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How to deal with poorly performing trainees – information for trainers

This page provides information for RCOG trainers to help them manage trainees who are struggling with their training programme, looking at both prevention and remedial action.

Hospital medicine is a potentially stressful environment, particularly for trainees. It’s important to try to limit trainees’ problems and also identify early anyone who’s finding it hard to cope. You should alert deanery staff if you’re concerned about a trainee’s progress to ensure a remedial plan/support for the trainee and trainers is put in place.

Preventing problems

When your trainees first start working with you, give them a positive welcome and make them feel like an integral part of the team. You may wish to write to the trainee 1 month before they start.

All trainees will attend an induction course which will familiarise them with how the O&G unit works. You can help with this orientation process by showing the trainees where equipment is kept – including tea and coffee!

Within the first 2 weeks, all trainees should meet with their Educational Supervisors for an induction. This is an opportunity for you to ask about their previous medical experiences, both good and bad, and to ask them about their life outside work. Try to emphasise that you welcome trainees coming to you with their problems at any stage of their training. For more information, please read the information for trainees about induction.

Praise is important – make a special effort to point out trainees’ contributions to the unit in their first days and weeks.

Identifying problems

Educational Supervisors and other mentors should meet with their trainees regularly to offer encouragement and screen for any signs of poor performance. It’s also helpful if other team members, including senior nurses and midwives, keep an eye on trainees’ performance and pass any concerns to the Educational Supervisor or nursing/midwifery mentor.

How to deal with problems if they arise

If any problems arise, inform the Educational Supervisor or College Tutor – the urgency will depend on your degree of concern.

The Educational Supervisor should then meet with the trainee in private. Before doing so, the Educational Supervisor needs to have a clear idea about the nature of the problem – it may be helpful to contact the trainee’s previous Educational Supervisors. Make sure the trainee knows that the interview is confidential, but that this isn’t binding if patient safety is compromised (e.g. cases of drug abuse or severe alcohol problems).

You should see this meeting as an opportunity to help the trainee and focus on their needs. Try to give praise while gently exploring the reported issues. It can be easier to start off by avoiding the words ‘problems’ and ‘reports’ and instead use phrases such as ‘Mrs X was concerned about you’. If the trainee isn’t forthcoming, you may need to use a more direct approach, but try to avoid being judgemental and try to emphasise the trainee’s positive attributes.

The causes of poor performance are often complex and it will be helpful to explore any possible reasons. This will help you discuss ideas for improvement.

Remember that a doctor’s primary responsibility is patient safety: you can’t ignore very serious problems in the hope that they go away. If necessary, you can ask for additional advice from other sources, such as the trainee’s deanery, Clinical Tutor, Clinical Director, Medical Director and Human Resources department.

What to do if problems persist

If the problem persists but isn’t a threat to patient safety, it may be useful for the trainee to have a further interview with another professional. Consider someone independent, such as the Clinical Tutor. Again, it’s important to be certain of the facts and focus on the trainee’s needs.

The trainee’s deanery can provide advice and support to both trainee and trainer.

Contact us

If you have any questions, or need more information, please see the list of contacts in the education and training team at the RCOG, or the A–Z of all useful contacts at the College.

Elsewhere on the site

Specialty training programme
Overview of the specialty training programme in O&G, including assessment and certification of training
Invited review service
Designed to help employers improve O&G services and/or individual clinical practice