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Postgrad Med J. 2020 Mar 6. pii: postgradmedj-2019-137076. doi: 10.1136/postgradmedj-2019-137076. [Epub ahead of print]

Challenges to well-being for general practice trainee doctors: a qualitative study of their experiences and coping strategies.

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Peninsula Postgraduate Medical Education School of Primary Care, Health Education England South West, Plymouth, UK.
Faculty of Health, University of Plymouth, Plymouth, UK.
Faculty of Health, University of Plymouth, Plymouth, UK



To identify the challenges to well-being experienced by general practice postgraduate trainees and to explore how the trainees respond to those challenges.


Qualitative focus group study with doctors in their final year of general practice training (n=16). The participants in the study were recruited from one training scheme in South West England. Data were thematically analysed.


Participants reported challenges to well-being relating to dysfunctional relationships with colleagues and patients, their workload, a perceived lack of support at work and also physical environmental challenges. They identified response strategies focused on cognitive processing, physical self-care, focusing on their professional purpose, building supportive relationships and adapting their working environment where possible. Additionally, there were factors that could support trainee well-being, including personal factors such as adaptability and self-awareness, but also external and organisational factors, such as culture, supportive colleagues and organisational adaptability in relation to workload management. The importance to trainees of the idea of being a 'good doctor' arose repeatedly in the data, as did the importance of the organisational environment. Participants reported finding their training placements in secondary care environments particularly challenging.


This research highlights the strategies that general practice trainees use in response to challenges, but also that the responsibility for maintaining well-being cannot be borne by individuals alone. This study identifies that supportive approaches by healthcare organisations and educators are vitally important to general practitioner trainees' well-being.


medical education & training; primary care

Conflict of interest statement

Competing interests: SA is an associate postgraduate dean with Health Education England South West. JR is a postgraduate trainee on a General Medical Council-approved training programme in geriatric medicine through Health Education England South West.

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