Training
required for revalidation, educational roles are often allocated only nominal time relative to workload. With fragile structures such as these, educating trainees becomes dependent on goodwill. Access to the independent sector remains a
critical issue. For doctors in craft and procedural specialties, adequate operative exposure is non-negotiable. Structural barriers preventing trainees from accessing independent-sector cases must be addressed if procedural competence is to be guaranteed. At the same time, the rigidity of current training models, particularly the limited scope for part-time pathways, requires reform so that trainees are not forced to choose between progression and sustainability.
Impacts on health All these factors have a significant impact on surgical trainees’ mental and physical health. Approximately 76.8% of trainees reported that surgical training physically impacted their physical health, including issues such as musculoskeletal problems, exhaustion, poor diet, and lack of exercise, while 84.3% indicated an adverse effect on their mental health, such as burnout, and stress from job responsibilities, training demands, and the recruitment process. 18.1% of those who reported physical health issues, and 23.3% of trainees who reported mental health issues, had to take sick leave. 90% of surgical trainees reported burnout - that’s 9 out of every 10 trainees experiencing conditions
90% >40% 63%
of surgical trainees report burnout
of surgical trainees have considered leaving surgery
of female trainees reported harassment from colleagues
so poor that their mental health is affected. Almost half (over 40%) have considered
leaving surgery. 8 out of 10 regularly work beyond contracted hours, and 1 in 3 skip meals during shifts. The report also highlighted increased incidences of pregnancy complications among surgical trainees: 31% experiencing major complications, compared to just 9% of the general population. This could be due to over 70% of pregnant trainees continuing to work night shifts or more than 40 hours a
It is shocking and saddening that training to become a surgeon comes along with such personal sacrifices; this is an unsustainable human cost. ASiT President, Raiyyan Aftab
week throughout pregnancy. On the subject of parenthood, a significant number of trainees reported delaying parenthood due to the demands of training: 56% of childbearing trainees and 40% of non- childbearing trainees. And pressures following returning to work after having children are an issue, with 61% of breastfeeding trainees reporting inadequate workplace provisions for breastfeeding when they returned to work. Sexual harassment in the surgical training setting is a serious concern, with 63% of female trainees reporting they have experienced harassment from colleagues. The ASiT report documents 11 reported incidents of rape at work in surgical settings. It is also clear that disparities in surgical training pathways are a key issue, highlighting systemic challenges in recruitment and assessment outcomes for minority groups. Discrimination and misconduct should not be the norm, nor should they be acceptable in any form in any workplace; therefore, creating and maintaining an inclusive, safe learning environment is a priority. The Confederation of British Surgery’s clinical
psychologist-in-residence, Dr. Richard Sherry, says: “The findings of the report speak to the real practical, physical, and emotional impact of training surgeons’ experience when proper care is not put into these trainees’ wellbeing. 76.8% in ASiT stated that training has had a negative impact on them, and an even greater number, 84.3%, have said that their mental health has suffered directly as a result of their surgical training. These are alarmingly high numbers in the population sample, communicating that these are not healthy occupational environments.” ASiT President, Raiyyan Aftab says: “It is
apparent that every surgeon is sacrificing something on their training journey. It is shocking and saddening that training to become a surgeon comes along with such personal sacrifices; this is an unsustainable human cost. We are calling for immediate change - for NHS leaders, policymakers and training bodies to consider and address this non-financial cost of training before we lose more talented surgeons. Surgical trainees always put patient care first - but who’s looking after surgical trainees?”
Calls for change So, what could change look like? The ASiT report is clear that reform cannot be piecemeal. It calls for urgent action across postgraduate medical education and training, beginning with measures to relieve bottlenecks at every stage of the pathway and to introduce meaningful flexibility into training structures. That flexibility must extend beyond rhetoric. It requires addressing the rigid divide between formal training posts
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www.clinicalservicesjournal.com I April 2026
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