Exploring the experiences of junior doctors who were shielding during the COVID-19 pandemic: a qualitative study of semi-structured interviews

Lancet. 2023 Nov:402 Suppl 1:S68. doi: 10.1016/S0140-6736(23)02084-6.

Abstract

Background: The term "Shielding" was introduced in the UK during the COVID-19 pandemic to protect approximately 4 million people at highest risk from infection. Shielding was characterised by extreme isolation and applied to those with certain illnesses, disabilities, and during pregnancy. For the estimated 1300 high-risk doctors, shielding meant abrupt departure from the clinical environment. We aimed to understand the impact of shielding on junior doctors (JDs) by interviewing them and their consultants.

Methods: This qualitative study used individual semi-structured interviews and reflexive thematic analysis. Virtual interviews were conducted between Sept 2, and Nov 30, 2022, using an interview guide, including open questions around impacts on training, career, and health. 11 JDs and 2 consultants were recruited via Scotland-wide purposive and snowball sampling. Written informed consent was obtained. 12 of 13 participants were women. Eight JDs were shielding because of health issues, and three because of pregnancy. Participant specialties included primary care, secondary care, and foundation and specialty training. Interview transcripts were coded by the lead author and the second author acted as a critical friend.

Findings: Despite making important contributions working from home, most JDs (73%, eight of 11) felt that their work was undervalued during shielding. They felt forgotten, feeling they had to "pester" supervisors to be allocated work. All participants reported inadequate support at Occupational Health and workplace levels, including limited supervision or information about training impacts. Negative attitudes towards JDs were experienced by 82% (nine of 11) of JDs, including being denied reasonable adjustments and threatened with dismissal if not following shielding advice. Consultants described supervisory challenges including not receiving guidance or resources and ongoing issues supporting disabled and pregnant JDs beyond the pandemic.

Interpretation: These findings offer novel qualitative insight into the impacts of shielding on JDs in Scotland. Findings indicated that support infrastructure was not fit for purpose. Given the significant number of JDs that take prolonged leave from the clinical environment, and the JDs working with disabilities and during pregnancy, these findings are of ongoing concern. Although the sample size was small and the study was set in a specific region, these findings suggest there is potential to improve support infrastructure and move towards a more inclusive clinical environment that recognises, celebrates, and benefits from the value of a diverse workforce.

Funding: Scottish Medical Education Research Consortium.

MeSH terms

  • COVID-19* / prevention & control
  • Female
  • Humans
  • Male
  • Pandemics
  • Physicians*
  • Pregnancy
  • Qualitative Research
  • Scotland