Identifying and helping doctors in difficulty
The majority of doctors will thrive within a supportive environment and transition safely and successfully back to work.
A small number of individuals however, may find it more difficult. It is therefore important to try to identify those that may be struggling as early as possible.
The causes for problems with returning back to work can be complex and so it is useful to consider any possible reasons to try and formulate action plans to help improve their progress (see flow chart below)11.
If the problem persists or there are concerns regarding patient safety, the issue will require a multi-faceted approach between clinical tutors, supervisors and HR and may require escalation to the Deanery or other regulating bodies11.
Further information is available from:
- Managing Trainees in Difficulty (version 3): Practical Advice for Educational and Clinical Supervisors. NACT UK: Supporting Excellence in Medical Education. October 2013
http://www.nact.org.uk/getfile/2960/ - Understanding performance difficulties in doctor. An NCAA report. National Clinical Assessment Authority. November 2004
https://www.ncas.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=9371
Flow chart on supporting doctors in difficulty
1. Early identification of problems
Look for ‘early warning signs’
e.g. Low work rate, lack of engagement in educational process
2. Establish and clarify circumstances
Initiate early, effective discussions
Form realistic learning plans
3. Explore underlying causes
e.g. Clinical, personal, sickness/ill health, environmental
If problems persist, can involve:
- Clinical Supervisors
- Director of Medical Education
- TPD and Head of School
- National Clinical Assessment Service (NCAS)
- GMC (if doctor’s medical registration is called into question)
Modified from Managing Trainees in Difficulty (version 3): Practical Advice for Educational and Clinical Supervisors. NACT UK: Supporting Excellence in Medical Education. October 2013