You are currently using an unsupported browser which could affect the appearance and functionality of this website. Please consider upgrading to the latest version or using alternatives such as Mozilla Firefox, Google Chrome or Microsoft Edge.

Supporting a doctor in difficulty

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:



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