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‘Trainees in Difficult Situations’

Trainees with personal conduct and performance issues are likely to be in the minority but often occupy a considerable amount of supervisor time and energy.

Trainees are employees and, as such, are expected to demonstrate appropriate professional behaviours with patients, carers and colleagues. Behavioural issues may be brought to your attention, and it is important to be fully aware of the GMC guidance Good Medical Practice (2006), which applies to all UK doctors, including those in training. Where there are potential infringements of the GMC’s guidance, consider the relative seriousness of the problem, and if in any doubt consult with the appropriate colleague(s).

In practical terms, it is important to be clear about whether there is an issue of improper personal conduct, which would be subject to the local trust or practice employment regulations, or an issue of poor professional performance. A useful distinction between these two categories is that matters of personal conduct – such as absence without leave, theft of trust property, bullying or sexual harassment – will normally apply equally to any employee. If a trainee’s behaviour or conduct has been questioned, then it is appropriate to agree with the director of medical education how any allegations of concern should be investigated in accordance with local human resources policy. Conduct issues with serious implications for the future professional work of the trainee should also be reported to the deanery after investigation is completed at local trust level. Actions should also respect national policies, GMC regulations and any obligations under law.

As a supervisor, you should ensure that accurate, contemporaneous, dated and signed records of feedback, supervision and appraisal sessions are kept (see the Appraisal module for good practice guidance). Multi-source feedback is an extremely helpful assessment tool to use where there are concerns about conduct and provides a good focal point for discussions about aspects of performance that are lacking.

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