ObjectivesThis study aims to assess the prevalence of health problems (eg, insomnia, binge-eating, substance use and ill health) among UK doctors and to investigate whether occupational distress increases the risk of health problems.DesignThis study reports the analysis of data collected at the baseline stage of a randomised controlled trial (protocol #NCT02838290).SettingDoctors were invited through medical Royal Colleges, the British Medical Association’s research panel and a random selection of NHS trusts across various UK regions.Participants417 UK doctors with an equivalent split of gender (48% males) and seniority (49% consultants).Main outcomes and measuresOutcomes were sleep problems (eg, insomnia), alcohol/drug use (eg, binge-drinking), ill health (eg, backache) and binge-eating (eg, uncontrollable eating). Predictor variables were occupational distress (psychiatric morbidity, burnout, job effort, work-life imbalance, coping with stress through self-blame or substances) and work factors (workplace and years practising medicine).Results44% of doctors binge-drank and 5% met the criteria for alcohol dependence; 24%–29% experienced negative emotions after overeating and 8% had a binge-eating disorder; 20%–61% had some type of sleep problem and 12% had severe/moderate insomnia; 69% had fatigue and 19%–29% experienced other types of ill health problems. The results show that occupational distress and job factors increase the odds of doctors using substances, having sleep problems, presenting with frequent symptoms of ill health and binge-eating. For example, burnout increased the risk of all types of sleep problems, eg, difficulty falling/staying asleep, insomnia (OR ≥1.344; p≤0.036). Even taking into consideration whether or not a doctor works in a hospital, the risk of health problems still rises when doctors have signs of occupational distress.ConclusionEarly recognition of occupational distress can prevent health problems among UK doctors that can reduce the quality of patient care because of sickness-related absence.

Objective: High mortality from cancer and rising patient numbers can trigger distress among oncologists because of a heavy and emotionally demanding workload. This systematic review and meta-analysis assesses the prevalence of high levels of distress among oncologists. Methods:The PRISMA protocol is registered at the PROSPERO international prospective register (Ref. 2015:CRD42015016325). We categorized data items according to the following distress factors: burnout, psychiatric morbidity, stress, depression, disrupted sleep, stressinduced physical symptoms, and substance use. We meta-analysed the prevalence of burnout and psychiatric morbidity using random effects models with MetaXL software. Results:The meta-analyses showed that 32% of 4876 oncologists had high burnout (±CI 28% to 36%) and 27% of 2384 had high psychiatric morbidity (±CI 23% to 32%). Studies also showed that 42 to 69% feel stressed at work, > 12% of oncologists screen positive for depression, many oncologists suffer from sleep deprivation, up to 30% drink alcohol in a problematic way, up to 20% of junior oncologists use hypnotic drugs and some frequently experience stress-induced complaints such as ulcers, gastric problems, headaches and arrhythmia. Conclusions:Occupational distress reduces career satisfaction, affects patient care and increases the chances of oncologists switching to another area of medicine therefore future research should explore appropriate interventions.Keywords: stress, burnout, psychiatric morbidity, sleep, meta-analysis, oncology, cancer.

Prevalence studies show high levels of burnout, anxiety, fatigue and other symptoms of distress among medical doctors. However, there are very few randomized controlled trials testing interventions against these problems. This randomized controlled trial (NCT02838290; ClinicalTrials.gov, 2016) tested interventions teaching 227 doctors about the psychology of burnout, stress, coping with patient death, and managing distress, as well as giving them information about prevalence rates among doctors. Primary outcomes included burnout, anxiety, insomnia, grief, alcohol/drug use, binge eating, physical symptoms, and psychiatric morbidity. The outcomes were tested before and after the interventions with a 7day time-lag. The intervention significantly decreased doctors' levels of burnout (e.g. emotional exhaustion and depersonalization) and anxiety. Doctors in the control group had no significant changes in these signs of distress. The intervention did not significantly reduce other health and habit-related outcomes potentially because these need a longer time-lag than 7 days. Interventions teaching doctors about the psychology of work-related distress reduce burnout and anxiety by helping doctors realize that distress is a normal, human reaction to external stressors, common in medicine, and solvable by learning about psychological coping strategies.

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