Workforce, training and education
Yorkshire and Humber
Home › Node › Supporting the wellbeing of PGDiTs

Supporting the wellbeing of PGDiTs

Overview

Regardless of your role, educators are often best placed to notice when a postgraduate doctor or dentist in training (PGDiT) is struggling and to help them access the support they need.

Educators play a critical role in shaping a PGDiT's experience of training, both through the formal mechanisms of supervision and assessment and through the day-to-day relationships and culture you help to create.

This page aims to help you to support the mental health and wellbeing of the PGDiTs you work with, recognise when additional support may be needed, and signpost effectively. It also acknowledges the very real impact that supporting a struggling PGDiT can have on you and also signposts to support for educators.

Contents

The importance of educator support

Whilst PGDiTs should take action to look after their own mental health, research evidence shows that the clinical working environment, including relationships with educators and supervisors, has a significant impact on whether they thrive or struggle during postgraduate training.

NHS publications highlight that personal resilience can’t compensate for an unsupportive workplace. Supportive supervision, psychological safety in teams, and timely access to help will all reduce the likelihood that day-to-day stress causes mental ill-health or burnout.  

Most PGDiTs will, at some point during their training, experience a period of significant stress, low mood, or other wellbeing difficulty. This is completely normal and the majority will recover well with appropriate support and continue to flourish in their training and careers.

Your role as an educator is not to provide clinical care or to solve every problem yourself. Your role is to notice, to listen, to signpost, and to ensure that the systems around the PGDiT are working as they should.

Recognising when a PGDiT is struggling

We recommend also reading our Mental Health Risks for PGDiTs page.

Common causes

It’s common for PGDiTs to try and mask challenges, which research frequently attributes to working in a profession prone to perfectionism and avoidant of help-seeking behaviours.

Underlying reasons for difficulties may include, but are not limited to:

  • Being the subject of a complaint or clinical incident investigation
  • Examination failure or receiving a developmental ARCP outcome
  • Periods of high workload
  • Transitions between posts
  • Adjusting when returning to work after sickness or other type of absence

These circumstances may not be experienced in isolation, and you should be mindful that a combination of factors may be affecting the PGDiT. External life events or personal circumstances such as bereavement, relationship breakdown or financial stress can also impact a PGDiT’s performance.

Signs to look out for

Some indications a PGDiT is struggling may be more obvious than others, for example, changes in appearance, comments about feeling hopeless or overwhelmed and increased sickness absences.

Others may be more subtle, and the following may be indications the PGDiT is experiencing difficulties:

  • Lateness for work
  • Increased presenteeism (i.e. arriving early for work and leaving late)
  • Changes in performance (i.e. as taking longer than usual to complete administrative tasks)
  • Disappearing between clinics
  • Not answering bleeps
  • Withdrawal from colleagues or social aspects of work
  • Colleagues may comment that they seem “off”
  • Increased irritability
  • Frequently looking tired
  • Difficulty concentrating, making decisions, or managing workload
  • Decreasing portfolio engagement and teaching attendance
  • Lack of or delayed responses to email communication
Scale of concern framework

Below is a copy of the Scale of Concern developed by the East of England Postgraduate Deanery, which provides a useful framework for thinking about when a PGDiT may benefit from additional support, either within their training programme and specialty or via a Professional Support Trainer Referral.

Having a supportive conversation

If you are concerned about a PGDiT, a one-to-one conversation is often the most valuable first step. You don’t need specialist training or a clinical diagnosis to have a useful conversation, what matters most is that you create the time and space for it, listen well, and signpost appropriately.

We recommend the following principles to approaching and managing the conversation to achieve the best possible outcomes for the PGDiT and for you:

  • Find a private space where you will not be interrupted and allow enough time that the conversation isn't rushed.
  • Open the conversation simply and directly, such as by asking "I've noticed you haven't seemed yourself lately, how are you doing?" is usually better than circling around the issue.
  • Ask opening questions such as "What has that been like for you?" or "Is there anything that would help?" invites more reflection and dialogue than asking yes/no questions.
  • If a PGDiT shares that they are struggling, treat it as significant. Do not minimise, compare, or attempt to reframe their experience. Attempted reassurances such as "everyone feels like that sometimes" can feel dismissive.
  • Resist the urge to offer advice, solutions, or reassurance too quickly. Allow the PGDiT to tell you what is going on in their own words and at their own pace.

  • The goal is to make space for the PGDiT and not to fill the space yourself: 

    Avoid offering reassurances that may make the PGDiT feel their experiences are being dismissed, such as "everyone feels like that sometimes"; Whilst hearing about similar experiences can be valuable, try not to make the conversation about you by sharing an anecdote from your training/career; Avoid giving unsolicted advice or pushing the PGDiT to discuss more than they are ready to.
  • Be honest about your role in supporting them, you aren't their therapist and you don't need to be. Your role is to listen, to support and to guide them towards the right support.

  • Make sure you are transparent: be clear about what you will and will not share, and with whom. Whilst confidentiality is important, is isn't absolute, and the PGDiT should be aware of scenarios in which you may have to share details without their prior consent, for example, if there are concerns about patient or the PGDiT's safety. 

Signposting to support

PGDiTs in Yorkshire and Humber have access to a wide range of confidential support services, most of which are accessed via self-referral which preserves their confidentiality and autonomy.

As an educator, you don't need to know all available services in detail, but you should be aware of the main ones listed below to feel confident in signposting and supporting a PGDiT to access them.

  • Workplace Wellbeing and Take Time are our regional counselling and psychological services. They are commissioned by the deanery and free for PGDiTs to access via confidential self-referral. The service a PGDiT should use is dependent upon their location in the region. Full information about each service can be found on our Access local counselling and psychological support page.
  • Most trusts have occupational health services and employee assistance programmes (EAP), which may also be a good first port of call for accessing work-based support. Information about these support options can usually be found on a trust's intranet or advice can be sought from the Medical Education Team.
  • NHS Practitioner Health is a free, confidential national service for doctors and dentists with mental health concerns or addiction.
  • BMA's 24/7 confidential counselling line is available to all doctors, including non-BMA members and is contacted by telephone: 0330 123124
  • NHS Talking Therapies services are available in all localities and provide counselling and therapeutic interventions accessible via GP or self-referral. 
  • For confidential and impartial guidance and support signposting, you may wish to submit a Professional Support Trainer Referral.

You can also signpost to our Mental Health and Wellbeing Resources and External Support Services Directory pages.

 

If you have urgent concerns about a PGDiT's mental health and safety, our emergency contact advice should be shared directly with them.

 

Supporting a return to work after a wellbeing absence

PGDiTs who have been absent due to mental health or wellbeing difficulties often need careful support to return to work safely and sustainably. A phased return, agreed adjustments, and regular check-ins are usually more successful than a return to full responsibilities on day one.

Occupational health will likely be a key partner in this process and will usually advise on fitness to return and any recommended adjustments. As an educator, your role is to engage with that advice constructively, work with the PGDiT to apply it within the training context, and ensure that the practical realities of the return are manageable. 

Supported Return to Training Programme

All PGDiTs who take time out of training are eligible to access courses through the Supported Return to Training Programme (SuppoRTT), a number of which focus on health and wellbeing topics including managing stress, increasing resilience and enhancing confidence. 

Those who have been absent for three months or more can access the full SuppoRTT offering, details of which can be found on our SuppoRTT webpages.

We strongly recommend using the SuppoRTT meeting framework to have a pre-return planning meeting to ensure a holistic and individualised plan for return is in place. Completing the accompanying pre-return meeting form is a critical mechanism for ensuring the right support is organised in advance of a return to training, which may include SuppoRTT-funded supernumerary and/or enhanced shadowing periods.

Looking after your own wellbeing

Supporting a struggling PGDiT can be emotionally demanding, particularly if the situation is serious or prolonged. It's common for educators to find themselves carrying significant concern between conversations, second-guessing their judgement, or feeling responsible for outcomes that are not theirs to control and it's important that you also have support available. Our recommendations include:

  • Speaking to a trusted colleague for peer support, which can be invaluable for sense-checking your approach and processing your own response.
  • Engage with reflective practice and/or supervision
  • Access our Development Courses for Educators and Supervisors, which includes content focused on your wellbeing and in supporting PGDiTs with their wellbeing
  • As a clinician, many of the same services that support PGDiTs - NHS Practitioner Health, BMA Counselling, your trust's Occupational Health service, are also available to you. 

You aren't expected to be the entire support system for a struggling PGDiT. The most effective support is usually a collaborative network which may include occupational health, the PGDiT's GP, specialist services, the wider workplace team, the Professional Support Service, and educators all playing their respective roles. Your contribution is important, but it isn't solitary.

 

X