Doctor health, burnout and impairment — structured clinical viva

This viva tests whether the candidate can use precise occupational-health language, protect patients, avoid DSM misclassification of burnout, and hold both compassion and governance.^[1][4]

Definitions. Name the Maslach triad. State ICD-11 occupational framing. Distinguish impairment (unsafe practice capacity) from burnout and from major depression. Link near-miss error to the known association between burnout/wellbeing and reported medical error / unit safety grades.^[1][5]

Differential. Exhaustion after nights may be burnout/fatigue, but passive SI after a complaint forces full psychiatric risk assessment. Screen SUD, anxiety, trauma, and bipolar features as indicated. Do not stop at “resilience deficit.”^[1][3]

Management. Immediate safety and possible duty restriction; confidential treatment pathway; organisational roster and culture fixes; evidence that organisation-directed interventions often outpace individual-only programmes.^[2][6]

Suicide. Physicians are an at-risk group; classic meta-analysis showed elevated rate ratios, especially for women physicians. Ask directly; arrange crisis care when needed.^[3]

Impaired consultant. Remove from duties if intoxicated; escalate; PHP/support; mandatory reporting principles without inventing sections; loyalty never outranks safety.^[4]