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A case of iatrogenic stress? Results of the RCOG August rotation survey

Abstract Although there are a number of studies of patient safety during the August rotation, they often focus on newly qualified doctors. It remains unclear whether negative impacts are due to doctors’ inexperience, lack of technical skill or other aspects of rotation. This study used an electronic survey to seek the views of doctors working in obstetrics and gynaecology in the UK. A total of 1,879 responses were received. The August rotation was felt to be a stressful time, with a negative effect on patient care (82%) and safety (73%), lasting up to 1 month (62%). Although reducing services was thought to be helpful, there was strong support for staggering the rotation by grade (80%). This would ensure availability of doctors to cover services during the induction period, which should improve patient care and reduce staff stress. In addition, intensive skills training for junior staff and a supportive culture during the 1st month could optimise the integration and performance of doctors of all grades.