The relationship between pre-registration house officers and their consultants.

CONTEXT Previous studies have drawn attention to the importance of the trainee/trainer relationship in determining job satisfaction and motivation to learn. OBJECTIVES To study the relationship between pre-registration house officers and their consultants through exploring an interpersonal exchange and the emotional context in which the exchange took place. To consider any association between the type of relationship implied and the trainee's attitude to their career. DESIGN Postal questionnaire covering a wide range of issues. This study focused on an open question about a significant or interesting exchange, followed by supplementary questions exploring the emotional context of the exchange. SETTING 336 hospitals throughout the United Kingdom. SUBJECTS A cohort of doctors were followed from the time of their application to medical school, and studied towards the end of their pre-registration year (n=2456). RESULTS The response rate to the questionnaire was 58.4%. Responses were categorised as Support and supervision; Unreasonable behaviour; Consultant fallibility; Fair criticism and No exchange. Over half the responses described an interaction that made them feel positive. Trainees particularly appreciated positive feedback, clinical support, teaching, career advice, patronage, or social interaction. The importance of formal appraisal or review sessions in providing the setting for a positive exchange was confirmed. Positive interactions were associated with a positive view of medicine as a career. A minority described an interaction that was negative, involving unreasonable demands, criticism (whether perceived as fair or unfair), humiliation, or sexism. These were associated with a more negative view of medicine as a career, and of themselves as doctors.