Looking After Ourselves
Because the people who spend their lives looking after others often need someone to look after them too.
This page is about you. Burnout, stress, and mental health struggles affect doctors at every level of training and practice — and yet we are often the worst at asking for help. You went into medicine to care for others. But caring for yourself is not selfish. It is the foundation of everything.
📅 Last updated: 14 April 2026
Downloads
Handouts, worksheets, and teaching materials — ready when you are. Because sometimes the most powerful thing you can do is sit down with a piece of paper and a quiet moment.
path: LOOKING AFTER OURSELVES/life-reflection-tools
- achieving life goals.pdf
- core values - what makes you tick.docx
- evaluate worry and take action help sheet.pdf
- motivating values.docx
- personal values - what makes you tick.docx
- self fulfillment - maslows self-actualisation on 2 sides of A4.docx
- self fulfillment - short index of self actualisation.docx
- self fulfillment - your self actualisation level.docx
- sorting out your life - a goal setting exercise.pdf
- stress check.pdf
- stress identification tool.pdf
- stress questionnaire by isma.pdf
- taking a sabattical in general practice.doc
- wheel of life - hows your life currently going.docx
- wheel of life.pdf
Web Resources
A hand-picked mix of official guidance and real-world doctor wellbeing resources. Because sometimes the best pearls are not hiding in the official documents.
🛡 Official Support Organisations
📱 Apps & Digital Tools
🩺 By Doctors, For Doctors
📖 Articles Worth Reading
🌱 Personal Development (Bradford VTS)
✦ A Reflection ✦
yet she carries craters, not in spite of her beauty, but because of it.
The sea fills poets with wonder,
yet in her depths she holds salt and darkness.
The sky — infinite, breathtaking, eternal —
yet she wears clouds without apology.
Nothing that is truly beautiful is perfect.
Everything that is truly whole is not flawless — just real.
You, too, are like this.
Your wounds are not your weaknesses.
Your uncertainty is not your failure.
Your exhaustion does not define your worth.
You were not made to be perfect.
You were made to be alive —
to love, to feel, to stumble,
and to rise again — a little wiser, a little gentler.
Stop chasing the approval of others.
Start coming home to yourself.
Be free. Be real. Be enough.
Because you already are.
— On the beauty of being imperfectly human
Why This Matters — The Numbers
No One Is Immune
Working as a doctor is one of the most rewarding things a human being can do. It is also one of the most demanding. Stress can occur at any point — from ST1 all the way up to experienced GPs, trainers, and TPDs. Trainees face particular pressures: membership exams, long shifts, night working, constant assessment, and the weight of responsibility. If stress isn't caught early, it can progress into anxiety, depression, and burnout. And burnout, left untreated, can destroy careers — and lives.
The evidence is sobering. These are not abstract statistics. These are your colleagues.
📊 If There Were 100 Doctors in This Room…
Sources: GMC National Training Survey 2024; BMA GP Trainee Survey 2024; UK prevalence data for depression in doctors
Six overlapping pressures combine to make medicine — and general practice in particular — one of the highest-risk occupations for burnout and mental ill health. Rarely is just one factor at play. It is usually the accumulation.
Workload & Time
Excessive patient demand, endless admin, shift patterns, and the relentless pace of NHS general practice — with no natural stopping point.
Responsibility Without Control
High clinical responsibility combined with limited autonomy over your workload, systems, and environment. The most psychologically corrosive combination.
Conflict Between Life & Work
Medicine demands so much that personal life, relationships, family, and rest become casualties. The work does not stay at work.
Relationship Difficulties
Tensions with colleagues, supervisors, or management at work — and the knock-on effects on partners, children, and friendships at home.
The Perfectionism Trap
Trying to achieve too much too quickly, striving to be the best rather than simply good, and attempting to do everything. Medicine attracts people with perfectionist traits — the same traits that eventually break them.
"We Should Be Above This"
The deeply ingrained belief that doctors should somehow be immune to the human vulnerabilities they treat every day. This stops people asking for help until it is very late. This is the most dangerous one of all.
The accumulation effect: None of these factors alone necessarily causes burnout. It is the overlap — two, three, four of these pressing simultaneously, without adequate recovery time — that tips people over. Recognise which ones are active for you right now.
The suicide rate in doctors is estimated at 2–5 times that of the general population. The ONS records the general population rate at approximately 11 per 100,000. In doctors, that means roughly 22–55 per 100,000 — translating to an estimated 45–100 doctor deaths per year in the UK. The evidence specifically suggests that GPs are at greater risk than most other specialties.
This is not a side-effect of the job. It is not inevitable. With the right support and the courage to reach out, doctors can and do turn things around.
🆘 If you are struggling right now:
Call Practitioner Health: 0300 0303 300
Or BMA Wellbeing: 0330 123 1245 (24/7)
Please don't wait. Just pick up the phone.
Understanding Burnout — The Progression
Burnout doesn't arrive all at once. It builds over time — often invisibly. The World Health Organisation (ICD-11) defines burnout as an occupational syndrome with three core dimensions. Understanding the stages helps you catch it early — in yourself, and in your colleagues.
How Burnout Develops Over Time — The Typical Journey
builds
& overload
exhaustion
& detachment
or breakdown
The ideal intervention window is in the first half of this journey — when you notice stress accumulating, not when you hit the wall. Early action changes everything. Waiting until crisis means a much longer recovery.
- Emotional exhaustion — feeling completely drained
- Depersonalisation / cynicism — detachment from work and patients
- Reduced personal efficacy — feeling ineffective, incompetent
Source: WHO ICD-11, 2019
Burnout is an occupational phenomenon — not a personal failing. It is caused by chronic exposure to workplace stress, usually in the absence of sufficient support. It can happen to the most capable, most dedicated doctors.
- Depression: 10–20% of UK doctors
- Burnout: affects 25–75% at some point
- Maladaptive coping (substance misuse): strongly linked to unaddressed burnout
Don't you think those numbers are worth sitting with?
Signs of Stress & Burnout — Know Yourself
Many of us notice these signs in others long before we notice them in ourselves. The key is to regularly check in with yourself — and when you notice any of these, pause, reflect, and reach out before it deepens.
- Low energy and persistent tiredness
- Headaches or physical tension
- Feeling agitated, irritable, or overwhelmed
- Trouble sleeping — especially waking with worry
- Losing interest in hobbies and activities you used to love
- Spending less time with family or friends
- Eating chaotically, weight change, relying on caffeine
- Alcohol or substance use increasing
- Gambling or other harmful behaviours
- Feeling detached from your patients or colleagues
- Dreading every working day
- Feeling like a failure or fraud
- Thoughts of self-harm or not wanting to be here
- Feeling completely numb or unable to care
The Invisible Erosion. One of the most telling early signs is when you stop doing the things that used to bring you joy — not because you've become a different person, but because you're quietly running out of energy. When the gym disappears, the friendships fade, and the evenings shrink to just the sofa — take notice. That pattern is speaking loudly.
Self-Check: Are You Burning Out?
Seven honest questions. Answer them as you truly are — not as you wish you were. Then step back and reflect. These questions are based on validated burnout inventory research and are used widely in occupational health settings.
No scores are stored. This is for you, not anyone else.
The 5 Foundations — Start Here
At different points in our lives, stress levels will vary. Some waves are unavoidable — that's life. But there are five things you can do right now that will dramatically reduce the impact of any stressful period. Think of them as your daily foundations. Without them, a stress level of 7/10 quickly feels like 15/10. With them, you can ride the same wave with far more grace.
⚡ The Stress Multiplier — Why Foundations Matter
The same stress feels dramatically different depending on whether your foundations are in place.
The stress didn't change. Your capacity to hold it did.
Sleep deprivation, poor nutrition, no exercise, and isolation don't reduce stress —
they destroy your ability to cope with it. The foundations are not optional extras. They are your floor.
Building Resilience
Resilience is defined as: "The capacity to prepare for, recover from, and adapt in the face of stress, challenge, or adversity."
It is not the absence of difficulty. It is the ability to keep going through it — and to come out knowing yourself a little better. Resilience is not a fixed personality trait. It is a skill. It can be built.
🔄 How to Build a Tiny Wellbeing Habit
"After I…"
"…I will…"
Big smile!
After parking at work
After washing hands
One gratitude
Quick stretch
The rule: make it too easy to fail. A tiny habit done daily beats a grand plan done never. Once it's effortless, add another.
Positive Self-Affirming Statements Before Surgeries
On-call, OOH, and busy surgeries can gradually wear you down — especially when the session is flooded with problems that feel trivial or repetitive. One difficult encounter can colour the whole day. You take that home, and it slowly builds into resentment. The following affirmations, said just before starting a session, can have a remarkable effect on your state of mind. But for them to work, you have to believe them. Say them again until you feel them.
- I am okay
- I am going to have a good, happy day today
- I am going to be kind and warm to all patients and staff, whatever is happening
- I am going to dance with patients and staff
- Today is going to be a good day
- And you know — it's going to fly by. So let's go…
Say all six. Say them again until you believe them. It almost always works. The trick is trusting it before you feel it.
Trainee Voices — What the Community Says
These insights are drawn from recurring patterns in GP trainee accounts, trainee forums, research interviews, and educational discussions within the GP training community. They represent themes that come up again and again — the things trainees wish they had known, the mistakes that keep repeating, and the wisdom that only comes from experience.
All clinical content has been cross-checked against RCGP, GMC, and BMA guidance. Nothing here contradicts official advice — it supplements it with the texture of lived experience.
🔁 The 10 Patterns That Keep Coming Up
"I'll sort myself out after ST3"
The most common self-deception in GP training. Trainees defer their wellbeing past the next exam, the next rotation, the next ARCP. But there's always a next thing. Burnout does not wait for a convenient moment. The time to tend to yourself is now.
The High-Achiever Trap
The trainee who appears to have it most together often crashes hardest. High academic achievers with perfectionist tendencies push through every warning sign — and by the time they stop, they are fully depleted. If you pride yourself on coping, treat that as a reason to check in, not a reason to assume you're fine.
The Hospital-to-GP Transition
Many trainees describe ST1 in GP as unexpectedly disorienting. You go from the clear hierarchy and close team structure of a hospital ward to sitting alone in a room making complex decisions without a safety net. That shift is real and significant. It is not a sign you've chosen the wrong specialty — it is a transition, and transitions take time.
"I Felt Like a Fraud the Whole of ST1"
Imposter syndrome is near-universal in GP trainees — especially in the first GP post. The breadth of general practice means you will frequently encounter things you don't know well. This is normal. It is the design. You are not expected to know everything. You are expected to know how to find out. Feeling uncertain is not incompetence. It's learning.
Micro-Joys Matter More Than You Think
Trainees who protect tiny moments of pleasure — a good coffee, a song on the commute, five minutes of sunlight — consistently report better wellbeing over time. It sounds trivial. It isn't. These small moments counteract the numbing effect of chronic stress. Noticing them intentionally is a genuine wellbeing practice, not fluff.
Set Boundaries Before You're Drowning
The trainees who protect their non-work time early in training — protecting evenings, protecting days off, protecting one hobby — report significantly better resilience throughout. Setting a boundary once you're already burnt out is like putting on a seatbelt after the crash. Do it now, while the system still has capacity for it.
Peer Support is Genuinely Powerful
Trainees who maintain strong connections with their VTS peer group — the other registrars on their scheme — consistently cope better. Not because anything was "solved," but because sharing the experience reduces the isolation. Your colleagues understand this world in a way that almost no one else can. Use each other.
"I Didn't Know Practitioner Health Existed"
A striking and recurring theme: trainees reaching crisis point before discovering that a confidential, free, specialist service specifically for doctors exists. In a 2019 GMC survey, a third of doctors in training did not know where to seek wellbeing support. Now you know. Write the number down: 0300 0303 300.
The "Second Victim" Experience
When something goes wrong with a patient — a missed diagnosis, an adverse outcome, a complaint — doctors often carry a heavy emotional burden that is rarely acknowledged. This "second victim" experience is real. Trainees describe replaying clinical decisions for months. If this happens to you: talk to your ES, your trainer, or call BMA Wellbeing. You are not alone in this.
LTFT is Not Failure — It's Strategy
Less Than Full Time training is a legitimate protected right for GP trainees in the UK. Many trainees who take LTFT to manage caring responsibilities, health concerns, or simply to protect their wellbeing report it as one of the best decisions they made. Don't let anyone — including yourself — frame it as weakness.
Key Frameworks — Understanding What You Need
From the GMC's Caring for Doctors, Caring for Patients report. When these three core needs are met, doctors are motivated and well. When even one is unmet, wellbeing deteriorates.
The New Economics Foundation's evidence-based framework, adopted by the RCGP for GP wellbeing. Five simple actions. All backed by research. All free. All available tomorrow.
These two conditions overlap but are distinct. Getting this right affects both treatment decisions and how you support colleagues. Burnout is an occupational phenomenon; depression is a medical condition. Both deserve proper help.
| Feature | Burnout | Depression |
|---|---|---|
| WHO classification | Occupational phenomenon (ICD-11) | Mental health condition (ICD-11) |
| Cause | Chronic, unmanaged workplace stress | Multifactorial — biological, psychological, social |
| Core feature | Work-specific exhaustion, cynicism, inefficacy | Pervasive low mood affecting all areas of life |
| Confidence | Loss of confidence in professional role | Global loss of confidence and self-worth |
| Anhedonia | Loss of joy in work specifically | Global loss of pleasure across life |
| Recovery setting | Often improves away from work | Persists across settings |
| Treatment | Occupational changes + support; may not need medication | Talking therapy, medication, full psychiatric assessment |
| Overlap | Significant overlap exists — both can coexist. A GP assessment is always needed. Do not self-diagnose. | |
Imposter syndrome — the persistent feeling of being a fraud despite evidence of competence — is near-universal in GP training. Research confirms it is particularly prevalent among high-achieving individuals in medicine and healthcare. Understanding it is the first step to reducing its grip.
😰 What It Feels Like
- "I was lucky they didn't ask about that in the SCA"
- "The patients think I'm a proper doctor but I'm just pretending"
- "Everyone else seems to know what they're doing"
- "When they find out I don't know this, it's all over"
- "I only passed because the questions happened to suit me"
✅ What to Remember
- The breadth of GP means everyone feels uncertain regularly — that's the specialty, not your inadequacy
- Your trainer knows you're a trainee. That's the entire point of the setup.
- Feeling uncertain is often a sign of insight, not incompetence
- Research shows imposter syndrome is most common in the most conscientious trainees
- Talk to your peers. You'll discover you're not the only one.
Psychological PPE — Protecting Your Mind
The Declaration of Geneva (updated 2017) now explicitly states: "I will attend to my own health, well-being, and abilities in order to provide care of the highest standard." This is not an optional aspiration. It is a professional commitment — part of the modern Hippocratic oath. Psychological PPE is the practical application of this commitment.
Green Zone
Functioning well. Stress is manageable. You're coping, sleeping, connecting with people. Build your PPE now — before you need it urgently.
Amber Zone
Early warning signs present. Sleep affected. Hobbies fading. Dread starting to creep in. This is the ideal moment to act — not a sign things are too bad, but a sign they need attention now.
Red Zone
Significant distress. Unable to cope. Dangerous thoughts possible. This is not the time to push on. This is the time to call for help — today, not tomorrow.
From the RCGP "Protecting Doctor Wellbeing: PPE for the Mind" framework — adapted for GP trainees. Your kit should include:
🛡 Preventive Layer
- Your personal early warning signs (know them before they appear)
- Your daily non-negotiables (sleep, movement, nourishment)
- At least one person you can talk to honestly
- Your boundaries — written down, not just thought about
- One activity outside medicine that is just yours
🏥 Reactive Layer
- Practitioner Health number saved: 0300 0303 300
- BMA Wellbeing saved: 0330 123 1245
- Your GP's name and surgery number
- Knowledge of your deanery's pastoral support
- BMA membership active (not for crisis — for before crisis)
Insider Pearls — What Trainees Say
Drawn from real trainee experience, the patterns that keep emerging — things worth knowing before you find them out the hard way.
"The people who burn out hardest are often the ones who seemed like they had it most together." High achievers with sky-high standards often push through the warning signs longest. By the time they stop, they're fully depleted. If you pride yourself on coping — take that as a reason to check in, not a reason not to.
The most dangerous thought in medicine is "I'll deal with this after my next exam." Burnout does not wait for exam results. It does not pause for a convenient moment. Trainees who defer their wellbeing indefinitely often reach a point where it can no longer be deferred.
In the SCA, being a compassionate colleague matters as much as being a skilled clinician. Trainees who show genuine warmth and practical wisdom in wellbeing scenarios — rather than moving robotically through a checklist — consistently score higher. Examiners notice kindness.
Many trainees discover Practitioner Health only when they are in crisis. This is backwards. It is a confidential, doctor-specific service that you can access for stress, anxiety, or concerns about your practice — long before things reach a breaking point. Think of it as preventative medicine for yourself.
Self-care is not a luxury. In medicine, it is a patient safety issue. A burnt-out, sleep-deprived, emotionally depleted doctor makes more errors. Looking after yourself is part of looking after your patients. This reframe changes everything.
IMGs: The adjustment to UK GP culture is real and takes time. The pace, the consultation style, the expectation that you'll "push back" in peer discussion, the very different patient expectations — these are genuine stressors on top of the usual workload. It is not a weakness to name this. It is insight.
Teaching Gems — From GP Educators & Wellbeing Experts
These teaching points are distilled from educational content, GP wellbeing webinars, and clinical educators working in this field. They represent consistent messages from those who have studied and taught this topic extensively.
Burnout is systemic, not personal
The framing of burnout as a personal resilience failure is both inaccurate and harmful. It locates the problem in the doctor rather than in the system creating unsustainable demands. Being burnt out does not mean you are not resilient. It means the demands exceeded your capacity for too long. That is a system problem, not a character flaw.
The culture of "just push through" is dangerous
Medicine has historically celebrated those who sacrifice most and complain least. This culture — while rooted in genuine commitment — is responsible for preventable harm: to doctors, to their patients, and to the workforce. Speaking up about your own wellbeing is not weakness. It is professionalism.
The wellbeing–patient safety link is real
A major study in the British Journal of General Practice (Hall et al., 2019) demonstrated a direct association between GP burnout, wellbeing, and patient safety incidents including near-misses and adverse events. A well doctor is not just happier — they are demonstrably safer for patients. Looking after yourself is looking after your patients.
Recovery from burnout is active, not passive
A week off does not fix months of depletion. Recovery requires active rebuilding: restoring sleep, gradually re-engaging with things that bring joy, addressing the occupational factors that contributed, and connecting with proper support. Rest is necessary but not sufficient. Recovery is a process, not a break.
75% of UK GP trainees have experienced burnout symptoms
The BMA's 2024 GP trainee survey found that three quarters of responding trainees had experienced burnout, stress, depression, or anxiety during their training. This is not a minority problem. It is the norm. The question is not whether you will face this — it is whether you have the knowledge and support to navigate it when you do.
The "wounded healer" pattern
Between 2008 and 2018, over 5,000 doctors presented to NHS Practitioner Health — and 88% of GPs who accessed the service presented with mental health concerns. The doctors who seem strongest on the outside often carry the heaviest burdens privately. This profession attracts carers. Carers need care too.
🏃 The Movement Evidence — Why Exercise is Non-Negotiable
Source: RCGP Physical Activity and Lifestyle Hub; NICE PH44; evidence base for exercise in mental health
Where Do I Start to Help Myself?
First and most importantly: It is fine not to be fine.
Many people are struggling to cope, and experiencing a wide range of emotions is completely understandable. You are not weak for feeling this way. You are human.
You're Never On Your Own
Tell a trusted friend or family member how you're feeling. If nobody is available, phone a helpline for a friendly conversation. Saying the words out loud, to another person, changes everything.
The Fundamentals First
Before anything else: eat well, sleep, exercise, spend time with the people you love, and try to see the positive aspects of life. Not all at once. One thing at a time.
Seek Expert Support
Talk to your GP or a specialist service. Counselling and talking therapy work. Helplines are available 24/7. You do not have to navigate this alone — and you absolutely should not try to.
It's Good to Talk
When things get tough, just talking — even once — can release a remarkable amount of pressure. You don't need a plan. You don't need to have figured it out. You just need to start. Here are the people and services you can talk to.
A UK study found that although 96% of doctors are registered with a GP, very few actually use their services — and a quarter of consultants bypass their GP entirely to seek specialist advice directly. Please don't do this.
- Make sure you are registered with a GP
- If you are unwell, see your GP — do not self-prescribe
- Never prescribe medication for yourself or your family
- If secondary care is needed, go via your GP for a proper referral
- If you feel you cannot see your current GP for any reason, change to another
Your GP will not judge you. They know how hard this job is. They will be honoured that you trusted them.
We strongly urge you to become a BMA member. They are extraordinary when things go wrong — litigation, sickness, employment disputes, and more. The people who most need the BMA are often the people who think they don't need it.
You will regret not being a member if something goes wrong. And they will not help you with an issue that predates your membership.
Yes, the subscription costs something. But what they provide in return — the BMJ, educational modules, legal counsel, and the peace of mind that comes from having a plan — is worth every penny. Don't bury your head in the sand. Join. Plan. Be ready.
Visit BMA.org.uk →Support Services Directory
- Practitioner Health — Free NHS service for doctors with mental health and addiction concerns. Confidential. Staffed by doctors.
- BMA Wellbeing — Counselling, peer support, information. Available to all doctors, students, partners, and dependants.
- Full BMA Support Directory — Alcohol, drugs, finance, mental health, relationships, legal, bereavement
- GMC Support Resources
- MPS Wellbeing Hub — Medical Protection Society
- Samaritans — 116 123 (free, 24/7). For anyone in crisis or distress.
- NHS Mental Health & Wellbeing
- Worldwide Suicide Crisis Lines — for international colleagues
- Enfys — Addiction Support — alcohol, drugs, gambling, sex, eating disorders
- e-Care App (Android) / e-Care App (iOS) — by ICAS
- Free Wellbeing Apps for NHS Staff
Practitioner Health
Free. Confidential. Run by doctors.
0300 0303 300
BMA Wellbeing Support
Available 24/7 — doctors, students, partners, dependants
0330 123 1245
Please don't wait. Don't overthink it. Pick up the phone. They are there, they understand, and they are waiting for your call.
For Trainers & TPDs
Wellbeing is not a "soft" topic. It is one of the most professionally important areas in GP training, touching on patient safety, GMC obligations, professional identity, and life beyond medicine. How you approach it as a trainer matters.
- Not knowing what Practitioner Health is or that they can self-refer
- Assuming that stress is a sign of weakness — not a normal human response to abnormal demands
- Not registering with their own GP (or feeling embarrassed to go)
- Believing they should just "get on with it" until training ends
- Not recognising the difference between normal exam stress and genuine burnout
- In SCA scenarios: rushing to fix before listening
- Role-play: struggling colleague comes to you for support — what do you do?
- Reflective discussion: "When did you last feel properly well? What helped?"
- Case: a doctor in your practice is showing signs of burnout — explore the professional duties
- Walk through the Maslach Burnout Inventory together
- Map out the support services together — many trainees have never heard of them
- Discuss GMP 2024 and what self-care as a professional standard actually means
- "What does a bad day at work feel like for you? A bad week? How do you recover?"
- "If a colleague told you they were struggling, what would your first instinct be?"
- "What would stop you from calling Practitioner Health if you needed to?"
- "How does your workload at the moment compare to what feels sustainable?"
- "What is one thing you do deliberately to protect your own wellbeing?"
- "What's the difference between a difficult period and burnout — and how would you know?"
Trainers: Your wellbeing matters too. The GMC National Training Survey 2024 found that 68% of GP trainers feel worn out at the end of the working day, and 50% of trainers show signs of high or moderate burnout risk. You cannot pour from an empty cup. Model the behaviour you're trying to teach.
This topic rarely appears as a full clinical scenario in the AKT, but the following concepts are examinable — particularly in questions about professional responsibilities, appraisal, and the referral of struggling colleagues.
WHO / ICD-11 Definition of Burnout
- An occupational phenomenon — not classified as a medical condition
- Three dimensions: emotional exhaustion, cynicism/depersonalisation, reduced personal efficacy
- Caused by chronic, inadequately managed workplace stress
- Distinct from depression, though overlap exists
Key Support Organisations — Know These
- NHS Practitioner Health — Free, confidential NHS service specifically for doctors. Referral or self-referral. Tel: 0300 0303 300
- BMA Wellbeing — 24/7, available to doctors and medical students. Tel: 0330 123 1245
- Samaritans — 116 123
- Occupational Health via employer
- Own GP — always the first port of call
Appraisal & Revalidation — Health & Wellbeing
- Annual medical appraisal is mandatory for all UK doctors with a licence to practise
- Since GMC Good Medical Practice 2024 (in effect from January 2024), appraisal has a formal wellbeing component
- GMP 2024 explicitly states doctors must take care of their own health and wellbeing
- Appraisal is a protected space to discuss health — it is not a performance management process
- If a doctor is unwell, this may be disclosed at appraisal and appropriate support arranged
- Revalidation occurs every 5 years; the Responsible Officer (RO) makes recommendations to the GMC
GMC Good Medical Practice 2024 — Key Points
- All four domains apply: Knowledge & Practice, Patients & Communication, Colleagues & Culture, Trust & Professionalism
- Explicit duty to create fair and inclusive workplaces
- Doctors must raise concerns if a colleague's health or behaviour may put patients at risk
- You have a duty to support struggling colleagues as well as report risk
- Self-care is explicitly part of professional standards — not an optional extra
Questions on this topic often describe a scenario where a colleague is clearly unwell or impaired. The correct answer will always balance: (1) compassion and support for the colleague, (2) duty to raise a concern if patient safety is at risk, (3) following the correct reporting pathway rather than handling it informally. Ignoring it and confronting the colleague aggressively are always wrong answers. Speaking to the colleague first privately is usually a correct early step — unless there is immediate patient risk.
SCA: Wellbeing Consultation Scenarios
This topic appears in the SCA in several forms — not as a clinical illness, but as a human and professional challenge. The scenarios are emotionally demanding and test your ability to balance empathy, professional duty, and practical action. Here are the most common types:
A fellow trainee, or a colleague at the practice, approaches you. They seem low, exhausted, or tearful. They confide that they're not coping — making errors, dreading work, or thinking about leaving medicine. They may not be asking you to "fix" anything. They just needed to talk to someone they trust.
🎯 What Examiners Are Looking For
- Listen first. Don't immediately go into problem-solving mode. Your colleague needs to feel heard before they need to feel helped.
- Normalise without dismissing. "We're all stressed" is dismissive. "What you're describing sounds really hard — and it takes courage to say it out loud" is not.
- Explore carefully. What is going on for them? How long? Any patient safety concerns? Any thoughts of self-harm?
- Gently signpost to appropriate support — Practitioner Health, BMA Wellbeing, their own GP, their TPD.
- Duty of care vs confidentiality. If patient safety may be at risk, this changes what you are obligated to do — you cannot simply keep it between yourselves. Handle this sensitively, not confrontationally.
- Don't make promises you can't keep. "I won't tell anyone" is rarely appropriate — and dangerous in this context.
🗣 Useful Phrases
- "It sounds like things have really built up. I'm really glad you felt you could tell me."
- "Take your time — there's no rush. I'm here."
- "I can hear how exhausted you are. That makes complete sense given what you're dealing with."
- "I want to help, but I want to make sure I understand properly first. What's been the hardest part?"
- "Have you been able to speak to anyone else about this? Your GP, for example?"
- "There's a service specifically for doctors — Practitioner Health. They're confidential, and they really do understand."
- "I care about what happens to you. I want to make sure you get the right support."
Common Candidate Mistake: Jumping straight to "you need to see Practitioner Health" without first sitting with the person. Examiners penalise the rush to fix. Presence before prescription.
A patient tells you that another doctor (your colleague) was rude, dismissive, or behaved unprofessionally during a recent consultation. They are upset and want "something done about it." You are on the receiving end of this complaint.
🎯 What Examiners Are Looking For
- Take it seriously. Do not minimise, defend your colleague, or dismiss the patient's experience.
- Acknowledge the patient's feelings — separate from whether the complaint is justified.
- Don't throw your colleague under the bus. You were not present. You don't know the full picture.
- Know the complaints process. Explain how to make a formal complaint if they wish. This is not about disloyalty — it is about the correct process.
- Reflect privately — is this a pattern? If your colleague is repeatedly the subject of concerns, your duty of candour may require action beyond this one conversation.
- Compassion for both parties. The patient deserves to be heard. The colleague may be struggling. These are not mutually exclusive.
🗣 Useful Phrases
- "I'm really sorry that was your experience. That's not the standard of care you should expect."
- "I want to be honest — I wasn't there, so I can only hear your side of things right now. But your experience clearly matters."
- "Would you like me to explain how to raise a formal concern? It's a process that exists precisely for moments like this."
- "Thank you for telling me. It takes something to say this out loud."
Balance is everything here. Examiners look for candidates who can simultaneously validate the patient, remain professional about their colleague, follow the correct process, and — if the colleague is known to be struggling — hold that quietly in mind too. That is sophisticated GP thinking.
A professional — sometimes even another doctor — presents with tiredness, low mood, poor sleep, and emotional numbness. They don't call it burnout. They say they're "just tired" or "a bit stressed." They may minimise it significantly.
🎯 What Examiners Are Looking For
- Explore occupational stress specifically — don't just treat this as generic depression
- Use gentle but direct ICE: "What do you think might be causing this? What's worrying you most?"
- Assess for serious risk (suicidal ideation) — this is a population at higher-than-average risk
- Avoid medicalising too quickly — not everything is a medication problem
- Safety-net thoroughly: "If things deteriorate or you start having worrying thoughts, please come back — or call 116 123"
🗣 Useful Phrases
- "How long has this been building up? Sometimes these things creep up on us without us realising."
- "It sounds like you've been carrying a lot for a long time. What would help most right now — do you know?"
- "I want to ask you something important — I hope that's okay. Sometimes when people feel this way, some darker thoughts can creep in. Has that happened for you at all?"
- "I don't want to just hand you a prescription and send you on your way. I want to understand what's going on properly."
- "If things feel like they're getting worse rather than better, please don't wait until your next appointment. Come back, or call 111."
Core Approach
- Presence before prescription. Sit with the person first.
- Silence is okay. Don't rush to fill it.
- Validate feelings. "That makes complete sense."
- Don't minimise. "Lots of people feel like this" helps no one.
- Normalise the struggle. Acknowledging it is the first step to healing it.
Safety Assessment (When Needed)
- Direct but gentle: "Can I ask you something important?"
- Name it: "...thoughts of harming yourself, or not wanting to be here?"
- Don't avoid it — asking does not plant ideas
- If risk present: Samaritans (116 123), A&E, or urgent mental health review
- Always safety-net clearly and explicitly
FAQ — Quick Answers
Yes. Practitioner Health is a confidential NHS service. It operates on the same basis as any clinical service — your GP will not be automatically informed, your trainer will not be informed, and your employer will not be informed. Information may only be shared in exceptional circumstances involving serious patient safety concerns, consistent with normal clinical governance. You can call them just to talk.
You can change your GP. You are entitled to register with any GP practice. If distance from your workplace feels important, registering at a practice geographically separate from where you work can help. You can also call the BMA or Practitioner Health as an alternative first point of contact if a GP feels too close to home.
Not necessarily — but it depends. If your colleague is struggling with stress or personal difficulties and there is no immediate threat to patient safety, your first responsibility is to offer compassionate support and encourage them to seek appropriate help. However, if you have reason to believe that their health is directly compromising patient safety, you have a professional obligation under GMC Good Medical Practice to raise a concern. This is not a betrayal — it is a duty of care. Handle it sensitively, speak to them directly first where safe to do so, and consult your own adviser (BMA or MDO) if you are unsure.
Yes — and increasingly so. Since GMC Good Medical Practice 2024 came into effect (January 2024), appraisal has a more formal wellbeing component. Appraisal should provide protected time to reflect on your own health and wellbeing. It is not a performance management process — it is a supportive, formative discussion. If you are struggling, your appraisal is a legitimate and appropriate place to begin that conversation.
Call if: you are feeling unable to cope with work; you are having thoughts of self-harm or suicide; your mental health is affecting your clinical performance; you are using alcohol, drugs, or other substances to cope; you have significant anxiety or depression affecting your daily life. You do not have to be in crisis to call. You can call if you are worried and unsure whether things are serious enough. That is exactly what the service is for.
Final Take-Home Points
The Bits to Remember Tomorrow
- Burnout is common, serious, and not a sign of weakness — it is a normal response to abnormal, sustained pressure
- The GMC 2024 survey found 40% of UK trainees feel burnt out — and 68% of GP trainers feel worn out at the end of the day. You are not alone.
- Burnout progresses through stages — catch it early in yourself and your colleagues. Don't wait for the crisis.
- The 5 foundations — sleep, eat, hydrate, move, build habits — are your non-negotiable baseline. Without them, everything else is harder.
- Register with a GP. See your GP. Do not self-prescribe. These are professional obligations, not just good advice.
- NHS Practitioner Health (0300 0303 300) and BMA Wellbeing (0330 123 1245) are free, confidential, and designed specifically for doctors.
- In SCA wellbeing scenarios: listen before fixing, validate feelings, signpost gently, and know when patient safety changes your duty.
- Appraisal now formally includes a wellbeing component — use it. It is a protected space for this conversation.
- GMC GMP 2024 explicitly states that self-care is part of professional standards. It is not selfish. It is your job.
- Self-care is a patient safety issue. A well doctor is a safer doctor.
Bradford VTS | bradfordvts.co.uk | For educational use only. Always verify clinical information. | ↑ Back to top