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Many of the problems discussed are well known: for example, difficult access to leave, short employment contracts, and enormous workloads in the context of significant staff shortages. These manifest with dissatisfaction, low morale and burnout. Without naming hospitals (although the results of the Hospital Health Check surveys are clear), these problems are more likely to arise in hospitals whose administrators place less focus on fostering a positive and inclusive culture for their medical staff. We have seen great strides in levels of satisfaction in health services that have taken seriously the need to treat DITs with the respect and individual focus that ought to be the right of any employee in any industry.  

Default one-year contracts for DITs are toxic entities whose time on this Earth should come to an end. A few years back, the AMA (WA) achieved a big leap forward by working with WA Health to introduce the three-year contracts on which new Interns are employed. Once expired, though, most DITs who remain with WA Health for their specialty training – which would typically be anywhere upward of a further half-decade – are shunted into the annual cycle of applying for their own jobs.  

It’s true that most are successful in achieving re-employment, so perhaps this would be tolerable (although not ideal) if the worst consequence were the need for some pointless administrative work on the part of both employee and employer. But there’s far more to it. Culturally, forcing people to re-apply for their jobs every year creates an uninclusive, stand-offish relationship between employer and employee. It creates the impression that they are a short-term contractor, rather than an enduring and valued member of staff whose ongoing contributions to service delivery and improvement are desired. It complicates and, in some cases, prevents the approval process for loans, in particular home loans. The demographics of DITs has significantly shifted in recent years and many DITs have significant family responsibilities. Worst of all, short-term contracts cause some DITs to conceal pregnancies, for fear of not being offered a subsequent contract once the employer assumes that they will take parental leave.  

The AMA (WA) has been lobbying for several years on multi-year contracts for DITs, and would support the staged introduction of multi-year contracts that would be available as the default to all DITs: training-length contracts for those in College training programs, and contracts of several years’ lengths for all others either new to the system, or after completion of their initial three-year contract signed on commencement of internship. I recently discussed multi-year contracts for DITs with the Minister for Health, who expressed strong support for the change. I’m pleased that the Chief Medical Officer has taken this on, and has our full support in working on implementation of multi-year contracts in the shortest possible timeframe. 

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