1. Trainee Support Dr Ed Pickles Trainee Support Lead ed.pickles@qvh.nhs.uk

2. Doctors in Difficulty

3. A trainee in difficulty an individual who needs extra support to help them overcome problems threatening completion of their training programme. Identifying trainees as ‘in difficulty’ is not to label them, but to initiate certain processes. The aim is to help them complete training successfully.

4. Causes of Difficulty Training environment – mismatches between trainee and trainer – bullying or harassment – excessive workload – commuting Personal issues – partner relationship, bereavement, critical family illness, visa problems

5. Causes of Difficulty Clinical development and examination performance Generic professional development

6. Causes of Difficulty Professional behaviour, including drug dependance Health concerns & absences, particularly mental health Disability Bullying / harassment

7. Signs anger, rigidity, absenteeism, failure to answer bleeps poor time-keeping or personal organisation change of physical appearance lack of insight clinical mistakes, failing exams bullying, arrogance, rudeness, lack of team working undermining other colleagues

8. Signs defensive reaction to feedback verbal or physical aggression, erratic or volatile behaviour lack of engagement, withdrawing from learning communication problems depression or other mental illness new physical illness or worsening of existing physical illness

9. Formal Appraisal ARCP Examinations WPBA Multisource feedback Clinical governance / incidents SUIs Complaints / litigation

10. Role of Deanery versus Trust Employer – performance – grievances – discrimination – whistleblowing – potential disciplinary matters – Trainees should be managed in the same way as any other NHS employee. Deanery – responsible for providing high quality training and education.

11. Sources of Support - immediate Educational Supervisor – regular appraisal College Tutor – LFG Clinical Supervisors – use those you ‘gel’ with Trainee colleagues – be nice to each other Register with a local GP – Don’t self prescribe

12. Other Sources - trust Clinical Tutor & PGME Manager Occupational Health – counseling – health advice – employee assistance programme Human Resources / Medical Staffing

13. Most issues easily managed by you and ES – Written Plans with SMART objectives – Confidential as possible Deanery involvement where training may require extension

14. Support - Deanery Educational Supervisor / College Tutor Training Programme Director Head of School Anaesthetic Trainee Support Lead – ed.pickles@qvh.nhs.uk

15. Deanery Internal Support KSS Careers Counselling – Career progression Language and Communication Support Practitioner Health Programme – Confidential Self-referral welcomed for KSS trainees

16. External Support BMA Counselling Service Hope4Medics Doctors’ Support Network Sick Doctors Trust (dependance) Medical Women’s Federation Samaritans AAGBI / RCOA

17. Questions?