RCOG World Congress 2023

Trainee Open Discussion Groups:
Supporting Wellbeing in Obstetrics andGynaecology Trainees

Background:

Obstetrics and Gynaecology (O&G) is a high stress and high-pressure specialty. Challenges include an increasingly complex obstetric population, combined with greater patient expectations and high rates of complaints and litigation.

Trainee surveys from the most recent RCOG workforce reports revealed that:

•89% have felt low in mood, depressed or anxious at some point in training

•36% met the criteria for burnout

•18% had clinically significant PTSD symptoms

•64% of consultants have experienced or witnessed workplace bullying

•The average attrition rate from the O&G training programme is around 30%

A Balint group is a purposeful, regular meeting among physicians with a trained facilitator to allow discussion of any topic that occupies a doctor’s mind. Providing trainees with regular opportunities to reflect on their experiences has the potential to foster resilience, reduce burnout and lower the risk of PTSD.

Objective:

Our objective was to assess the impact and acceptability of regular psychologist-led discussion groups for trainees within Obstetrics and Gynaecology in the Wessex Deanery.

Design and Method:

The sessions were implemented into deanery teaching sessions in April 2021, initially funded by the COVID recovery fund, and subsequently by the Wessex Deanery teaching fund. Sessions were split by training level: ST1-3 and ST4-6, with the other cohort having their lunch break during the other group’s hour long discussion.

Trainee feedback was gathered through online surveys from 5 sessions, from 09/02/22 with a total of 67 responses.

Trainees were asked if they agreed that:

•The session was relevant for their personal development

•The session was relevant for supporting colleagues

•Wellbeing sessions are useful for O&G trainees

•The session is the right length

They were also asked for suggestions for improvements, and for any other comments.

Results:

A range of topics were discussed including challenges of training, difficult cases, the stresses of yearly rotations, e-portfolio and under-appreciation from seniors.

The psychologists felt that morale was low and ongoing support was needed.

•75% of trainees felt the session was relevant fortheir personal development

•78% felt it was relevant for supporting colleagues

•80% felt that wellbeing sessions were useful for O&G trainees

•41% of trainees felt that an hour was an appropriate duration for the session, with 42% wanting longer sessions

Trainees liked the fact that any topic could be discussed. They felt reassured knowing that colleagues had similar concerns and doubts, as it helped with the feeling that they were not alone.

Suggestions for improvements included:

•More frequent sessions, with smaller groups

•Having the same psychologist for each session

•Having a programme of themes to cover

•Using a range of wellbeing approaches to suit differing personalities.

Themes identified:

Trainees felt that:

•Life in training can feel unsustainable

•Moving to less than full time or out-of-program helped, but trainees feel stigmatised and believe this can be seen in a negative light

•E-portfolio demands are time consuming, with inadequate rota admin time set aside for it

•More autonomy is desired, particularly at senior level

•The impact of seeing peers burning-out and leaving training is heavily felt

•They were not valued or appreciated

Session feedback:

“I like these sessions because they remind me that we all face the same

doubts and challenges- we’re not alone!”

“I think it’s good that trainees are free to bring up anything”

“It’s really useful to know that others are having the same problems and worries”

“It’s good to think about how you would handle situations, and discuss

important softer skills like communication”

“I think it really benefits from being facilitated by a psychologist”

Conclusion:

•There is a clear need for wellbeing support in O&G trainees

•Open discussion groups with a trained psychologist during teaching days are a useful and acceptable interventionfor trainees

•The trainees felt the groups were relevant to their own development and in supporting their colleagues, with discussions helping to reassure trainees that they were not alone

RCOG World Congress 2023

Trainee Open Discussion Groups: Supporting Wellbeing in Obstetrics and Gynaecology Trainees

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