Morale and satisfaction of doctors and trainees in the UK

Doctors in the United Kingdom have recently been confronted by rapid changes in their clinical and professional practice over which individual doctors have had little or no control. These factors have ranged from the disastrous attempt to implement a new system for appointing junior doctors, radical redesign of health care delivery and increasing political interference in the regulation of doctors to the impending introduction of compulsory revalidation for all doctors. Not surprisingly morale could be better but it is encouraging that trainees express high and rising satisfaction with the training they receive and that senior doctors expressed high job satisfaction although reporting they had insufficient leisure time which adversely affected their morale. Female doctors working part-time were more likely to report a better work-life balance. Introduction Current wisdom is that morale is low among British doctors. While this is a non-evidence based view which has been believed by British doctors for decades, there are some new major drivers which have damaged morale and these include the chaos caused by synchronous introduction of new appointments processes and a new training scheme in 2007 (Douglas, 2007) which has affected morale at all levels but particularly among trainees and the imminent introduction of reaccreditation (Donaldson, 2008) for all doctors which is particularly concerning older doctors. This article reviews some of the drivers affecting morale of doctors and the accompanying evidence. As the drivers vary with career progression, the paper will chronologically follow career steps.