article · African Journal of Primary Health Care & Family Medicine
Junior medical interns working in rural and regional district hospitals experience high-pressure, emotionally charged workplace encounters with clinical supervisors, colleagues, and patients. These intense situations trigger distressing emotional responses, including anxiety, frustration, and helplessness. When left unregulated, these feelings directly impair intern well-being, clinical performance, and patient care delivery. In response to unmanaged stress, junior doctors report engaging in counterproductive behaviours, such as abrupt communication, avoidance, and a reluctance to seek necessary guidance from senior staff. To mitigate these adverse outcomes, interns report a clear requirement for formal emotional competence training within undergraduate medical curricula. Additionally, there is a recognised need for targeted institutional programmes that provide ongoing emotional support to healthcare practitioners navigating high-stress rural clinical rotations.
Unaddressed emotional stress among junior clinicians directly threatens patient safety, service delivery, and doctor retention in underserved rural areas. Understanding the psychological toll of clinical encounters highlights the necessity for medical schools and healthcare institutions to integrate emotional skills training and formal support structures, helping ensure clinicians deliver safe, compassionate care in high-pressure environments.
This early-stage exploratory research points to the development of structured emotional competence training curricula and institutional support programmes for medical schools and hospital networks. Potential users include healthcare educators, training hospitals, and medical regulatory bodies seeking to improve clinician retention and patient care. Because the findings are qualitative and based on twelve interviews, practical interventions remain at a conceptual stage and require formal design, curriculum integration, and testing before real-world adoption.
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BACKGROUND: Junior doctors experience high-pressure emotional interactions, often with limited support during their rural hospital rotation. Little is known about the effect of such encounters on the emotions and behaviour of clinicians. AIM: This study explores the experiences of interns during emotionally charged encounters in the workplace with clinical supervisors, colleagues and patients. SETTING: The study was conducted in a one regional and three rural district hospitals. METHODS: A qualitative exploratory study was conducted using semi-structured interviews with 12 interns undergoing training in the Eastern Cape, South Africa, between May 2024 and August 2024. A purposive sample of second-year medical interns who had completed a 2-month rotation in a rural district hospital setting was interviewed. Data were coded and subsequently analysed thematically. RESULTS: Three themes emerged: 'being a doctor in an emotionally charged clinical environment', 'the emotionally competent doctor' and 'the emotional support needs of junior doctors'. Emotionally charged clinical encounters elicited strong, distressing emotions in interns, including anxiety, frustration, and feelings of helplessness, which affected their well-being, service delivery, and clinical performance. Unregulated emotions resulted in counterproductive behaviours, such as abruptness, avoidance, or reluctance to seek guidance. Participants expressed a need for structured emotional competence (EC) training and additional emotional support. CONCLUSION: Junior doctors face emotionally charged encounters in their clinical practice. Unregulated emotions may drive counterproductive behaviours, affecting service delivery and patient care. Effective educational activities need to be developed to support the development of EC in undergraduate medical education. A programme targeting the emotional well-being of doctors, especially junior doctors, could provide additional support.Contribution: Identifies a need for EC training of doctors.
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DOI: 10.4102/phcfm.v18i1.5435
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