One in five trainee doctors report hesitation in escalating care, GMC survey finds

More than one in five trainee doctors have felt hesitant about escalating patient care in the past year, according to new data from the General Medical Council (GMC). The finding—published in the GMC’s 2025 national training survey—raises concerns about clinical confidence and patient safety across NHS settings.

The annual survey, the UK’s largest of its kind, collected responses from over 71,000 doctors and trainers. For the first time, it included questions about escalation of care, a vital safety practice. While 79% of trainees said they never felt apprehensive about escalation, 21% admitted to hesitating at least once in the last 12 months. Rates were highest in high-pressure specialties such as surgery, medicine, emergency medicine, and obstetrics and gynaecology—approaching one-third.

• Burnout connection: Those who hesitated were significantly more likely to report symptoms of burnout, highlighting the urgency of creating psychologically safe environments for early-career clinicians.
• Training quality and supervision: Despite concerns, 76% of trainees rated their teaching as good or very good, and 87% praised their clinical supervision—suggesting that individual educator support remains strong even amid system pressures.
• Educator challenges: Rota gaps continue to undermine training consistency, with 29% of educators reporting a negative impact on their ability to deliver teaching.

Professor Pushpinder Mangat, the GMC’s Medical Director and Director of Education and Standards, called the findings “extremely concerning” and stressed that failure to escalate care in time can pose serious risks to patients.

“Doctors need to work in environments where they feel comfortable escalating,” he said. “The Government’s 10-Year Health Plan rightly recognises that a modern health service must empower its workforce and foster a culture of openness and safety.”

Professor Mangat added that the GMC would continue to share workforce insights to help address concerns, support innovation, and ensure every doctor can thrive in a system prepared for the future.

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