Stress, burnout, depression and work satisfaction among UK anaesthetic trainees: a qualitative analysis of in-depth participant interviews in the Satisfaction and Wellbeing in Anaesthetic Training study

Anaesthetists experience unique stressors. Recent evidence suggests a high prevalence of stress and burnout in trainee anaesthetists. There has been no in-depth qualitative analysis to explore this further. We conducted semi-structured interviews to explore contributory and potentially protective factors in the development of perceived stress, burnout, depression and low work-satisfaction. We sampled purposively among participants in the Satisfaction and Wellbeing in Anaesthetic Training study, reaching data saturation at 12 interviews. Thematic analysis identified three overarching themes: (1) factors enabling work-satisfaction; (2) stressors of being an anaesthetic trainee; (3) suggestions for improving working conditions. Factors enabling work-satisfaction were: patient contact; the privilege of enabling good patient outcomes; and strong support at home and work. Stressors were: demanding non-clinical workloads; exhaustion from multiple commitments; a 'love/hate' relationship as trainees value clinical work but find the training burden immense; feeling 'on edge', even unsafe at work; and the changing way society sees doctors. Suggested recommendations for improvement include: having contracted hours allowed for non-clinical work; individuals taking responsibility for self-care in and out of work; cultural acceptance that doctors can struggle; and embedding wellbeing support more deeply in organisations and the specialty. Nearly all trainees discussed feeling some levels of burnout, which were high and distressing for some, and high levels of perceived stress. Yet trainees also experienced distinct elements of work-satisfaction and support. Our study provides a foundation for further work to inform organisational and cultural changes to help translate anaesthetic trainees' passion for their work, into a manageable and satisfactory career.