Junior doctors need to stand up for themselves | AMA (WA)


Exhausted doctor

Junior doctors need to stand up for themselves

Sunday May 15, 2016

Dr Jemma Hogan, Intern, Sir Charles Gairdner Hospital

The latest issue of Medicus (which focused on sexual harassment) has brought to light the fact that junior doctors are often at the mercy of their seniors.

Since starting my internship this year, I have been greatly concerned by the sense of fear I have seen amongst my peers.

As freshly minted graduates, many are out to prove themselves as the best and brightest intern to their consultants – but at what cost?

Junior doctors can often take a while to ‘find their feet’. Some will find the pressures of internship an easy adjustment while others will still find it extremely challenging.

I’ve seen multiple junior doctors go whole days without eating, drinking or going to the bathroom. Some will argue this is a skill of time management, but most of us would have experienced days where the pressure to perform tasks is overwhelming.

In these situations, many juniors feel an additional pressure – the expectations of their consultants.

While I believe that most consultants have reasonable expectations of their junior staff – as conscientious overachievers – junior doctors often have overinflated ideas of these expectations and subsequently struggle to keep on top of their workload for fear of a poor end-of-term assessment or bad report.

I find that these unrealistic expectations are particularly pervasive in the idea of overtime.

Many junior doctors will often work hours of unpaid overtime each week (forgoing thousands of dollars in
potential earnings each term) for fear that claiming these additional hours will reflect poorly on them and their end-of-term assessment.

Most senior clinicians recognise the time pressures of the junior roles within their department and are often happy to sign off on the overtime forms submitted. From these forms, they can also identify deficits in work hours/ staffing arrangements and can make changes for the benefit of future junior doctors coming through the same positions.

Without the information provided by these forms, they cannot make the changes needed and so continues the cycle of silent discontent and frustration amongst the junior staff.

This also carries through to leave entitlements. Many junior doctors feel the pressure to attend work even when they are unwell (either mentally or physically) and often suffer in silence or until the pressure all becomes too much. This can lead to suboptimal patient care and exposure to potentially harmful microbes, which often results in poorer overall health outcomes for patients.

Despite the fact that they are legally entitled to two weeks of sick leave a year, I would hazard a guess that the sick leave rates of both junior and senior doctors are probably the lowest in healthcare, if not all professions.

Leave in general is unfortunately a significant problem at all hospitals for junior doctors in Western Australia.
Many of my colleagues have struggled to gain access to both professional development and annual leave entitlements this year.

Some have even had to accept that they are not able to take any leave due to the lack of relievers at their particular network.

I understand the pressures on a system with limited funds and resources but surely a solution can be formulated to ensure all junior doctors have access to the leave they are entitled to take, whilst still meeting the expectations of their consultants.

Junior doctors need to stand up for themselves in the workplace and be reminded that they are legally entitled to claim overtime and sick leave as well as professional development and annual leave.

They also need to have a conversation with their seniors at the commencement of each term to ensure they have a realistic understanding of the expectations required.

The pervasive culture of acceptance surrounding the lack of basic workplace entitlements needs to change. Only then will we be able to retain junior medical staff in the current system and attract others planning on entering the workforce.