Concerns for doctors returning to work

Coming back to work is never easy: whether a career break has been voluntary or involuntary, professional or personal, it’s common for a sense of dread to accompany that first Monday morning back in the 9-5.

Never is this more true than when returning to training as a Junior Doctor. Working within the NHS comes with unparalleled challenges with high stakes, long hours and immense scrutiny from supervisors, the Trust and the general public. The ward can feel like a warzone even at the best of times: without a clear strategy for return, the countdown to returning to training can feel like a ticking time bomb.

Doctors are almost always taken for granted, expected to always be on call and to always make the right call – a patient in critical condition doesn’t have much understanding for it being a doctor’s first day back on the job, after all. But with such high expectations, it’s no surprise that returning to training can often cause a crisis in confidence. Work by Health Education England found lack confidence in clinical knowledge and skills, low self-perception of capability and an inability to adjust to new personal circumstances in the workplace to be the most common concerns for Junior Doctors in coming back into work. These worries worsen based on the length of time spent away but are consistent amongst specialisms and even level of training; those entering their final years of training display the same levels of self-doubt as those in early stages.

Our own research echoed these primary concerns. When reaching out to returning junior doctors, returned junior doctors and those who had decided to end their training completely, our surveys found lack of confidence, both personally and professionally, to be at the core of hesitancy in returning to training. Our interviewees all shared some degree of trepidation over failing during simple practical procedures, being behind their colleagues in terms of current research, clinical protocols and best practice and even in potentially discovering they may have lost their passion for medicine altogether.  

Top 10 Concerns for Doctors returning to training:

1. Lack of personal confidence
2. Lack of perceived clinical competence
3. Issues catching up with current clinical research and working protocols
4. Issues in stress management
5. Issues in grief management
6. Issues adjusting to a new working environment
7. Issues accessing follow-on support  
8. Issues of childcare  
9. Fear of potential judgment from colleagues for time taken away from training
10. Continued personal health concerns

Although these themes are common to all those returning, it is important to remember each individual story requires individual attention. There is no ‘one-fits-all’ approach to returning to training, making it so important that every Junior Doctor is provided with a tailored transition strategy and is not forced to draw support from colleagues’ anecdotal advice alone. Often worries relate to why time was taken off in the first place – a decision unique to the individual. For example, new parents fear their ability to balance childcare with clinical practice, bereaved Junior Doctors dread battling death on a daily basis and those who took time off due to stress question their ability to cope back in such a pressured environment. The case studies you will read in our following resources demonstrate that although concerns may be shared amongst returning Junior Doctors, it is essential to remember, and be compassionate for, the idiosyncrasies of these.

The importance of asking for help cannot be overstated. Confidence is at the core of good decision-making; a virtuous cycle exists between self-belief and positive clinical outcomes where both facilitate the other. There are many steps that can be taken to bolster this both during time away from training and in the initial transition back. Please follow on for information on what resources are available for supporting return and also for maintaining both confidence and competence during time away.

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