'What is 'wellbeing' to doctors in training, and how do we improve it? Results of a quantitative survey and thematic analysis of internal medicine trainees.

Introduction: The wellbeing of medical trainees has come into sharp focus in recent years, particularly since the COVID-19 pandemic. Workforce pressures are well documented, as is the need to retain staff. There are a number of initiatives to try and improve the wellbeing of staff, including the introduction of wellbeing and education dellows for stage 1 internal medicine trainees in some regions. We recognise that there is often a gap between what is offered and what is wanted or accessed by trainees. Objective: This work aims to identify what 'wellbeing' means to this group of staff, and to provide evidence for interventions that they would find useful. Methods: We distributed a survey to the target group of staff in London, followed by a series of structured interviews and focus groups. We used a practical thematic analysis to explore the determining factors of trainee wellbeing. Results: 156 trainees responded to the survey, and 15 participated in the interviews and focus groups. Seven themes were identified: culture, helplessness and distrust, individual circumstances, physiological needs/safety, rotas and work patterns, stress at work, and value. Conclusion: This study identifies several key factors related to medical trainee wellbeing. To our knowledge, it is the first looking specifically at stage 1 internal medicine trainees in the UK.