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Can compassionate leadership of senior hospital leaders help retain trainee doctors?
  1. Wen Wang1,
  2. Jennifer Creese2,
  3. Maria Karanika-Murray1,
  4. Kevin Harris3,
  5. Mark McCarthy3,4,
  6. Christopher Leng3,5,
  7. Christopher King5
  1. 1School of Business, University of Leicester, Leicester, UK
  2. 2Department of Population Health Sciences, College of Life Sciences, University of Leicester, Leicester, UK
  3. 3College of Life Sciences, University of Leicester, Leicester, UK
  4. 4University Hospitals of Leicester NHS Trust, Leicester, UK
  5. 5Northampton General Hospital NHS Trust, Northampton, UK
  1. Correspondence to Dr Wen Wang, School of Business, University of Leicester, Leicester LE1 7RH, UK; ww156{at}


Background High burnout and low retention rates among trainee doctors threaten the future viability of the UK medical workforce. This study empirically examined factors that can sustain trainee doctors.

Method A total of 323 trainee doctors from 25 National Health Service (NHS) Trusts in England and Wales completed an online survey on their training and employment experiences. A mixed method approach was employed.

Results Structural equation modelling revealed that perceived compassionate leadership of hospital senior leaders (CLSL) (i.e., doctors in senior clinical and management positions, and senior managers) is directly and negatively associated with trainee doctors’ burnout and intention to quit. We propose the associations may be indirectly strengthened through two mediating pathways: increased psychological contract fulfilment (PCF) of training/organisational support and reduced worry about the state of the NHS; however, only the former is supported. The model can explain a substantial 37% of the variance in reported burnout and 28% of intention to quit among trainee doctors. Being a Foundation Year (FY) trainee was significantly associated with poor PCF and burnout. Rich qualitative data further elaborated on their experiences in terms of senior leaders’ awareness of their training/working experiences, listening to and acting on.

Conclusions Active and demonstrable CLSL plays a vital role in trainee doctors’ retention. It has both direct (through support) and indirect effects through improving trainee doctors’ PCF to reduce burnout and intention to quit. This seems particularly valuable among FY doctors. Implications for the development and management of the medical workforce are discussed.

  • empathy
  • Senior medical leader
  • trainees
  • secondary care
  • management

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • X @DrWenWang

  • Correction notice This article has been corrected since it was first published. Acknowledgements section has been updated.

  • Contributors WW, MM, CL, MK-M, KH and CK conceived, designed and collected all data for the study. WW, JC and MK-M conducted the data analyses and interpretations. All authors participated in drafting, critical revising and final approval of the article. WW is the overall content guarantor.

  • Funding This work was supported by the British Academy Innovation Fellowship (grant number IF2223\230023).

  • Disclaimer The views expressed in this article are those of the author(s) and do not necessarily represent the views of the British Academy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.