Junior doctors can do a lot to add value to the health services, but they are a demotivated lot as they feel that their contribution is not valued.
The findings prompt the authors to conclude that junior doctors are "an untapped NHS resource," at a time when the NHS needs to draw on all the help it can get.
The authors emailed an online questionnaire to 3766 doctors in training, from their first year after qualifying (foundation year 1) to pre-consultant level in one of the 10 strategic health authority regions in England (South Central region).
Among other things, the doctors were asked a range of questions about their working life, including their views on their role and future. In all, just under 1500 doctors replied, giving a response rate of just under 40%.
Most (89%) respondents said it was "extremely" or "very important" to feel part of a team in their organisation, with a similar proportion answering that doctors needed to be effective leaders to "a very great" or "great extent."
But despite nine out of 10 respondents (91%) saying that they had ideas for ways to improve services, only one in 10 (10.7%) said they had had their ideas implemented.
Overall, more than four out of 10 (just under 44%) had tried and failed to get an idea implemented or felt unsure how to go about it.
When asked how valued they felt, overall, more than 83% said "not valued at all" or only "sometimes valued."
More than three out of four (just under 78%) felt undervalued by their chief executive, a similar proportion (77%) felt undervalued by their employing organisation, while 79% felt undervalued by the NHS as a whole.
While three quarters did feel highly valued by their non-consultant medical colleagues, almost 60% said they did not feel equally valued by senior consultant colleagues.
The authors say that their findings indicate that junior doctors are adapting to new roles within the NHS, but feel unable to realise their full potential as agents of change.
They point out that junior doctors' frequent rotations between different hospitals, organisations, and specialties enable them to readily spot good and bad practice, and that all doctors on the front-line have a key role in improving the quality of care.
"We have demonstrated that the junior doctor medical workforce has both the desire and the ability to start contributing to improvement in the NHS, but feels that the environment in which they work is not sufficiently receptive to their skills," write the authors.
And they conclude: "If the government is to achieve the aim of improving productivity and quality in the NHS on a restricted budget then all employees need to feel valued and engaged to optimise organisational performance."