We cannot keep asking doctors to be more resilient

When conversations about doctor wellbeing come up, the focus often falls on individuals. We talk about resilience, coping strategies and wellbeing programmes. While these interventions have their place, they can sometimes distract from a more uncomfortable truth: many of the pressures affecting resident doctors are created by the systems in which we work.

A recent comparison of workforce wellbeing challenges in the UK and Australia found that, despite major differences between the two healthcare systems, many of the underlying problems facing resident doctors are remarkably similar. What struck me most when reading the research was not the differences between the two countries, but the extent of the shared challenges. Despite differences in healthcare funding, workforce capacity and service structures, resident doctors in both countries report high levels of workload pressure, moral distress and uncertainty about their future.

On paper, there are reasons to expect different outcomes. Australia has more doctors per head of population, spends more on healthcare per person and offers comparatively higher overall remuneration for many doctors. Yet wellbeing concerns persist. In both countries, resident doctors describe heavy workloads, training pressures and growing dissatisfaction with working conditions. Importantly, early-career doctors appear especially vulnerable.

These findings echo concerns raised by resident doctors through the RCP’s next generation campaign, including pressures created by intense competition for training posts, limited flexibility within training pathways and uncertainty about career progression. 

This should prompt us to think differently about what is driving poor wellbeing. If these challenges exist across different healthcare systems, then the problem cannot simply be individual resilience or even a single national policy. The evidence points instead to a series of shared structural pressures.

Healthcare demand continues to rise as populations age and patients present with increasingly complex needs. Administrative burdens consume valuable clinical time. At the same time, expectations of work and career progression are changing. Today's resident doctors are more likely to prioritise flexibility, work–life balance and sustainable careers. Health systems need to evolve in response.

One of the most significant concerns is the growing mismatch between workforce expansion and training capacity. Increasing medical school places is important, but it is not enough on its own. If training opportunities fail to keep pace, bottlenecks emerge, creating frustration, uncertainty and a risk that talented doctors leave the profession or seek opportunities elsewhere. Recruitment matters, but retention matters just as much.

For too long, workforce wellbeing has been treated as a secondary issue rather than a fundamental part of healthcare delivery. Yet there is a clear connection between staff wellbeing, workforce stability and the quality of patient care. A healthcare system cannot be considered sustainable if the people working within it are experiencing chronic distress or planning their exit.

The 2026 GMC report on workplace experiences reinforces that connection. Drawing on its barometer survey and qualitative interviews, the report found that pressures in doctors’ working environments can create barriers to providing the standard of care they want to deliver. Being unable to give patients sufficient care can affect doctors’ wellbeing, professional fulfilment and sense of purpose, making it harder to retain them and adding to the pressure on those who remain.

One of the clearest messages I take from the research is the need for a broader shift in thinking. Workforce planning must become a genuine long-term priority, with retention valued alongside recruitment. We must reduce unnecessary administrative burdens and create greater flexibility within training and career pathways. Just as importantly, we need organisational cultures where doctors feel listened to, valued and supported. Compassionate leadership is not a soft extra; it is an essential component of a healthy workforce.

However, workplace improvements must be carefully planned, evidence based, properly resourced and evaluated. Even well-intentioned changes can add further complexity and frustration if they are poorly designed or inconsistently implemented, undermining the wellbeing they are intended to improve.

The NHS England 10 Point Plan to improve resident doctors’ working lives is a welcome practical step. It addresses many of the basic workplace issues resident doctors have raised, including rota information, annual leave, payroll errors, repeated mandatory training, course expenses and the disruption caused by rotations. These concerns have also been central to the RCP’s next generation campaign. The plan’s emphasis on board-level oversight and accountability is particularly important, because its success will depend not on publication but on consistent delivery and whether resident doctors experience meaningful improvements in their working lives.

We also need to consider the experience of trainers. The GMC report found that satisfaction among specialists fell in 2025, with the decline most notable among those who were trainers. Trainers need protected time, structured support to carry out their role and proper recognition of the training they deliver within their job plans. As resident doctor numbers increase, trainer and supervisor capacity must increase too. When resident doctors see senior colleagues struggling to deliver the standard of care to which they aspire, it can cause them to question whether a long-term NHS career will provide the professional satisfaction they are seeking.

The authors of the UK and Australia comparison conclude that workforce wellbeing should be treated as a measure of health system performance. We routinely track waiting times, activity levels and financial performance; their analysis makes a compelling case for monitoring workforce wellbeing with the same seriousness. 

For resident doctors, this conversation is about more than wellbeing initiatives or workplace perks. It is about creating a profession where people can thrive, build fulfilling careers and continue delivering high-quality care throughout their working lives. Ultimately, protecting resident doctor wellbeing is not simply about supporting individual doctors. It is about safeguarding the future of healthcare itself, because we cannot build sustainable health services on the assumption that doctors will simply absorb ever-growing pressures. 

If we are serious about retaining the next generation of physicians, workforce wellbeing must be treated as a core measure of system success.

You can read the full research paper, Resident doctor workforce wellbeing worldwide: lessons between the United Kingdom and Australia, in the latest issue of the RCP journal, Clinical Medicine.