Counselling for Doctors: Confidential Support and Your Options
Doctors are trained to look after other people and to keep going. Many find it much harder to be on the other side, as the person asking for help. By the time a doctor reaches out, they have often been struggling for a long time, carrying on at work while things quietly got worse.
If that is where you are, this guide is for you. It looks at why doctors so often put off getting help, what the GMC actually needs to know, the confidential support available, and what to look for if you decide to see a counsellor privately. I have worked in the NHS myself, and with NHS staff as clients. Most of what follows applies whether you are a medical student, a resident doctor, a GP or a consultant.
Why doctors put off getting help
The reasons are familiar, and none of them are a sign of weakness.
- The culture. Medicine has long rewarded endurance. Many doctors learned early that struggling was something to hide.
- Fear for your career. Worries about the GMC, about references, or about being seen as unreliable stop many doctors from saying anything at all.
- It's too close to home. You may know the people who run local mental health services, or have trained alongside them.
- Self-diagnosis. It is easy to talk yourself out of needing help when you know the criteria and can always find someone worse off.
- No time. Rotas, on-call and exams leave little room for appointments.
- Not knowing where to go. The support for doctors is spread across many organisations, and it is hard to know which one fits.
What the GMC needs to know
This is often the biggest worry, so it is worth being clear.
The GMC says it only needs to be made aware of a doctor's health condition if it poses a risk to patients (GMC). Having counselling for burnout, stress, low mood or a difficult case does not, in itself, mean anything needs to be reported.
Getting support early is usually the best way to protect both your health and your practice. Your defence organisation or the BMA can give you advice on your own situation if you are unsure.
Free and confidential support for doctors
There is more support available than many doctors realise. These are some of the main services. Many also offer wellbeing resources and signposting beyond counselling itself.
BMA counselling and the Doctor Advisor service
The BMA runs a free, confidential counselling line, open 24 hours a day, and a Doctor Advisor peer support service. Both are open to all doctors and medical students in the UK, whether or not you are a BMA member (BMA). Its counsellors are BACP members.
NHS Practitioner Health
Practitioner Health is a free, confidential NHS service for doctors and dentists with mental health or addiction problems, independent of employers and regulators. The GMC describes it as available to all doctors in England and Scotland (GMC). Counselling for NHS staff explains more about who can use it and its limits.
DocHealth
DocHealth is a confidential, not-for-profit service offering psychotherapeutic consultations to doctors anywhere in the UK, delivered online by consultant medical psychotherapists. Fees are on a sliding scale based on your grade and circumstances (DocHealth).
Peer groups
Doctors in Distress runs confidential facilitated groups where doctors support each other. The Doctors' Support Network is a peer support network for doctors and medical students with mental health concerns. Talking with people who know the job from the inside can help in a way nothing else does.
Help for doctors in training
Resident doctors can contact their deanery's Professional Support and Wellbeing service, which can help with exams, rotations, health and difficult situations at work.
Your trust's services
Most trusts have an employee assistance programme, occupational health and sometimes a staff psychology service. These are free and quick to reach, though usually short-term.
When private counselling makes sense
The free services do a great deal of good, but they don't suit everyone. Many choose to see someone privately when they:
- want no connection at all with the NHS organisations they work in or might work in later
- need longer-term support than a brief service can offer
- want to choose the counsellor themselves, and change if it doesn't feel right
- want specialist trauma therapy, such as EMDR, after a particular case or incident
Online sessions make it easier to see someone well away from your area, so you are unlikely to cross paths professionally. How online sessions work explains what is involved.
What doctors bring to counselling
Everyone's reasons are different, but some themes come up often.
- Burnout. Exhaustion, cynicism and feeling you are no longer good at the job, even when colleagues would say otherwise. Burnout in the NHS looks at this in more detail.
- Incidents and complaints. A patient death, a serious incident, a complaint or an investigation can leave doctors with intense guilt, self-doubt and anxiety. Second victim syndrome describes this experience.
- Moral injury. Not being able to give the care you know a patient needs, because of beds, time or staffing.
- Perfectionism and self-criticism. The traits that get people through medical school can turn against them later.
- Life outside work. Relationships, family pressures and the strain of rotations and relocations.
- Being a patient. Many find it uncomfortable to be on the receiving end of care, and put off seeing their own GP. Your own wellbeing matters as much as your patients'.
- Career decisions. Whether to stay in a specialty, go part time, or leave medicine.
Pressures at different stages of a medical career
Medical students. Heavy workloads, exams and a culture of comparison can take a toll early. Many students worry that admitting to struggling will follow them into their careers.
Resident doctors. Rotations mean moving hospitals, sometimes cities, every few months. That can leave you without settled support at work or at home, just as the responsibility and hours increase.
GPs. High list sizes, short appointments and the weight of carrying risk in the community can leave GPs feeling they are always behind.
Consultants and senior doctors. Senior roles bring responsibility for teams, services and difficult outcomes. Complaints and investigations often land hardest at this stage, and senior doctors can feel there is nobody above them to turn to.
What counselling is like
The first session is mostly about getting to know each other. You talk about what has brought you, what is happening at work and at home, and what you would like to be different. You don't need to arrive with a diagnosis or a plan.
In person centred counselling, I don't tell you what to do. You spend your days giving advice and making decisions for others, and it can be a relief to have a space where you can think out loud without being assessed. Together we try to understand what is going on for you, and what you need.
If a particular case or incident keeps coming back to you, EMDR may help with the memory itself. We can talk about whether it might suit you, and go at your pace.
Choosing a counsellor as a doctor
A few things are worth checking.
- Registration. Choose someone on a professional register, such as the BACP or UKCP.
- Any professional connection. Ask whether the counsellor has any link to your trust, your deanery or the organisations that might refer to them.
- Notes and confidentiality. Ask what is written down, where it is kept, and in what circumstances anything would be shared.
- Experience. Ask whether they have worked with doctors or other healthcare staff. You shouldn't have to explain the basics of the job.
Some worry that a counsellor will be intimidated by them, or that they will need to perform being a good client. You don't. A good counsellor will treat you as a person first, not as a doctor.
In my own work, I don't share anything with your employer, occupational health or the GMC without your agreement, unless there is a serious risk to you or someone else.
Frequently asked questions
Will the GMC find out if I have counselling?
Not from me. I don't share anything without your agreement, unless there is a serious risk to you or someone else. The GMC says it only needs to know about a health condition if it poses a risk to patients.
Should I see my own GP?
Your GP can help, including with medication and time off if you need it. Some prefer to register with a GP outside the area where they work, so that their care is separate from their professional life.
Can medical students get support?
Yes. The BMA counselling and peer support services are open to medical students, and most medical schools have their own student support services.
Can I have counselling during a GMC investigation?
Yes. Many find support helpful while a complaint or investigation is going on. Your defence organisation can advise you on the process itself. Counselling is a separate, confidential space for how it is affecting you.
How many sessions will I need?
It varies. Some people find a few sessions are enough to get through a difficult patch. Others want longer to work through something that has built up over years. We review how things are going together, and you can stop at any time.
What if I'm in crisis?
If you are thinking about harming yourself, contact your GP urgently, call NHS 111, or call Samaritans on 116 123 at any time. In an emergency, call 999.
Talking to someone
I'm a BACP registered counsellor offering person centred counselling and EMDR therapy in Nottingham and online. If you would like to ask whether I might be the right fit, you can get in touch before committing to anything.