DE06 The impact of dermatology Specialty Certificate Examinations preparation on trainee wellbeing and financial burden: a mixed-methods survey study

Abstract

Burnout is an increasing problem among medical trainees, driven by rising training costs, hidden examination expenses and significant psychosocial pressures. The 2025 General Medical Council National Training Survey reported that 56.1% of dermatology trainees were at moderate-to-high risk of burnout. A paucity of research exists to explain why; however, it is widely assumed that the dermatology Specialty Certificate Examinations (SCE) impact wellbeing and finances, alongside personal and professional outcomes. A comprehensive understanding of SCE candidate behaviours can identify these issues and assist in supporting trainees. This study sought to evaluate the impact of preparation for the dermatology SCE upon trainees, focusing on wellbeing, burnout and financial burden. A cross-sectional electronic survey was distributed to doctors who had completed the dermatology SCE within the past decade or were preparing for the 2025 sitting. Survey items explored dedicated preparation period characteristics, resource expenditure and perceived financial strain – measured using Likert scales. Open-ended responses were analysed by thematic analysis. Fifty respondents completed the survey; 44% passed the SCE, while 20% had previously failed. Preparation commonly involved question banks, web resources and national courses, yet only 62% felt confident in their resources. Most studied for 16–24 weeks, averaging 19 h weekly. Although preparation improved dermatology knowledge and clinical confidence, it coincided with substantial detriments to wellbeing – including burnout, low mood and disrupted work–life balance. Financial strain emerged as a major determinant of adverse outcomes; those reporting high financial burden experienced markedly higher burnout, anxiety and reduced quality of life. Limited institutional support, difficulty accessing study leave and reliance on personal time and finances were frequently reported. While SCE preparation offers educational value, it imposes considerable psychological and financial pressures. The high-stakes format and inconsistent institutional support appear to intensify distress. Structural reforms are needed to reduce inequity, alleviate financial burden and embed preparation within training pathways.