How do senior hospital doctors perceive their role in supporting junior colleagues with navigating ethical issues in end-of-life care?

OBJECTIVES: Newly qualified doctors look to senior doctors for support in dealing with the unique ethical challenges of end-of-life care. The aim of this study was to explore senior doctors' experience of supporting first-year and second-year resident doctors including the strategies used. METHODS: A qualitative descriptive design involved focus group interviews followed by inductive content analysis. RESULTS: 70 senior doctors from medicine, surgery, orthopaedics, geriatrics, palliative medicine, cardiothoracic surgery, neurosurgery and vascular surgery participated in 15 focus groups. Two themes explained the clinical reality of senior doctors who supervise junior doctors and how they support them. The first theme, Context: 'the job is brutal', details the pressure on and vulnerability of both senior and junior doctors. The second theme, Support: 'it is the human part we want to live, we also have the expertise', encompasses what senior doctors do and would like to do more of to support junior doctors. Meeting junior doctors on a human level and role modelling self-awareness and reflection are the most effective ways of support. The lack of value placed on these ways of support is a source of frustration. CONCLUSIONS: In the intense setting of the acute hospital, when dealing with ethical questions in caring for patients who are dying, junior doctors are challenged by their inexperience of mortality, personally and professionally. Senior doctors have much to impart from their years of experience and reflection. Recognising the value of senior doctor support is essential for the personal and professional well-being and growth of the next generation of doctors.