• Dr Sarah Thornton, RCoA Elected Council member
• Dr Jon Chambers, RCoA Elected Council member
• Dr Simon Maguire, RCoA Bernard Johnson Advisor for Training
• Dr Roger Langford, RCoA Bernard Johnson Advisor for Training
• Dr Chris Taylor, RCoA Elected Council member
• Russell Ampofo, RCoA Director of Education, Training and Examinations

The GMC survey has been a longstanding part of the training calendar since 2005. While completing it may feel like a chore, and results often feel like they disappear into the ether, they are taken very seriously by those with responsibility for training.

Heads of Schools of Anaesthesia analyse the results to identify areas for improvement, and the Directors of Medical Education in each trust must share their response with postgraduate deans and trusts’ boards. Reports are compiled, and changes are made to address the highlighted issues.

As a College, we review this data annually through our Anaesthetists in Training Committee, which helps us target our efforts for the coming year. This year, we have pinpointed both the strengths and the areas needing attention within anaesthetic training.

Strengths

We outperform other specialties in recognising the importance of dedicated time in trainers’ job plans to support education. We do well at providing exam support and one-on-one teaching for practical procedures. Feedback is overwhelmingly positive, with 98% of responses rating quality of feedback as fair and constructive, and 96% saying that it is delivered sensitively. Additionally, 97% of anaesthetists in training (AiTs) feel confident that their posts provide adequate experience, while 98% rate that experience as very good, good, or adequate. Educational supervision is accessible, with appropriate contact levels reported by 94% and 90% of AiTs respectively. Overall satisfaction remains high, particularly regarding teaching quality, clinical supervision, and the value of the experience.

Areas for improvement

Despite these positives, we need to focus on several important issues, including fatigue, mentorship, and sexual misconduct within our specialty. Key survey findings are highlighted below.

• Impact of fatigue – 29% of Stage 2/3 doctors report that fatigue has affected their training progress, with 5% indicating a significant impact. In Stage 1, 26% noted some impact, and 5.7% reported significant issues. Additionally, 20% reported that they were too tired to get home after a night shift at least once a month, with 8% experiencing this weekly. Alongside the Association of Anaesthetists, we collaborated to form the Fight Fatigue campaign, initiated in 2017, which emphasises training for both trainers and residents. Initiatives included presentations, departmental posters, and improvements in rest facilities. In recognition of this problem the GMC survey has added further questions about fatigue, indicating that it remains a significant problem. It is clear that further education on available resources is needed.

• Mentorship – our programme reports a mentorship rate of 35%, below the national average of 44%. While we may have an unofficial mentorship culture, making this more explicit could enhance career progression and overall wellbeing. Trainees in other specialties have an overarching educational supervisor for the entirety of their training, and this is a model we have recommended in the rotational training guidance produced in August 2024 which may help provide that mentorship.
• Sexual misconduct – the GMC and NHS staff surveys have recently incorporated questions in relation to sexual misconduct, reflecting the pressing need for action in this area. Our specialty reports instances of sexual misconduct higher than the national average. Data reveals concerning trends, such as 15% of respondents unwilling to report misconduct and 17% hesitant to challenge inappropriate behaviour. In response to the overwhelming data provided by the Working Party for Sexual Misconduct in Surgery of which we are a member, and the NHS staff survey and the GMC trainee survey, the GMC has released guidance for employers on handling offenders and supporting victims. NHSE has introduced a sexual misconduct framework for trusts, including an  to empower managers in addressing inappropriate behaviour.

Looking ahead

Our focus for the coming year will centre on creating a safe and supportive environment for our colleagues training both in and out of formal training programmes. We’ve already begun by publishing a Rotational Training Guidance that encourages national bodies, schools, and hospitals to address the non-clinical aspects of training most impacting our members’ wellbeing, and by.providing registration and oversight of emerging Portfolio pathway training programmes for obtaining entry onto the specialist register. After reports of bullying and harassment of Dual CCT FICM doctors with different base specialties, we have worked with FICM to help change that dynamic by highlighting their skill sets and learning needs.

We have also produced guidance for educational provisions for SAS/LED and MTI doctors to elevate and try to improve the support they receive to a similar standard to that experienced by survey respondents. We are also running differential attainment masterclasses aiming to bridge the attainment gap for doctors taking the FRCA.

As a College we are committed to working with all stakeholders and schools of anaesthesia to enhance mentorship, add overarching educational supervisors, improve workplace culture around fatigue, and actively address inappropriate behaviour in all areas. Stay tuned for updates as we work hard to create a better and more equitable learning environment for all doctors in the workplace, whether they are in formal training programmes or not.