COVID putting junior doctors under strain
Read the full 2022 Resident Hospital Health Check results.
Three years into the pandemic, Queensland’s junior doctors are increasingly concerned that overwork and fatigue may lead to them making medical mistakes, according to AMA Queensland and ASMOFQ’s 2022 Resident Hospital Health Check.
The survey of doctors in training at Queensland hospitals found that almost 60 per cent were concerned about making a clinical error due to fatigue caused by hours worked, up from 51 per cent last year and 48 per cent in 2020.
A total of 719 junior doctors responded to the annual survey from AMA Queensland’s Committee of Doctors in Training (CDT) and ASMOFQ (Australian Salaried Medical Officers’ Federation Queensland), which compares the junior doctor experience and staff wellbeing in public hospitals around the state.
CDT Chair Dr Rob Nayer said the steady increase in concern about possible fatigue-induced clinical errors highlights the toll COVID has taken on the medical profession and the failure of hospital authorities to take enduring action on both the hours worked and the quality of formal and bedside teaching and training.
“Every year, more and more doctors in training raise fatigue and overwork as a key concern, and the pandemic has exacerbated the pressure,” Dr Nayer said.
“This year we have seen unprecedented stresses on our hospitals, doctors, and all healthcare workers. We know ambulance ramping and access block remain big issues around the state, and it’s really showing a negative impact on the frontline health care providers, which is frequently our junior doctor workforce.
“Doctors, nurses and all healthcare staff are exhausted and now, more than ever, hospitals need to provide a safe, supportive environment for staff.
“AMA Queensland will be taking these results to tomorrow’s Queensland Health Workforce Summit. We need urgent and sustainable action to train and retain our doctors.”
This year, the survey contained new questions about the quality of formal and bedside teaching and training, and whether hospitals are doing enough for staff mental health and wellbeing.
Only 38 per cent of respondents were satisfied with their formal training, and just one in four with their bedside training, while only 39 per cent thought their hospital was looking after mental health and wellbeing adequately.
“These findings are particularly important ahead of tomorrow’s summit,” Dr Nayer said.
“Poor training leaves junior doctors feeling unprepared, which affects mental health and contributes to their fear of making mistakes.
“If we’re not training our doctors properly, we won’t have a future generation of specialists to give Queenslanders the high-quality healthcare they deserve.”
Dr Nayer said a contributing factor to the fatigue being felt by doctors across Queensland was the excessive amounts of overtime required to just keep up with the demands on our hospitals.
“Worryingly, one in six said they were working up to or more than 24 hours’ overtime per fortnight, and almost one in five did not have an adequate break of 10 hours or more between shifts,” Dr Nayer said.
“These trainee doctors are working exceedingly long hours, often in a very stressful environment, which can leave some vulnerable to anxiety, depression and burnout.
“Burnt out doctors are at high risk of making clinical errors. To give Queenslanders the best health care, doctors need to be rested and able to think clearly.
“We do not want to see anyone leave the profession early due to inadequate safeguards and support.”
The survey highlighted some encouraging improvements, with a slight drop in the percentage of respondents experiencing bullying, discrimination and/or harassment and a rise in confidence that reported incidents are being appropriately addressed by hospitals.
However, three-quarters (75 per cent) were concerned there might be negative consequences for reporting incidents, compared to 71 per cent last year and 55 per cent in 2019 – before the pandemic started.
Five in six respondents (85 per cent) were paid all the un-rostered overtime they claimed, up from 76 per cent last year, and only 17 per cent reported being advised not to claim overtime – a big improvement on 25 per cent in 2021 and 27 per cent in 2020.
However, one in four still said they were concerned claiming overtime may negatively affect their assessment.
“A culture of fear that stop doctors from standing up for themselves also stops them from standing up for their patients,” Dr Nayer said.
“It’s good to see some improvements but while some hospitals scored As in some areas, no hospital scored higher than a B overall this year.
“We will be discussing these results with doctors in training at the AMA Queensland Junior Doctor Conference on the Gold Coast next month.
“We know that trainee doctors use the results of the Resident Hospital Health Check when they make their decisions about their next year’s placements and the Junior Doctor Conference is an opportunity to share experiences with their colleagues.”
Download the full 2022 Resident Hospital Health Check.
The AMA Queensland Junior Doctor Conference is on 29 and 30 October. Details are available here.
Background
- The seventh annual AMA Queensland/ASMOFQ Resident Hospital Health Check was held over July and August, with 719 junior doctors across 33 hospitals taking part.
- Hospitals are scored from A to E. Data from all responses is used to calculate state averages but results for individual hospitals are only reported when there were more than 20 respondents.
- 58 per cent of respondents reported that they had been concerned about making a clinical error due to fatigue related to long work hours (up from 51 per cent in 2021 and 48 per cent in 2020).
- 58 per cent were satisfied that their leave preferences were taken into consideration, down slightly from 2021 (59 per cent) and 2020 (62 per cent).
- 56 per cent had applied for professional development leave, a large increase from 2021 (36 per cent) and 2020 (28 per cent).
- 31 per cent experienced bullying/discrimination/harassment, with a further 17 per cent witnessing one or more of these behaviours.
- 28 per cent reported that they had felt unsafe at work (30 per cent in 2021).
- Less than half of respondents were satisfied with the hospital facilities (42 per cent) and the quality of the formal teaching and training (38 per cent).