If we want better training, we must support supervisors

Becoming a consultant is meant to feel like a step forward. More autonomy, more leadership and a chance to shape the next generation. But for some new consultants, one responsibility arrives before they feel ready: supervising a doctor who needs extra support.

This blog reflects on findings from my recent study in The Clinical Teacher, which explored what happens when new consultants are asked to supervise a doctor requiring additional support. When a doctor requires extra support, the challenges are often complex, ranging from performance concerns to wellbeing or professionalism issues. What emerges clearly is that supervision in these circumstances can be personally and professionally demanding for the supervisor.

Many new consultants described feeling unprepared for the role, even if they had received formal training. The theory didn’t always translate into practice. Supervisors found themselves navigating pastoral care, workforce processes and liaison with multiple stakeholders, often while still adjusting to the wider responsibilities of their new consultant role. It is not difficult to see how this combination can feel overwhelming.

One of the most striking findings was the inconsistency in support available for supervisors themselves. Some consultants described being given a name with no background information or structured handover. Others had more positive experiences, with clear information shared in advance and departments working collectively to support supervision.

Where systems were collaborative, with access to training leads, collegial advice and regular discussions, supervision felt more manageable. Where support was fragmented or difficult to access, the burden fell heavily on individuals. In practice, supervisors’ experiences are shaped not only by the resident doctor’s needs, but also by the support systems around them.

The impact on time from supervision was a recurring theme. Consultants described hours spent on emails, meetings, documentation and conversations with multiple stakeholders. Often, this went far beyond the time formally allocated in job plans.

Alongside the practical workload was the emotional burden of supervision. Some supervisors felt guilty about whether they were doing enough, or whether they were doing the right thing in the first place. Others described the emotional strain of supporting a struggling resident doctor, sometimes carrying that burden beyond the working day. Taken together, the study suggests something more concerning: this work can contribute to burnout, particularly for new consultants already navigating a challenging transition.

If we want to support resident doctors, we must also support those responsible for supervising them. This research points to several clear priorities:

• Better preparation: practical, meaningful experience of supervision needs to be embedded more effectively in training.
• Stronger handover processes: supervisors need clear, timely information about a resident doctor’s support needs.
• Protected time: job planning should reflect the real workload involved in supervision.
• Support networks: supervision should be a shared responsibility, not an isolated one.

There is also a broader cultural shift required. Supporting a doctor who is struggling should not be seen as an individual burden to manage alone. It is part of delivering safe, effective care, and it needs system-wide backing. We talk a lot about supporting resident doctors to thrive. But that ambition depends on supervisors who are equipped, supported and confident in their role.