TRAINEE SURVEY 2017

Dr Abhishek Joshi BJCA SecretaryDr Jubin Joseph BJCA President

Conflicts of Interest: None

BACKGROUND & AIMS

• Thirteen years of surveys• Designed by trainees• Measures trends in training and opinions

of trainees• Open to all doctors at registrar level• NTN & non-NTN holders• OOP trainees

FOCUS FOR 2017

• Training Environment• Rota Gaps• Access to Advanced Modular Training• Acute General Medicine• Working Culture

• Echocardiography Curriculum 2016

DEMOGRAPHICS

DEMOGRAPHICS

497

GENDER: ALL NTNS

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Male Female2014 2015 2016 2017

GENDER: ALL NTNS

60%

71%

81%

72%75%

40%

29%

19%

28%25%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

ST3ST4ST5ST6ST7

Male Female

Region Responses % of Total

East Midlands 37 9%

NE Thames 32 8%

East of England 31 7%

Wales 31 7%

North Western 30 7%

Scotland 28 7%

S Thames 28 7%

Yorkshire & Humber 27 6%

West Midlands 26 6%

Oxford 24 6%

NW Thames 24 6%

Northern 20 5%

Mersey 15 4%

Wessex 15 4%

KSS 15 4%

SW Peninsula 14 3%

Severn 13 3%

Northern Ireland 12 3%

REGIONAL RESPONSES

Region Responses Turnout

SW Peninsula 14 82%

East of England 31 67%

East Midlands 37 56%

North Western 30 55%

Wales 31 52%

Oxford 24 50%

Mersey 15 50%

Severn 13 48%

Northern Ireland 12 37%

Scotland 28 36%

West Midlands 26 35%

Wessex 15 34%

S Thames 28 33%

Northern 20 33%

NE Thames 32 32%

KSS 15 32%

Yorkshire & Humber 27 30%

NW Thames 24 16%

REGIONAL RESPONSES

TRAINING QUALITY

WOULD YOU RECOMMEND YOUR DEANERY TO

POTENTIAL CARDIOLOGY TRAINEES AT ST3?

Region 2017 2016 2015 2014West Midlands 100% 83% 73% 86%

Mersey 93% 92% 93% 100%

Oxford 88% 73% 52% 30%

London - S 86% 76% 89% 81%

Severn 85% 67% 57% 67%

London - NE 81% 58% 94% 94%

Yorks & Humber 78% 78% 79% 82%

Northern Ireland 75% 57% 54% 50%

KSS 73% 50% 63% 88%

London - NW 71% 81% 78% 85%

Northern 70% 72% 83% 94%

Wales 68% 76% 74% 69%

Wessex 67% 83% 64% 76%

East of England 65% 56% 73% 56%

SW Peninsula 64% 53% 75% 70%

Scotland 64% 50% 82% 60%

East Midlands 51% 50% 58% 62%

North Western 37% 46% 48% 57%

WHAT IS GOOD ABOUT YOUR HOSPITAL?

HOW COULD TRAINING BE IMPROVED AT YOUR HOSPITAL?

WHICH CURRICULUM AREAS DID YOU FIND

DIFFICULTY IN ACCESSING AT ST3-5 LEVEL?

37%

35%

35%

33%

33%

31%

30%

25%

18%

15%

14%

13%

11%

6%

0% 5% 10% 15% 20% 25% 30% 35% 40%

Pulmonary hypertension

CMR

ACHD

CT

Nuclear

Inherited cardiac conditions

Heart disease in pregnancy

Cardiac electrophysiology

Academic cardiology

Echo

Heart failure/ transplantation

Device therapy

Cardiac rehabilitation

Coronary intervention

WHICH CURRICULUM AREAS DID YOU FIND

DIFFICULTY IN ACCESSING AT ST3-5 LEVEL?PCI CMR CT Nuclear Echo EP

Heart

failure Devices ACHD Academic ICC Pregnancy PH Rehab None

West Midlands 4% 15% 27% 23% 4% 23% 15% 15% 31% 23% 42% 23% 35% 8% 23%

Mersey 20% 33% 13% 47% 20% 33% 27% 7% 53% 20% 33% 53% 60% 7% 13%

Oxford 4% 17% 17% 21% 4% 33% 38% 8% 42% 25% 42% 38% 50% 13% 13%

S Thames 4% 14% 25% 32% 18% 18% 4% 14% 18% 7% 18% 25% 29% 18% 25%

Severn 0% 23% 38% 46% 0% 38% 15% 8% 23% 15% 38% 38% 31% 8% 31%

NE Thames 3% 6% 13% 19% 6% 19% 3% 9% 19% 6% 9% 16% 44% 9% 25%

Yorks & Humber 11% 44% 37% 22% 26% 15% 19% 15% 22% 7% 19% 15% 44% 15% 15%

Northern Ireland 8% 50% 58% 42% 67% 25% 33% 25% 58% 17% 25% 67% 25% 0% 8%

KSS 0% 53% 27% 47% 27% 20% 13% 13% 53% 53% 33% 47% 47% 20% 13%

NW Thames 4% 21% 17% 50% 8% 29% 0% 21% 25% 8% 25% 25% 17% 33% 25%

Northern 15% 30% 35% 35% 15% 35% 10% 25% 50% 40% 55% 40% 45% 20% 5%

Wales 3% 65% 48% 16% 6% 13% 3% 6% 26% 6% 26% 13% 19% 0% 6%

Wessex 13% 33% 33% 40% 20% 20% 7% 20% 13% 33% 27% 27% 33% 13% 13%

East of England 0% 58% 45% 52% 19% 29% 23% 16% 52% 23% 42% 32% 39% 6% 6%

Scotland 11% 46% 36% 29% 21% 14% 11% 14% 43% 0% 32% 39% 36% 7% 7%

SW Peninsula 0% 36% 29% 57% 0% 50% 21% 14% 50% 29% 21% 50% 64% 7% 7%

East Midlands 0% 22% 41% 32% 11% 22% 16% 11% 43% 27% 38% 24% 41% 11% 14%

North Western 10% 53% 57% 43% 23% 47% 17% 10% 30% 30% 43% 40% 53% 13% 10%

HOW MANY EXTRA HOURS DO YOU WORK

EACH WEEK?

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

0hrs 1-5hrs 6-10hrs 16-20hrs >20hrs2014 2015 2016 2017

WHY DO YOU WORK EXTRA HOURS?

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Clinical workload Pressure from Seniors Pressure from Managers ARCP Requirements Personal Choice Not applicable

2014 2015 2016 2017

ACUTE GENERAL MEDICINE: PROPORTION OF TIME

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

0% 1-20% 21-40% 41-60% 61-80% 81-100%

ACUTE GENERAL MEDICINE: TIME UNSUPERVISED

0%

5%

10%

15%

20%

25%

30%

35%

40%

0% 1-20% 21-40% 41-60% 61-80% 81-100%

ACUTE GENERAL MEDICINE: CURRICULUM BASED TRAINING

0%

10%

20%

30%

40%

50%

60%

0% 1-20% 21-40% 41-60% 61-80% 81-100%

TRAINING IN ADVANCED MODULES: PROPORTION OF TIME

0%

5%

10%

15%

20%

25%

30%

35%

0% 1-20% 21-40% 41-60% 61-80% 81-100%

24%

TRAINING IN ADVANCED MODULES: WHY <40%?

32%

30%

23%

15%

0% 5% 10% 15% 20% 25% 30% 35%

I am often required to cover empty on-call slots

I am often required to cover other sub-specialities

There is a high ratio of trainees to opportunities

There are few opportunities in my region

WHAT PROPORTION OF YOUR ROTA IS UNFILLED?

24%

11%

20%

14%

16%

13%

1%0%

0%

5%

10%

15%

20%

25%

30%

0% 1 - 5% 6 - 10% 11 - 15% 16 - 20% 21 - 40% 41 - 50% >50%

30%

HOW OFTEN ARE YOU ASKED TO FILL ROTA GAPS?

15%

30%

32%

23%

0%

5%

10%

15%

20%

25%

30%

35%

Never Every few months Monthly Weekly

> Monthly Rota Gap Cover

Mersey 67%

North Western 63%

Yorks & Humber 59%

Northern Ireland 58%

Northern 55%

East of England 55%

SW Peninsula 50%

Wessex 47%

Severn 46%

NW Thames 42%

East Midlands 41%

S Thames 36%

West Midlands 35%

KSS 33%

Oxford 33%

Wales 29%

NE Thames 22%

Scotland 11%

UNFILLED ROTA GAPS HAVE REDUCED MY ACCESS TO TRAINING

Strongly Agree Agree Neither Agree Or Disagree Disagree Strongly Disagree

HAVE YOU EVER WITNESSED BULLYING OR UNDERMINING BEHAVIOUR IN A CARDIOLOGY POST?

50%

29%

50%

71%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Undermining Bullying

HOW OFTEN HAVE YOU BEEN UNDERMINED IN THE PAST 4 WEEKS?

68%

14% 13%

5%

1%0%

10%

20%

30%

40%

50%

60%

70%

80%

Never Once More than once Every Week Every Day

32%

% Reporting Undermining

East Midlands 83%

East of England 47%

Northern Ireland 29%

Wales 27%

Severn 25%

London - NE Thames 24%

Oxford 23%

Wessex 22%

Scotland 19%

Yorkshire and Humber 18%

London - NW Thames 17%

South West Peninsula 13%

North Western 13%

West Midlands 11%

Mersey 10%

Northern 8%

London - S Thames 0%

Kent, Surrey and Sussex 0%

HOW OFTEN HAVE YOU BEEN UNDERMINED IN THE PAST 4 WEEKS?

0%

5%

10%

15%

20%

25%

Once More than once Every Week Every Day

All Women EU Grads Non-EU Grads

HOW OFTEN HAVE YOU BEEN BULLIED IN THE PAST 4 WEEKS?

88%

10%

1% 1%0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Never More than once Every Week Every Day

12%

% Reporting Bullying

Northern 20%

Wessex 20%

East Midlands 16%

South West Peninsula 14%

Wales 13%

East of England 13%

London - NW Thames 13%

West Midlands 12%

London - S Thames 11%

Scotland 11%

North Western 10%

Oxford 8%

Severn 8%

Mersey 7%

London - NE Thames 3%

Yorkshire and Humber 0%

Northern Ireland 0%

Kent, Surrey and Sussex 0%

HOW OFTEN HAVE YOU BEEN BULLIED IN THE PAST 4 WEEKS?

0%

5%

10%

15%

20%

25%

More than once Every Week Every Day

All Women EU Grads Non-EU Grads

CORE ECHO TRAINING

SUMMARY OF NEW ECHO CURRICULUM

• Applies to Core Trainees from November 2016

• e-learning module

• Log-book of cases (150-200)

• 5 video cases

ARE YOU AWARE OF THE 2016 CHANGES TO THE ECHO CURRICULUM?

71%

29%

Yes

No

ARE YOU AWARE OF THE 2016 CHANGES TO THE ECHO CURRICULUM?ST5

80%

20%

Yes

No

WERE YOU INFORMED OF THE CHANGES BEFOREHAND?

0%

10%

20%

30%

40%

50%

60%

70%

80%

Yes No

HOW WERE YOU INFORMED?

0%

10%

20%

30%

40%

50%

60%

70%

Training ProgrammeDirector

Echocardiography Lead BJCA email Word of mouth Other (please specify)

“I AM ABLE TO ACHIEVE MY CORE CURRICULUM REQUIREMENTS IN TTE”

Strongly Agree Agree

Neith

er Agree O

r Disagree

Disagree

Stron

gly Disagree

DO YOU THINK THE NEW REQUIREMENTS FOR

ECHOCARDIOGRAPHY ARE ACHIEVABLE FOR THE

MAJORITY OF CARDIOLOGY TRAINEES?

Yes22%

No44%

Don't Know34%

HOW OFTEN DO YOU RECEIVE ECHO TRAINING?

0%

5%

10%

15%

20%

25%

30%

More than once aweek

Once weekly Between one andthree times a month

Less than once amonth

I do not receivetraining

AVERAGE ECHO NUMBERS: CORE TRAINEES

222

0

50

100

150

200

250

Year 1 - St3 Year 2 - St4 Year 3 - St5

AVERAGE ECHO NUMBERS: ST5S

0

5

10

15

20

25

30

0 100 200 300 400 500 600 700 800 900 1000

No

. Of

Trai

nee

s

Number of Echos

ARE YOUR ECHO LISTS BLEEP-FREE?

26%

36%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Yes

2016 2017

SUMMARY

• Training Experience

• Huge regional variation persists

• Service provision imposing further on training

• Rota gaps are affecting access to training

• Undermining and bullying must be explored

• Echo

• New curriculum appears achievable (as long as youknow about it!)

• Access to training is improving

ACKNOWLEDGMENTS

Azeem Ahmad BCSCarolyn Hargreaves BCSProf. Russell Smith SACDr. Alison Calver SAC

BJCA Deanery representatives

Twitter: @theBJCASlides (and more data) on BJCA.co