#KnockItOut FAQs


What is #KnockItOut?

#KnockItOut is a campaign to tackle bullying, harassment and undermining launched by the RCoA Trainee Committee and the AAGBI GAT Committee jointly in April 2017.

Why have we launched the campaign?

We have launched #KnockItOut to support #HammerItOut, the British Orthopaedic Trainees’ Association’s (BOTA) campaign, which aims to tackle the problem of bullying, harassment and undermining in Trauma and Orthopaedics (T&O). The Association of Surgeons in Training
(ASiT) have also launched #CutItOut in support. Please see the launch statement on the College website for further information.

What do we mean by the terms ‘bullying’ and ‘undermining’?

The GMC National Training Survey defines these terms:

Bullying is behaviour that hurts or frightens someone who is less powerful, often forcing them to do something they do not want to do.’

Undermining is behaviour that subverts, weakens or wears away confidence.’

What evidence do we have of this being a problem in Anaesthesia?

As we mention in the launch statement, the GMC National Training Survey (NTS) has not flagged this as a particular problem in Anaesthesia, but we are also aware that there is a reluctance to report concerns via the NTS and appreciate it can be difficult to raise concerns. Wherever it occurs, bullying and undermining is not acceptable and as members of the wider theatre team we support our surgical colleagues’ campaign to tackle bullying and undermining in the workforce.

So what can we do to help?

There are often complex factors at play that provide barriers to a supportive environment. In February 2015, the GMC published Building a Supportive Environment - a review to tackle undermining and bullying in medical education and training. This highlights factors contributing to positive workplace behaviours and a supportive learning environment. Examples of positive strategies include flattening of hierarchies in departments to facilitate more open discussion and workshops to build understanding of bullying behaviour.

The Academy of Medical Royal Colleges (AoMRC) Trainee Doctors Group (ATDG) published a document called Creating Supportive Environments in September 2016, which looked at behaviours which compromise safety. Educating ourselves about such behaviours is a step forward. The answer is not simple but to quote the AoMRC: "put simply, we cannot look the other way if we witness poor behaviour or tolerate it if we are the victim of it."

What should I do if I experience or witness bullying or undermining?

The BMA has collated useful information on the next steps to take if you feel you have experienced bullying or undermining or witnessed it in a colleague. Bullying and undermining can have significant effects on not only an individual’s wellbeing but also that of a department or organisation. GAT and the RCoA Trainee Committee are committed to supporting our trainees’ morale and wellbeing. If you are struggling in any way due to some of these issues, please do not forget to:

  1. talk to somebody: fellow trainees, family and friends
  2. meet with your clinical or educational supervisor, College Tutor or mentor
  3. use one of the available support and welfare schemes:

What do we hope to achieve by the #KnockItOut campaign?

  • To raise awareness of our surgical colleagues’ #HammerItOut and #CutItOut campaigns and the issues of bullying, harassment and undermining.
  • To contribute to development of a positive and supportive workplace environment within anaesthesia, the surgical specialties and the NHS as a whole.

What actions will GAT and the RCoA Trainee Committee be taking to achieve these aims?

We will work collaboratively with our colleagues at BOTA and ASiT to promote the campaigns both on social media and directly with our membership, thus widening the dialogue around this issue. We will highlight resources available to support those who have experienced or
witnessed bullying or undermining. We hope that by speaking up about the issue we can encourage others to do the same.

Where can I find out more information?

  • More information about the BOTA #HammerItOut campaign, including a Statement of Intent, can be found here.
  • The GMC review ‘Building a supportive environment’ can be found here.
  • The AoMRC document ‘Creating a supportive environment’ can be found here.
  • The BMA website has comprehensive information about bullying and harassment here.