Training, job demands and mental health of pre-registration house officers

Abstract

Objectives: This study aims to explore pre-registration house officer (PRHO) perceptions of work role, job requirements and mental health, in order to enhance work role preparation by means of identifying potential areas for curriculum development.

Design: Phase 1 took place 6 weeks before completion of the pre-registration year. A total of 56 PRHOs completed questionnaires which included a diary of activities, recorded daily over a 2-week period (ward rounds, on-call, audit, administration, continuing medical education, etc.), items relating to perceived occupational control, and the Maslach Burnout Inventory. In phase 2, in the final 2 weeks of the preregistration year, 36% (n=18) of phase 1 participants were randomly selected for interview.

Setting: Three hospitals in the North-west of England.

Results: The average working week was 56 h, with 10% working in excess of this figure. The average weekly proportion of time spent on organized continuing medical education was 5%. Routine administrative tasks took up one-fifth of PRHO time and were perceived as lacking in training or educational elements. Of the PRHOs, 52% (n=29) desired further advice/training on the technical and management aspects of the job. Additional training was required on topics such as chest drains, delegation and time management. PRHOs felt this should be given prior to commencement of the pre-registration year. In terms of mental health, 25% (n=14) were experiencing burnout. Occupational control was external; many individuals perceived events as often occurring outside individual control.

Conclusions: These findings have implications for the undergraduate curriculum and support General Medical Council recommendations for curriculum reform. It is suggested that organizational skills such as managing responsibility/delegation and additional training in practical procedures should be an integral part of the medical undergraduate curriculum.