Around 10% of 50,000 doctors in training in England take approved time out of training for various reasons such as parental leave, sick leave, career breaks and research. Returning to training can be challenging and is a major concern for trainees and trainers. During this period, trainees report lack of confidence in clinical knowledge and technical skills, lack of contact with supervisors, breakdown in pastoral relationships and support when actively sought out [1].
We recognised these challenges and piloted a virtual simulation course, UPDATES, supporting return to work for doctors in training within the general medical specialty.
We identified trainees within the general medical specialty on approved time out of training, and circulated communication via emails and flyers regarding the UPDATES course to them as well as our trust’s medical resourcing department, postgraduate department, college tutors and clinical directors. Our sessions consisted of workshops including interesting cases, new guidelines, and simulated communication scenarios. The courses were delivered by simulation faculty and held virtually, with the morning to read course materials and the afternoon to work through cases. Participants were asked to complete pre- and post-course surveys to enable a full understanding of their experience during time out of training and its subjective impact on clinical and non-technical skills.
Pre-course survey showed participants had been out of training for at least 2 months due to maternity and sickness. At least 20% of participants felt their clinical and non-technical skills had changed since last working and only 40% felt connected to their trust and department. Candidates reported feeling “loss of confidence and lack of clinical knowledge”, “anxious”, “work related stress issues” and “lack of support”. Post-course survey revealed all candidates felt better connected to the trust and the course helped maintained their clinical and non-technical skills. Candidates reported “a great interactive session”, “every department should run a course like this to keep maximum people updated” and “enjoyed the format, very interactive and informative”.
Our findings are synonymous with that of Health Education England. Trainees report lack of confidence and pastoral support during time out of training. We have shown the delivery of virtual simulated courses addresses these issues and maintains clinical and non-technical skills to support return to work.
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1. SuppoRTT [Internet]. Health Education England. 2017; Cited 30/04/2024. Available from: https://www.hee.nhs.uk/our-work/supporting-doctors-returning-training-after-time-out.