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COVID-19 pandemic: perspectives on trainee well-being from UK doctors on the general medical rota
  1. Winifred Garr1,
  2. John Kilic2
  1. 1Medicine/Education, Surrey and Sussex Healthcare NHS Trust, Redhill, UK
  2. 2Intensive Care, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  1. Correspondence to Dr Winifred Garr, Medicine/Education, Surrey and Sussex Healthcare NHS Trust, Redhill RH1 5RH, UK; winifred.garr1{at}

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We thank Dr Launer for the article entitled: ‘Burnout in the age of COVID-19’,1 that, and the themed issue of your esteemed journal were read with great interest. We write to share perspectives on well-being before and during the COVID-19 pandemic from UK trainees on the general medical rota.

An online survey was sent to trainees from foundation year (first year post-qualification) to senior specialist registrar grade on the general medical rota at a UK hospital (n=53), at two points in 2020: in January, prior to the ‘first wave’ of the pandemic, and June 2020, in the midst. In January trainees (n=33) reported: feeling unsupported, heavy workloads, and emotionally disengaging to get the job done. Most (73%, n=24) had never attended a ‘debrief’; and 97% (n=32) felt they would find it useful. By June (n=20), there was in addition: distress regarding personal protective equipment, ‘acting up’ and fatigue. This is a potent cocktail for burnout. Most (55%, n=11) had never attended a ‘debrief’, and 100% (n=20) felt they would find it useful.

With survey respondents keen to ‘debrief’, there is a clear willingness to engage in open communication, to address not only clinical aspects, but also the emotional. The explanations of a ‘debrief’ were mixed among the respondents, with some opting for that of a traditional ‘clinical debrief’, citing a means of learning from clinical events,2 while others defined that more typically ascribed to a ‘Balint group’ (a place to discuss the emotional aspects of clinical encounters).3 The use of Balint groups is well established in general practice and psychiatry.4 This could be extended to medical teams; and may provide a feasible means of improving trainee well-being at this particularly challenging time, and beyond. Indeed the General Medical Council have cited Balint groups as both an outlet for stress, and a means to prevent burnout.3

The COVID-19 pandemic has exacerbated the emotional toll on trainees. Hope is on the horizon with the start of the vaccine rollout, but a difficult and challenging period remains immediately ahead. We cite a role that Balint groups in particular can play in the evolving COVID-19 pandemic and beyond, improving the care we take of: ourselves, our colleagues and ultimately our patients. There is a real opportunity to improve this aspect of the trainee experience. Embedding this positive change into the culture within medicine is one that stands to provide both current and generational benefits. Support here is an important and realistic goal, so we truly can ‘build back better’.5



  • Contributors WG designed and carried out the project, and wrote the letter. JK supervised the project.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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