The medico-legal helpline: A content analysis of postgraduate medical trainee advice calls

Med Educ. 2020 Sep 15. doi: 10.1111/medu.14374. Online ahead of print.


Context: Available literature exploring medical liability and postgraduate medical education consistently posits that postgraduate trainees worry about their exposure to medico-legal liability. This assumption has formed the basis for research and curriculum development.

Objectives: The aim of this study is to use Canadian medico-legal data to describe the encounters that lead trainees to seek external guidance. This study will provide empirical evidence on trends and themes related to medico-legal advice requests from physicians-in-training.

Methods: Our primary dataset consisted of records of calls from physicians-in-training to the medico-legal help-line of the Canadian Medical Protective Association (CMPA), a national mutual defense organization providing medico-legal advice and liability protection for over 95% of Canada's physicians. We conducted a trend analysis of the frequency of calls for advice over 10 years from physician-in-training compared with non-trainee physicians. Furthermore, we performed a content analysis of calls made over the most recent 2 years (2016-2017) to elucidate the concerns that led to trainees seeking medico-legal advice.

Results: The 10-year trend analysis revealed that the annual growth in the number of advice calls from trainees (8.8%) exceeded other CMPA physician groups, and was in excess of trainee population growth over the same period. The content analysis identified 4 core themes: managing confidential information, complex care situations, academic matters, and patient safety incidents.

Conclusions: Our findings indicate that trainees are asking questions about their medico-legal liability with increasing frequency, and contribute new information as to the issues that lead to trainees seeking help. We believe that understanding trainees' medico-legal advice requests will support medical educators to tailor quality improvement education to learners' needs.