Confidence boost in returning to work

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Jade Loughran
Specialty Trainee, Welsh School of Anaesthesia

Hannah Bevan
General Practice Trainee, Wales Deanery

Jennifer Myo
Specialty Trainee, Welsh School of Anaesthesia

 Frances Kent
Consultant Vascular Surgeon, East of Scotland Vascular Network

Returning to training after an extended break is recognised as a particular challenge in any trainee’s career. Up to 10% of trainees are taking time out of training at any one time¹ and the vast majority of those have concerns about returning to training².

As part of Health Education England’s 2017 programme, Enhancing Junior Doctors’ Working Lives, and factored into the 2017 contract negotiated by the BMA, is an annual and recurring budget of £10m to provide personalised support measures for returning trainees in England.

Support needs

This funding isn’t matched for trainees in Wales, and research was carried out in 2022 to ascertain what barriers surgical trainees faced in returning to training and what support was needed. All trainees interviewed were affected by low confidence and explained that trainers were not necessarily in the best position to provide support³.

“I tried to come across quite excited [about returning] and reassure them that I’d be good. I think, like most surgeons, we try and hide any insecurities,” said one surgical trainee.

Rather than initiatives to help with surgical skills, this group suggested that support for non-technical aspects would be of most benefit to them.

Similar surveys undertaken among trainees in the Welsh Schools of both Anaesthesia and General Practice in 2023 echoed this finding, with confidence returning to work being highlighted as a common issue, and calls for trainee-led “better soft support”.

These pieces of work led to the development of the Return to Training RestaRTT workshop. The vision was for an informal, free-to-attend day of workshops, run by trainees who had themselves previously taken time out of training. The objective was to provide a forum to discuss non-clinical topics relevant to trainees returning to work, delivered in a child-friendly environment.

The pilot workshop was supported financially by the Welsh Schools of Surgery, Anaesthesia and General Practice, and BMA Wales. The programme included morning talks on imposter syndrome and confidence building, employment matters, breastfeeding and returning to work, and a keynote presentation from Welsh endurance adventurer and athlete Lowri Morgan, who spoke about returning to athletic training after having a baby. The afternoon session incorporated specialty breakout sessions for trainees to network and discuss issues specific to their training programmes and rotas.

The course was advertised via Health Education and Improvement Wales (HEIW), which sent the details to trainees on all training schemes in Wales. Of the 30 spaces, 22 were filled within 48 hours, with a waiting list starting up within one week of advertising. Delegates attended from across specialties including surgery, anaesthesia, medicine, oncology, emergency medicine, psychiatry, obstetrics and gynaecology, and general practice. And 15 delegates brought their babies.

The pre-course questionnaire revealed that only one of the 30 trainees felt there was excellent support for trainees returning after an extended break. Most had concerns around confidence on returning to training, with many highlighting concerns about the challenges of juggling being a parent with clinical work and exams. Fewer than a quarter (22%) of trainees had a structured pre-leave meeting with their training programme director or training lead.

Feedback from the event was overall very positive, with 17 out of 25 trainees feeling 100% satisfied with the event (average score on a Likert scale for satisfaction = 9.5/10). Delegates gave the workshop an average of 8.5/10 for increasing their confidence and 9.5/10 for helping their return to training.

Many commented positively about being able to bring their babies to the event, saying they couldn’t have attended otherwise. The event cost £2,028 to run (plus voluntary time from the organising committee). All trainees reported that they would recommend the workshop and all but one would value attending the workshop again after subsequent periods of leave.

Long-term gains

Organising and running this event was hugely valuable to the trainee organising team, who felt they were making a positive step in supporting their trainee colleagues in their own return journey. They demonstrated a need for support of this group and believe this workshop proved to
be a low-cost, high-value tool in support provision.

Funding has now been secured from HEIW for the current financial year as part of its Trainees Transforming Training programme, with the next event scheduled for early 2024.

It is hoped that recurrent funding will be offered to support this workshop to run long term.

Qualitative research is under way into the needs of all trainees returning after an extended period away in order to develop a similar workshop for them. A trainee-led working group is planning a Scottish workshop for April 2024. The organisers have also been working to establish peer mentor networks within their specialities to offer additional support to colleagues taking time out of training.