Junior doctors' experiences of personal illness: a qualitative study.

摘要

OBJECTIVES: Professional status and working arrangements can inhibit doctors from acknowledging and seeking care for their own ill health. Research identifies that a culture of immunity to illness within the medical profession takes root during training. What happens when trainee doctors become unwell during their formative period of education and training? What support do they receive and how do they perceive that the experience of ill health affects their training trajectory? These research questions were developed by a multidisciplinary team of researchers and health professionals, who adopted a qualitative approach to investigate the experiences of personal illness among trainees in their Foundation Programme (FP) years. METHODS: Semi-structured interviews were conducted with eight FP trainees from the Severn Deanery in southwest England who had experienced significant illness. Interpretative phenomenological analysis was used to conduct and analyse the interviews, resulting in a comprehensive list of master themes. This paper reports an interpretative analysis of the themes of Support, Illness Experience, Crossing the Line, Medical Culture, Stigma and Disclosure. RESULTS: Ineffective communication within the medical education and employment system underpins many of the difficulties encountered by trainees who are unwell. Coping style plays a key role in predicting how trainees experience support during and after their illness, although this may be influenced by their particular diagnoses. The barriers to disclosure of their illnesses are discussed within the context of mobilising and maintaining support. Concern about the impact of missing training as a result of ill health appears to be significant in the transmitting of an ethos of invulnerability within the medical culture. CONCLUSIONS: Suggestions to improve support procedures for trainees who are unwell include the provision of greater flexibility within the rotation system along with independent pastoral support. Promoting the importance of disclosing significant illness as early as possible might go some way towards challenging the culture of invulnerability to illness that prevails among doctors.