Workplace discrimination affects 'worrying' number of trainee doctors, GMC survey reveals

Micro-aggressions, negative comments and stereotyping are just some of the workplace issues affecting trainee doctors, a report by the General Medical Council (GMC) has revealed today (Tuesday 11 July).

The regulator’s annual national training survey was completed by more than 70,000 doctors across the UK who are either in training or act as trainers. It included questions on discrimination for the first time this year, uncovering worrying insights into the experiences of trainees.

The new questions posed to trainees covered topics such as unfair treatment, stereotyping and confidence in reporting discriminatory or unprofessional behaviours. Answers relate to their experiences with colleagues or fellow healthcare professionals, rather than with patients or relatives.

Though most doctors in training say they work in supportive environments, more than a quarter (27%) said they’ve experienced micro-aggressions, negative comments, or oppressive body language from colleagues. Poor behaviours are more prevalent in some specialties, with instances rising to a third for those working in obstetrics and gynaecology, emergency medicine, and surgery.

More than one in ten trainee doctors reported they had felt ‘intentionally humiliated’ in front of others. The questions highlighted a particularly negative experience for those in their two-year long Foundation Programme – doctors who have completed medical school and entered their first paid clinical work while training. One in five (22%) of foundation trainees said they’d been blamed for something they didn’t do in their current post, compared to one out of ten (10%) on specialty or core programmes.

More than a quarter (28%) of trainees said they had heard insults, stereotyping or jokes relating to their or another person’s protected characteristics* in their post. This number rose to 38% for foundation trainees.

The results highlighted that many feel uncomfortable speaking up. Only six out of ten (60%) said they would feel confident about reporting discrimination without fear of adverse consequences.

Despite these experiences, eight out of ten (83%) trainees said they had a good or very good experience in their post. Over three quarters (77%) said that staff, including fellow doctors-in-training, always treat each other with respect.

Training also remains to be of a high quality, with almost three quarters (74%) of all trainees rating the quality of their teaching as either good or very good.

"Though it’s encouraging to see the majority of trainees report supportive workplaces, there are worrying findings which suggest doctors early in their careers are having a much more negative experience. "

Professor Colin Melville

GMC’s Medical Director and Director of Education and Standards

Professor Colin Melville, the GMC’s Medical Director and Director of Education and Standards, said:

‘Though it’s encouraging to see the majority of trainees report supportive workplaces, there are worrying findings which suggest doctors early in their careers are having a much more negative experience.

‘Discrimination doesn’t just affect individuals, it impacts teamwork, communication and potentially patient safety. We know many organisations are already acting to address these important issues, but these findings should make clear to all healthcare professionals how poor behaviour adversely impacts others. It’s essential we create and encourage cultures where those who witness or experience discrimination are supported to speak up.’

Nine out of ten trainers (89%) said they enjoy their role in developing doctors, however, systemic pressures mean some struggle to use allocated time specifically for that purpose. A third (33%) of secondary care trainers and a quarter (24%) of GP trainers reported difficulty in balancing responsibilities. More than half (52%) of trainers are measured to be at high or moderate risk of burnout.

Prof Melville added:

‘We are seeing continuing proof of pressures affecting trainers, including increasing rates of burnout and difficulties with finding adequate time to provide training. The recent publication of NHS England’s long term workforce plan** was welcome, but efforts to expand medical education will falter without a focus on the number, needs and wellbeing of trainers.

‘Everyone has the right to work and train in a healthcare system which is fair, free from discrimination and where they’re respected and valued. It’s only right that we, as a regulator, raise the alarm when evidence of concerns is identified.’

Read the National training survey: summary report 2023 and visit our national training survey page to access the online reporting tool.