Anxiety

Anxiety in a Trainee Doctor

A dermatology specialty registrar (ST 3) was diagnosed with generalised anxiety disorder, by her GP. She was finding undertaking clinic work very stressful and so also self-referred to occupational health. She had high internal standards and never felt that she was good enough at her job, despite satisfactory educational feedback. She had recently returned to work from maternity leave.

Following an initial assessment, various measures were advised to support and enable her to continue her work and training. With her consent, her clinical supervisor was contacted and a plan to allow her to pace her work was agreed. She was advised to take five minute breaks between each patient in clinic. This helped her look through the notes to prepare her thoughts for the next patient. The consultants emphasised that they were available to discuss any case that she felt unsure of. Her supervising consultant offered to review her clinic letters in order to make sure that there was a ‘safety net’ with regard to the quality of clinical letters.

To help with her sense of agitation, she was instructed on relaxation techniques. She self-referred to NHS Practitioner Health, a confidential consultation service for all doctors working in London, where she received cognitive behavioural therapy,  which has been shown to be very effective for her condition. She was also encouraged to seek the support of her spouse and parents regarding childcare and household chores, to help alleviate non-workplace stresses. Positive and constructive feedback from her colleagues and seniors gradually brought about improvements in her confidence levels with time.