or not covering the right information. In some cases, they were not happening at all.

The effect on wellbeing and patient safety

We commissioned independent agency Community Research to find out how common these issues with induction were. And to identify the impact on doctors, patients and the health services as a whole.

The team did a rapid literature review of issues relating to induction, followed by a series of telephone interviews with doctors across England, Scotland and Northern Ireland.

They spoke to doctors that were new to post or had returned to work recently, those in primary and secondary care roles and doctors at different stages of their career. This included doctors in training, locums, international medical graduates and newly qualified consultants.

The research revealed a huge difference in the quality of inductions. Some told us about good experiences, but every doctor they spoke to could remember at least one bad incident.

In some cases, the poor inductions affected doctors’ wellbeing, but there were also times where it had an impact on patient safety. For example, some doctors told us that emergency procedures hadn’t been explained properly and others weren’t shown where vital equipment was.

Surprisingly, it was often simple things that made inductions more effective. Basic steps such as sending roles and responsibilities ahead of a doctor’s start date and including information about the hospital often changed the way doctors felt about their role and workplace.  

The importance of a sense of belonging

Inductions can also help to create a sense of belonging. One doctor in training told us about a consultant who made every new team member text him their name when they first started. Now they were over the social awkwardness of messaging him, he said, they wouldn’t have any issues contacting him if there was a problem.

A simple step, but one that immediately made people feel welcomed and supported.

Fostering an ethos of belonging isn’t just important to doctors. It can help to create positive working environments for all healthcare staff and can improve retention in hospitals and practice that struggle with recruitment.

Supporting a sustainable workforce

Later this year, we’ll publish our Completing the picture survey, which also explores the impact of induction on the workforce. It found that 8.1% of doctors who have moved away from practising in the UK see a lack of a formal induction as a barrier for them returning to work here. Given that’s a potential pool of more than 7,000 doctors, it’s not an insignificant figure.

Induction is also key for international medical graduates that are adapting to practice in the UK. And while our Welcome to UK practice workshops provide support, an effective induction in the workplace is also vital.

Our research has shown that induction can help to create fair, safe and more inclusive environments for all doctors. It also has a direct impact on recruitment and retention. During times of pressure there is a chance that they fall down the priority list. With the effects of the pandemic expected to impact our health services for a long time, it’s vital that this doesn’t happen.

We’ll be working with leaders from across the four nations to make sure that creating safe and effective inductions remains a focus. The positive impact that they have will not only benefit doctors, but patients and the wider health services too.

If you have a question for Steve about our research into the importance of induction please email Research@gmc-uk.org.