David Oliver: Supervision and clinical autonomy for junior doctors—have we gone too far?

Doctors in training grades can gain experience ranging from independent, lightly supervised practice to a more constant, “helicopter” presence of consultants directing most decisions.1 Is the current balance right, or has it tipped too far towards the hands-on boss? Helping junior doctors to feel ready for more senior, unsupervised roles as they ascend the training ladder means allowing them to work more in difficult scenarios involving team leadership, autonomy, and risk acceptance.2 If opportunities to step up are limited, the lack of opportunity becomes self reinforcing as doctors lack the confidence to take on more senior roles. In adult internal medicine specialties, surveys have shown that doctors are very concerned about their capacity to take on medical registrar roles. This isn’t just because of …