Doctors in training still overworked, bullied

The second national Medical Training Survey (MTS) shows doctors in training are continuing to be affected by excessive hours, unpaid overtime, and bullying and harassment in the workplace.

Almost 22,000 doctors in training – more than half of all trainee doctors in Australia – took part in the Medical Board of Australia survey, which was conducted late last year.

While most trainees rated their training experience highly, one in five reported experiencing bullying, harassment or discrimination, and almost one in two reported an excessive workload.

“It was pleasing that the overwhelming majority of trainees rated their training experience highly in the 2020 survey, despite interruptions due to COVID-19,” AMA President, Dr Omar Khorshid, said today.

“This is a testament to the high quality of training in Australia and the commitment from supervisors, Colleges and senior medical staff to supporting trainees during this challenging time.

“However, the results show we have more work to do to address long standing issues we know we can do better on - unpaid overtime and excessive hours being worked, the absence of a structured learning experience for prevocational trainees and, most importantly, stamping out bullying and harassment, which is still a big issue in medicine and health.

“It’s time for State and Territory health departments to get serious about valuing the time doctors in training spend learning and providing excellent patient care by reviewing and providing appropriate staffing and adopting better rostering practices.

“It’s also time for employers to get on board and improve their workplace culture. They have a legal responsibility to provide a safe workplace for all employees.”

The survey found that only half of all respondents reported being paid for unrostered overtime all or most of the time.

“Turning a blind eye to practices that allow doctors to work excessive hours of unpaid, unrostered overtime is not only inefficient and unproductive, but puts patient care and doctor wellbeing at risk,” Dr Hash Abdeen, Chair of the AMA Council of Doctors in Training (CDT), said.

“We need to explore the reasons why this is happening. Are there tasks that doctors are doing that contribute little to learning and could be transferred to other staff? Have rostering and staffing practices been reviewed?

“This survey again sees doctors in training reporting unacceptable levels of bullying and harassment and fear of reporting it. This is particularly the case for our Indigenous colleagues.

“It’s just not good enough in 2021. We need to start calling this out for what is and creating safe systems for reporting, and mechanisms that demonstrate visible action and support all those involved.”

Only two out of five prevocational and unaccredited trainees reported having a training or professional development plan, and this cohort was more likely than other trainees to report having to compete with other doctors to access teaching and development opportunities (53 per cent).

“A structured learning experience is vital in preparing doctors in training for future medical practice,” Dr Abdeen said.

“Prevocational and unaccredited trainees are particularly vulnerable to being taken advantage of as they don’t have the protections offered to those in an accredited training program.

“The AMA has called for all prevocational training places to be accredited. We know it can be done and we need to start sharing our experiences.”

Doctors in specialist training also reported issues with exams, transparency, and alignment with College curriculum.

“The impact of COVID-19 on training provides us with an opportunity to review the suitability of one-off, high stakes, barrier exams as an assessment tool for progression to Fellowship,” Dr Abdeen said.

“This type of assessment places significant stress on trainees, and the lack of transparency in costs associated with training is an ongoing area of dissatisfaction for trainees.

“The time is right to start a conversation about alternative methods of assessment and what that might look like.”

The results of the Medical Training Survey are consistent with the AMA Doctor in Training Hospital Health Checks run each year in States and Territories around the country.

The survey is available on the Medical Training Survey website.

Background

• 21,851 doctors in training across the profession completed the survey.
• 81 per cent said they would recommend their current training position to other doctors.
• 81 per cent said they would recommend their current workplace to other doctors.
• 46 per cent considered their workload ‘heavy’ or ‘very heavy’.
• Only 50 per cent were paid for unrostered overtime ‘always’ or ‘most of the time’.
• 22 per cent reported that an undesirable workplace culture, including the amount of work expected of them, had a negative impact on their wellbeing.
• 21 per cent reported having to work unpaid overtime.
• 21 per cent personally experienced bullying, harassment and/or discrimination in their workplace and 34 per cent had experienced and/or witnessed this behaviour. The most common source was senior medical staff.