Sources of work-related psychological distress experienced by UK-wide foundation and junior doctors: a qualitative study

Ruth Riley, Marta Buszewicz, Farina Kokab, Kevin Teoh, Anya Gopfert, Anna K Taylor, Maria Van Hove, James Martin, Louis Appleby, Carolyn Chew-Graham

Research output: Contribution to journalArticlepeer-review

115 Downloads (Pure)


OBJECTIVES: This paper reports findings exploring work cultures, contexts and conditions associated with psychological distress in foundation and junior doctors.

DESIGN: Qualitative study using in-depth interviews with 21 junior doctor participants. The interviews were audio-recorded, transcribed, anonymised and imported into NVivo V.11 to facilitate data management. Data were analysed using a thematic analysis employing the constant comparative method.

SETTING: NHS in England.

PARTICIPANTS: A purposive sample of 16 female and five male junior doctor junior doctor participants who self-identified as having stress, distress, anxiety, depression and suicidal thoughts, or having attempted to kill themselves.

RESULTS: Analysis reported four key themes: (1) workload and working conditions; (2) toxic work cultures-including abuse and bullying, sexism and racism, culture of blaming and shaming; (3) lack of support; (4) stigma and a perceived need to appear invulnerable.

CONCLUSION: This study highlights the need for future solutions and interventions targeted at improving work cultures and conditions. There needs to be greater recognition of the components and cumulative effects of potentially toxic workplaces and stressors intrinsic to the work of junior doctors, such as the stress of managing high workloads and lack of access to clinical and emotional support. A cultural shift is needed within medicine to more supportive and compassionate leadership and work environments, and a zero-tolerance approach to bullying, harassment and discrimination.

Original languageEnglish
Article numbere043521
Number of pages11
JournalBMJ open
Issue number6
Publication statusPublished - 23 Jun 2021

Bibliographical note

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.


  • Attitude of Health Personnel
  • England
  • Female
  • Humans
  • Male
  • Medical Staff, Hospital
  • Psychological Distress
  • Qualitative Research
  • United Kingdom


Dive into the research topics of 'Sources of work-related psychological distress experienced by UK-wide foundation and junior doctors: a qualitative study'. Together they form a unique fingerprint.

Cite this