**Background:** Gastroenterology was identified as one of the major physician specialties at highest risk of burnout even before the COVID-19 pandemic. The pandemic placed additional service pressures on an already overextended workforce, with increased elective endoscopy and outpatient waiting lists. The British Society of Gastroenterology (BSG) Workforce Report 2021 had already warned of inadequate consultant number expansion to address mounting service demands. This survey aimed to understand the consequences of the pandemic and post-pandemic recovery phase on workload, well-being, and workforce attrition in UK gastroenterology and hepatology.
**Methods:** This nationwide cross-sectional survey was commissioned by the BSG Supporting Women in Gastroenterology (SWiG) committee and authorized by the BSG Executive committee. A 23-item survey was distributed electronically to all physician and trainee members of the BSG via emailed newsletter and social media, remaining open from 18 August 2021 to 1 October 2021. Statistical analysis was performed using SPSS V.25.0. Non-parametrically distributed continuous variables were reported as medians with IQRs, with group differences tested using Mann-Whitney U tests. Categorical variables were described as raw numbers or percentages with group comparisons using χ² tests. Multivariable binary logistic regression models included confounding demographic variables and were expressed with odds ratios (OR) and 95% confidence intervals (CI). P values <0.05 signified statistical significance. Free-text responses were qualitatively explored using thematic analysis.
**Key Results:** There were 180 responses (response rate 28.8% of those who opened the email; 8.8% of all BSG physician members). 38.2% (n=21/55) of those who contracted COVID-19 felt pressured to return to work before they felt ready. 43.8% (71/162) had a regular increase in out-of-hours working. On multivariable logistic regression, this was independently associated with newly appointed consultants (OR 5.8, 95% CI 1.15–29.5, p=0.033), full-time working (OR 11.6, 95% CI 2.26–59.3, p=0.003), personally developing COVID-19 (OR 4.1, 95% CI 1.49–11.2, p=0.006), and planning early retirement (OR 4.0, 95% CI 1.55–10.56, p=0.004). 92% (150/164) believed the workforce is inadequate to manage the service backlog; new consultants expressed the highest median anxiety level at 84.5 (IQR 76.3–92.0) on a 0–100 Likert scale. 49.1% (80/163) felt isolated due to remote working, and 65.9% (108/164) felt reduced face-to-face patient contact made their job less fulfilling. 34.0% (55/162) planned to work more flexibly, and 54.3% (75/138) of consultants planned to retire early. Early retirement was independently associated with male gender (OR 2.5, 95% CI 1.1–65.4, p=0.023), feeling isolated from the department (OR 2.3, 95% CI 1.1–4.5, p=0.023), and increased anxiety over service backlog (OR 1.02, 95% CI 1.01–1.04, p=0.003). 30.7% (55/179) had personally developed COVID-19, with Black or Minority Ethnic respondents disproportionately affected (46.4% vs 25.0%, p=0.023). 73.9% (105/142) had accessed or been made aware of well-being resources.
**Clinical Implications:** The pandemic has placed an additional burden on work-life balance, well-being, and workforce retention within gastroenterology and hepatology. Over half of consultants surveyed planned early retirement, and the vast majority believed the workforce is inadequate to address service backlogs. Newly appointed consultants, full-time workers, and those who contracted COVID-19 were disproportionately affected by increased out-of-hours working. The study highlights the need for mentoring and peer-support schemes, increased workforce numbers, effective job planning supporting flexible working and phased retirement, protected time for professional development, and reduced general medicine commitments. The authors note limitations including a low response rate, potential selection bias with over-representation of women and those aged 55+, and under-representation of Black and Minority Ethnic consultants. Despite these limitations, the findings highlight critical lessons for future workforce planning.