TY - JOUR
T1 - Sources of work-related psychological distress experienced by UK-wide foundation and junior doctors
T2 - a qualitative study
AU - Riley, Ruth
AU - Buszewicz, Marta
AU - Kokab, Farina
AU - Teoh, Kevin
AU - Gopfert, Anya
AU - Taylor, Anna K
AU - Van Hove, Maria
AU - Martin, James
AU - Appleby, Louis
AU - Chew-Graham, Carolyn
N1 - © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.
PY - 2021/6/23
Y1 - 2021/6/23
N2 - OBJECTIVES: This paper reports findings exploring work cultures, contexts and conditions associated with psychological distress in foundation and junior doctors.DESIGN: Qualitative study using in-depth interviews with 21 junior doctor participants. The interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method.SETTING: NHS in England.PARTICIPANTS: A purposive sample of 16 female and five male junior doctor junior doctor participants who self-identified as having stress, distress, anxiety, depression and suicidal thoughts, or having attempted to kill themselves.RESULTS: Analysis reported four key themes: (1) workload and working conditions; (2) toxic work cultures-including abuse and bullying, sexism and racism, culture of blaming and shaming; (3) lack of support; (4) stigma and a perceived need to appear invulnerable.CONCLUSION: This study highlights the need for future solutions and interventions targeted at improving work cultures and conditions. There needs to be greater recognition of the components and cumulative effects of potentially toxic workplaces and stressors intrinsic to the work of junior doctors, such as the stress of managing high workloads and lack of access to clinical and emotional support. A cultural shift is needed within medicine to more supportive and compassionate leadership and work environments, and a zero-tolerance approach to bullying, harassment and discrimination.
AB - OBJECTIVES: This paper reports findings exploring work cultures, contexts and conditions associated with psychological distress in foundation and junior doctors.DESIGN: Qualitative study using in-depth interviews with 21 junior doctor participants. The interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method.SETTING: NHS in England.PARTICIPANTS: A purposive sample of 16 female and five male junior doctor junior doctor participants who self-identified as having stress, distress, anxiety, depression and suicidal thoughts, or having attempted to kill themselves.RESULTS: Analysis reported four key themes: (1) workload and working conditions; (2) toxic work cultures-including abuse and bullying, sexism and racism, culture of blaming and shaming; (3) lack of support; (4) stigma and a perceived need to appear invulnerable.CONCLUSION: This study highlights the need for future solutions and interventions targeted at improving work cultures and conditions. There needs to be greater recognition of the components and cumulative effects of potentially toxic workplaces and stressors intrinsic to the work of junior doctors, such as the stress of managing high workloads and lack of access to clinical and emotional support. A cultural shift is needed within medicine to more supportive and compassionate leadership and work environments, and a zero-tolerance approach to bullying, harassment and discrimination.
KW - Attitude of Health Personnel
KW - England
KW - Female
KW - Humans
KW - Male
KW - Medical Staff, Hospital
KW - Psychological Distress
KW - Qualitative Research
KW - United Kingdom
UR - http://www.scopus.com/inward/record.url?scp=85108632375&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2020-043521
DO - 10.1136/bmjopen-2020-043521
M3 - Article
C2 - 34162634
SN - 2044-6055
VL - 11
JO - BMJ open
JF - BMJ open
IS - 6
M1 - e043521
ER -
