Trainee Support Service


Trainee Support Service (TSS)

Supporting trainees through training difficulty

It is widely understood that some postgraduate medical and dental trainees will experience health, behavioural, performance or educational difficulties during their training.    The Trainee Support Service (TSS) has been established to provide specialist support for doctors in training and dentists working across the north east and north Cumbria experiencing difficulty in a personal or health capacity which is affecting their ability to train and advising on any potential workplace adjustments.   The service is intended to provide information to the employer and HEE NE on how the individual can be supported to remain or return to the workplace.  This service will only be available to dental trainees and post foundation medical trainees of the HEE NE and not consultants, trust grade or non-consultant career grade post holders within the region.

It is envisaged that doctors in training needing long term support for health or wellbeing issues would access this through their General Practitioner. This guidance should be read in conjunction with the North East and north Cumbria Doctors and Dentists (in training) in Difficulty Guidance.


The purpose of the service is to:   

- support doctors in training to maximise their professional progression by providing them with the strategies and assistance to succeed in their training

- support those involved in the training structures to manage doctors in training with difficulties impacting on the workplace

- ensure a culture of support and development

- provide clear criteria for assessment and ensure consistent application of guidelines across the north east and north Cumbria

- ensure a responsible use of funding and resources

- support doctors in training during the process of leaving a training programme in the rare event that support and remediation are unsuccessful

TSS Overview

The Trainee Support Service consists of two main elements:

The Occupational Health Service will only be available to dental trainees (including dental foundation trainees), GP and specialty trainees.  Medical Foundation trainees will access Occupational Health Services from their employer.  The Occupational Health Service will provide a full pre-employment / placement screening service and operate in conjunction with the sickness absence policy of the Lead Employer Trust (LET). The service will provide the LET and TPD with details of how the doctor in training can be supported to remain or return to their training / work place.  The role of the service is to provide short term support to the trainee whilst they access longer term solutions and advise the LET/TPD on reasonable adjustments to the training environment that maybe considered.

Specialist services are available to provide initial support to trainees experiencing difficulties or symptoms of:

- Stress and anxiety

- Depression

- Emotional exhaustion/burnout

- Bereavement

- Relationship problems

- Abusive relationships

- Alcohol dependence

- Eating disorders

- Mental illness

- Other conditions e.g. dyslexia

Access to the specialist services listed above should be limited to 3 sessions to assist the doctor in training while their own GP is arranging any longer term solution.  The service will be confidential and detailed information will not be disclosed to the LET or HEE NE contact without the doctor in training's prior consent, unless there is risk to personal and/or patient safety or impact on the successful completion of their training.  In this situation notification of the outcome must be made to an agreed source. 

A request for an Occupational Health review should be made through the LET as the employer.  There is no self-referral process for doctors in training but information on the management of common musculoskeletal conditions, guides for common mental health conditions, control of infection queries or minor ailments is available through the website, email or telephone options listed below:


Telephone (0191) 282 1188 and selecting option 1. 

If a doctor in training experiences any potential exposure to blood born viruses through needle stick, bite or scratch injuries this should be reported initially to the host Trust Occupational Health service. They will carry out the appropriate assessment and inform the TSS service of the incidence. The TSS will coordinate the follow up care.

Any GP or dentist who sustains a needlestick injury should contact the TSS service by email or phone the advice line (0191) 2821188.  Doctors in training who think they may need PEP should attend their local Emergency Department in their host Trust and inform TSS the next day who will provide continued support.


The Educational Support Service provides access to confidential coaching services, advice and educational support in the following areas:

- Communication skills

- Personal effectiveness / prioritisation / delegation

- Receiving and working with feedback                 

- Working in teams

- Confidence and decision making

- Leadership skills including assertiveness

- Developing resilience


What is coaching?

Coaching is essentially a series of structured conversations over a time limited period where the coach aims to help the coachee achieve a mutually identified set of goals to improve performance and/or development.  It is a voluntary, confidential one to one relationship which aims to encourage the individual to reach solutions for themselves.  

More information on coaching can be found here: What is coaching and what should I expect?

It is envisaged that trainees needing long term support for health or wellbeing issues would access this through their General Practitioner.

How to refer a doctor in training

Referral to the Educational Support Service (ESS) should be made by either the Head of School, Training Programme Director or Lead Training Programme Director and channeled via the School Manager.  We recommend that referral forms are completed in liaison with the doctor in training to ensure full understanding and acknowledgement of the reasons for the referral and support request.  There is no self-referral process but doctors in training may access confidential coaching outside the Educational Support Service via Coachnet.


The Senior Business Manager (Learner Support and Faculty Development) will review the referral and either identify a suitable coach from the regional network or meet the doctor in training to review the issues and identify appropriate action. 

Level 1 concerns/ issues – Supervisor with support if required from TPD

Level 2 – Supervisor and TPD with advice if required from TSS

Level 3 – TPD/Head of School/Supervisor/TSS


Management of issues that could be described as not serious and not repetitive.

Management of ongoing issues with no evidence of improvement.

Management of persistent or significant issue unlikely to be resolved at a local level.

Examples could include some absent portfolio documents, some gaps in knowledge or skills, reported minor non-clinical skills gaps, occasional miscommunication or delay in acquiring areas of professional competence e.g. exam failure.  Issues at this level are likely to be best addressed at local level.  


Examples could include continued failure to complete work place based assessments, problems with generic skills such as team working or professionalism, health/disability matters requiring specialist help, repeated exam failure.   Issues at this level are best addressed at local and School level.


Examples could include failure to engage with the educational process for the specialty, unsatisfactory progress (e.g. ARCP outcome 3), repeated patient or staff complaints that suggest performance, conduct or behavioural problems, serious disciplinary issues, involvement in serious untoward incidents.  Issues at this level may benefit from referral to ESS.


CoachNet -self-referral coaching for all

NELA provides a one-to-one confidential coaching service to NHS staff throughout our region.  People find coaching useful when experiencing issues that are affecting performance and personal effectiveness.  Coaching helps to address issues such as leadership, organisational skills, confidence and assertiveness, work/life balance and many more.   Coachees simply select their preferred coach and make direct contact with the coach. 

Support for Doctors

If you or a colleague is looking for support there are a range of organisations, services and websites which can offer help.

For information visit: 

 Academy of Medical Royal Colleges 

Also see the blog below for the rational for the support.

Blog: Professor Carrie MacEwen


Sudden Death in Doctors in Training

For information visit:

Health Education England