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The importance of engaging junior doctors

Dr Raunak Singh, a Royal College of Physicians (RCP) chief registrar and specialty trainee in geriatric medicine at University Hospitals of Leicester NHS Trust, explains how junior doctors at his trust are benefiting from an improved working environment.

Junior doctor morale has taken a significant downturn in recent times, in the context of ever increasing workloads and higher intensity training, as well as the challenging landscape since the implementation of the 2016 junior doctor contract. 

Despite this, it has been incredibly heartwarming to see not just the show of support towards junior doctors, but an increased awareness that junior doctor engagement is more important than ever. Having input into how our training and working lives are designed, governed and implemented is key to engendering a supportive, proactive and positive workplace environment. 

In my capacity as chief registrar, I have learned that trusts need to be proactive in listening to this large cohort of their workforce, who are in danger of becoming disillusioned. It is well-known that a happy workforce is a more productive workforce. This certainly holds more meaning when we recognise that the current junior workforce will become the future senior workforce.

As a junior doctor body, we must avoid apathy, and become positively and responsibly engaged, if we are to feel empowered.

Dr Raunak Singh, chief registrar

My trust, University Hospitals of Leicester NHS Trust (UHL), have certainly been progressive in this respect, offering multiple ways for junior doctors to have their voice heard. There is excellent support from a dynamically engaged department of clinical education, who proactively seek feedback from junior doctors and continually strive to improve the experience of both training and non-training grades. There are avenues for highlighting concerns such as the 'gripe tool', a process by which issues that affect our daily working lives can be raised.

Committees and working groups such as the doctors in training committee, contract forum, medical education and training committee, executive quality board, and many others, carry significant trainee representation. These provide tangible avenues for junior doctors to effect change. As a junior doctor body, we must avoid apathy, and become positively and responsibly engaged, if we are to feel empowered. 

UHL has further recognized the importance of junior doctor engagement by supporting the RCP’s chief registrar scheme, with two appointments across this large three-site trust. I have had invaluable mentoring and support from senior level including the deputy clinical director, deputy director of medical education and director of medical education.

[The chief registrar role] is helping to strengthen the feeling that we are not ‘just’ junior doctors, but a valued part of the workforce

Dr Raunak Singh, chief registrar

The chief registrar role provides a bridge between juniors and seniors, as well as clinicians and managers. It is helping to strengthen the feeling that we are not ‘just’ junior doctors, but a valued part of the workforce. For example, as part of my work as chief registrar I have established JDFMed, a junior doctor forum in medicine, where open discussion facilitates change. I have also helped organise induction within my directorate, provided trainee input into medical workforce planning, and contributed to improving the exception reporting processes.

The trust has acknowledged the importance of two vital documents: Junior doctor morale: Understanding best practice working environments and the recent Eight high impact actions to improve the working environment for junior doctors. With the support of our department of clinical education, I have conducted a trust-wide survey to assess junior doctor morale. This will help to capture an accurate picture locally, and inform future bespoke actions that respond to the issues raised in these reports. Together, with the backing of the medical director and chief executive, we plan to run a trust-wide 'Listening into Action' programme, with a view to identifying issues and effecting the changes necessary for sustained improvements. 

The motto at UHL is ‘one team, shared values’ and I hope that we can continue to engender this feeling of being valued. As the junior doctor workforce, it's vital that we engage and get involved in our organisations, as well as feel supported and empowered to do so.

Dr Raunak Singh, chief registrar

Recruitment for the 2018–19 chief registrar scheme is now open. If you have any questions, or you would like to register your interest, please email Natalie Pink, Future Hospital project manager, at chiefregistrar@rcplondon.ac.uk.