Supporting the wellbeing of Stage 1 Internal Medicine trainees

Since 2018, the national training survey has included questions to measure burnout risk among doctors in training. Results consistently show that burnout levels vary between specialties. In 2023, 77% of Stage 1 Internal Medicine Trainees (IMTs) were identified as being at moderate or high risk of burnout – higher than the national average of 66% for all trainees.

What action was taken?

In response, a regional London IMT Stage One Training Programme Director (TPD) successfully secured funding from the NHS England COVID Recovery Fund. This enabled the appointment of IMT Educational and Wellbeing Fellows across each of the four regions of London. Their aim was to better understand the factors affecting Stage 1 IMT wellbeing and to develop practical, targeted support.

The Fellows created a new survey tailored to IMTs, to gain insights into the different aspects of wellbeing. It was based on questions from the national training survey but focused specifically on the IMT experience. The survey was anonymous and voluntary, and sent to all stage 1 IMTs in London. Over 150 trainees responded.

The survey, along with follow-up interviews and focus groups, helped identify seven key themes affecting wellbeing:

  • Workplace culture
  • Individual circumstances
  • Helplessness and distrust 
  • Physiological needs and safety
  • Rotas and work patterns
  • Stress at work
  • Value.

Based on these findings, several initiatives were introduced, including:

  • A ‘Wellbeing Directory’ of resources across London to increase accessibility of support.
  • ‘Wellbeing Cafes’ – spaces for doctors to access support and wellbeing activities.
  • Training sessions for IMTs and supervisors providing education on key wellbeing topics. 
  • A ‘Wellbeing Day’, organised by fellows and TPDs. This provided study-leave approved protected time for doctors to engage in workshops and learn about evidence-based wellbeing interventions and support.
  • One to one, near-peer support for individual doctors with training and wellbeing issues. 
  • The development of a rotational passport for staff requiring essential adjustments.

What was the outcome?

While the overall percentage of IMTs at moderate or high risk of burnout stayed at 71% across the UK in 2024 and 2025, London saw a small improvement – from 69% to 67%. Notably, the number of London IMTs at high risk of burnout dropped from 27% to 20%, bringing it in line with the national average across all specialties.

The project’s findings have been widely shared and published. It was also recognised as a finalist in the Royal College of Physicians’ 2025 Patient Care Awards. 

A dedicated task force has now been set up to continue this important work. Two more part time IMT Wellbeing Fellowships have been funded through the NHS London Innovate MD Fellowship Scheme for 2025–2026.