Doctors look after our health, but who looks after theirs?
It’s increasingly recognised that the NHS is chronically understaffed and under-resourced. Ask any doctor currently working in a UK hospital, and they will refer to ‘corridor medicine’ becoming the norm along with 4 hour waits to see a doctor. General Practice is just as bad with GP’s and family doctors reporting waiting times of up to nine weeks for appointments and six times the average number of patients per GP.
In today’s society, we know medics are incredibly busy, working and making the best of a bad situation to ensure the health and wellness of others is at the top of their priorities. What they won’t necessarily tell you is how these working conditions affect their own health and wellbeing and how they are expected to adapt to this new-found ‘normal’ with increased working hours, spiralling workload and lack of support, all while still providing the gold-star standard of care every patient deserves.
With current working conditions as they are, it’s not surprising to read that last year according to findings published in the MBJ Open medical journal, 55% of UK doctors met the criteria for burnout and ‘emotional exhaustion’, with one in five resorting to the use of drugs or alcohol as a ‘coping strategy’. Indeed, a British Medical Association survey of 4,300 medics in April 2019 revealed worrying levels of burnout with junior doctors suffering the highest burnout rate across the medical profession at 91% and GP partners, who co-own surgeries, came second, at 88%.
These findings raise concerns, not only for the health of NHS workers, but also the quality of care patients are being provided with. While it’s through no fault of the doctors (blame extreme workloads and rota gaps), it does show us that work-related stress can no longer be ignored. Not only is it affecting the physical and mental wellbeing of doctors, which could lead to severe health problems, it’s also meaning doctors are leaving their careers early as they simply can’t cope, which in turn adds additional stress to a system that is already operating at maximum capacity.
In 2018, according to the annual United Kingdom Foundation Programme Office (UKFPO) survey, it found just 38% of second year doctors chose to continue their careers in the NHS and enter speciality training (including general practice) – compared to 83% in 2010! This has been compounded by a crisis at the other end of a scale, where up to 69% of consultants have had to cut their hours due to punitive pensions tax.
But, what can we as a society do?
Firstly, we need to realise that if we don’t start looking after our doctors, we won’t have anyone left to look after our patients. Doctors are human beings; they need and should have access to a wide variety of support networks both in their place of work and within the wider medical world. We need to make it easier for them to take decompression breaks, whether it be as simple as giving doctors access to an on-call room where they can get their heads down or allowing time off for personal reasons.
There also needs to be flexibility within the system to allow for career development, not just on a medical skill level, but also on important subjects such as leadership and resilience where medics can engage and come away with the tools they need to thrive and feel better equipped to deal with challenging work settings both at home and across the world. It’s something we personally feel very strongly about here at World Extreme Medicine (WEM). There is nothing more important than our mental health, it’s integral to our physical health and our ability to be the best medics we can be, which is why we set up WEMski: Mental Health in Medics – a mini-conference concentrating on mental health and resilience for medical and allied healthcare professionals.
In fact, resilience and mental health are key themes introduced and discussed across all of our WEM courses and feature heavily within the content. Our courses also provide a way in which medics can stay healthy within their job role by providing a reconnection with the type of medicine they signed up to in medical school. Quite often we find by going back to basics, working as a team, problem solving and thinking outside the box without the pressures of everyday life, it means the passion and energy they originally had for medicine is revitalised and they leave not just with new skills, but also with a new sense of purpose and a network of support with like-minded individuals they wouldn’t have otherwise had.
Another great example of this forward thinking is nicely illustrated by the Clinical Fellowships offered by the Royal Devon & Exeter Hospital Foundation. The team have recognised that to attract high quality middle grade doctors for their Emergency Department, they need a more flexible outward looking recruitment policy. They have teamed up with the Exeter University Medical School to offer an exciting 3-year MSc Fellowships in Extreme Medicine as part of a unique post that combines working in the emergency department, whilst completing all of the modules of the Masters Degree in Extreme Medicine.
Has this worked for the department?
The jury is still out, but the initial pilot resulted in 100% retention and students reporting that they were returning to their posts with improved team-working and problem solving skills, alongside a greater understanding of the interplay of complex human factors that is a day-to-day occurance in a busy ED.
WEM Founder, Mark Hannaford says:
“I am dedicated to being part of the future solution to help medical professionals attain a better work/life balance that ultimately encourages them to stay in medicine. It’s important that they do so, that they have the opportunity to escape the pressures of their medical career by changing pace, gaining new knowledge and useful experience, so as well as returning to their team happier people, they are also returning as more effective clinicians.”
Being a firefighter in Australia a lot of people have asked me for my opinion on the current bushfire crisis – so let’s talk about the fires.
Burjor is both a past consultant dentist for the British Antarctic Survey Medical Unit and a resident expedition dentist for 
Ben has been a Paramedic since 2014 and is a Critical Care Paramedic on the Thames Valley Air Ambulance.
Abbi is an Anaesthetics clinical fellow currently working at Chesterfield Royal Hospital and is also currently completing the RCSEd Diploma in Mountain Medicine (DiMM).
Wayne is a Specialist Retrieval Practitioner with the Emergency Medical Retrieval Service operating out of Glasgow, providing enhanced pre-hospital trauma care. The service also conducts specialist transfers of critically ill or injured patients from remote and rural locations across Scotland.
Jodie is an ED trainee in Wessex, battling to balance getting outdoors with an ED rota.
Neil is a consultant in anaesthesia, major trauma and pre-hospital emergency medicine.
Mel is a GP with a keen passion for expedition medicine.
Currently London based, Jim completed his emergency medicine training in June 2018 and has since been working as a HEMS doctor for Essex and Herts Air Ambulance. In 2021 he will be undertaking a secondment with London’s Air Ambulance.
Hannah is an Emergency Medicine Registrar in the East of England, but mostly wishes she was in the mountains. She is a qualified Mountain Leader, and aspirant International Mountain Leader, having been involved in expeditions with school groups for many years.
Luca is a HCPC registered Senior Paramedic Team Leader, who holds a BSc (Hons) in Paramedic Practice and is currently undertaking a masters in Advanced Practice.
The climate
Become part of Antarctica’s story
The wildlife
A ‘bucket list’ journey
Born in a dark corner of North Wales, Rich spent his childhood exploring Snowdonia with his Dad. An offer to study at Peninsula Medical School took him to the South West, and he hasn’t looked back.
Isla is a Yorkshire lass living in Sheffield, UK where she is a locum Emergency Medicine SpR.
Ben has been a Paramedic since 2014 and is a Critical Care Paramedic on the Thames Valley Air Ambulance. With a particular interest in human factors both within pre-hospital medicine and the expedition arena, Ben’s interest in Expedition medicine has seen him take on medic roles on a number of remote expeditions in Canada.
In her life before medicine, Emma lived in a caravan in Wales, worked as a healthcare assistant, travelled solo around the world having never been on a plane, hiked the Himalayas, studied Geography at Cambridge and volunteered in Nepal, China, India, Sri Lanka and Zambia (Teaching, Tsunami relief and TB hospices). After graduating, she taught in Geneva and undertook an internship at the UN and WHO, where she attended the Human Rights Council and World Health Assembly.
Taryn is a qualified nurse who trained in Australia and spent the first part of her career working as Nursing Officer in the Australian Army. During her time in the military she completed her Master’s in Public Health and Tropical Medicine and began providing healthcare to in complex remote environments including Kenya, Papua New Guinea and remote Australia.
Roger is a Scottish Patient Safety Programme Fellow who trained in the UK, New Zealand and Sweden. He has previously worked for Kent, Surrey and Sussex Helicopter Emergency Medical Service. (HEMS) and now currently instructs on Advanced Trauma, Medical and Paediatric Life Support in the UK and overseas. As an Educational Coordinator for Emergency Medicine at the Scottish Centre for Simulation and Clinical Human Factors he has designed, developed and delivered multiple high-fidelity simulation courses.
Jamie grew up in the wilds of Northumberland, where this endless empty landscape instilled a sense of adventure and a desire to explore every corner of the world and to help others do the same. Believing that travel, endeavour and adventure are the best teachers in the world, Jamie has travelled extensively, but finds that his heart beats hardest in cold and mountainous environments; rather unsurprisingly for a Geordie. This passion for the unknown has taken him from the Deserts of North Africa to the Arctic Tundra of Greenland and Svalbard. An adventure athlete, climber, surfer, runner, mountaineer, he believes in challenging yourself and pushing your limits in every opportunity.
Burjor is both a past consultant dentist for the British Antarctic Survey Medical Unit and a resident expedition dentist for 
Claire is an Emergency Medicine doctor with a passion for expedition and remote medicine. She has provided medical support for expeditions in many environments, but mostly enjoys working in cold & polar regions.
Hugely experienced, John is UK-trained GP, with extensive pre-hospital emergency care experience who moved to New Zealand where he initially worked in rural general practice before and now works in rural emergency departments, in between adventures.
