Opinion
More trainee doctors removed from hospitals over concerns for their welfare
Dr Evelyn Lewin applauds medical colleges for taking a stand against toxic work environments for junior doctors.
This week saw a further two trainees temporarily removed from a NSW hospital by their medical college.
Gruelling hours, understaffing, stress, bullying, harassment.
Sadly, these are not new issues junior doctors face in hospitals. Far from it, in fact.
However, it seems like the tide is slowly turning, as several medical colleges have taken a stand and pulled trainees out of undesirable working conditions.
That is what happened this week, when two junior doctors were removed from a NSW hospital by a peak medical college.
This is the fourth recent example of such an occurrence in the last nine months.
This time, it was the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) that temporarily withdrew two trainees from Tamworth Hospital over concerns of unsafe shift work, overtime and on-call hours.
This follows from the news last week that Sydney’s St George’s Hospital has had its intensive care unit barred from training junior doctors by the College of Intensive Care Medicine (CICM), amid allegations of bullying and dysfunction among senior doctors.
CICM President Dr Raymond Raper said that ‘taking [away] accreditation is the last resort’.
‘It’s a terrible situation for St George … we feel terribly for them. [But] we have to look at the welfare of our trainees and our Fellows,’ Dr Raper said.
In October last year, CICM also took away Westmead Hospital’s ICU training accreditation in response to reports of bullying and harassment.
Meanwhile, in November, the Royal Australian College of Surgeons banned Sydney’s Royal Prince Alfred Hospital's cardiothoracic surgery department from training its registrars in 2019 over similar allegations.
While it’s upsetting to hear of issues such as bullying, harassment and unsafe shift work occurring at hospitals, it’s refreshing to see medical colleges intercepting to improve the lives of its training doctors.
And so they should.
After all, students choose to study medicine for a variety of reasons, but a common goal is almost always to help people.
Doctors are usually caring people who believe they have entered a caring profession. And yet, the way our profession sometimes treats junior doctors is hard to believe.
For so many years, appalling treatment of junior doctors has been almost a ‘given’.
If junior doctors complained – about long hours, stress, being overworked, bullying, and so on – they were often dismissed, belittled even, as more senior doctors said conditions used to be ‘so much worse’ for them.
When you think about it, it seems inconceivable that we expect junior doctors to withstand such conditions, and still expect them to do their job properly.
Many can’t.
That is potentially why research from Beyond Blue found that, compared to older doctors (51–60 years), younger doctors reported higher rates of burnout.
It’s possibly also why doctors abandon the medical profession altogether.
I personally know of so many who have walked away from careers in medicine. While their reasons are varied, I wonder if that would still be the case if the medical work environment was more supportive.
As doctors, we are taught to care for our patients, but we also need to care for ourselves – and for young doctors in training.
Earlier this year, Dr Yumiko Kadota made headlines when the young registrar resigned from a hospital’s plastic and reconstructive surgery department due to being overworked within a toxic culture.
Perhaps one of the saddest – and most alarming – aspects of a story that made headlines throughout the country was the fact no senior doctors came to Dr Kadota’s defence during her struggles, which included working 24 consecutive days.
So she did the only thing she felt she could in such a distressing situation – she resigned.
I applaud her for coming forward and sharing her story.
I also applaud senior medical staff, like Dr Raper, who will not tolerate work environments that impede on the welfare of junior doctors.
Banning hospitals from having trainees, or temporarily removing such doctors from those environments, will not stop all of the issues that plague junior medical staff.
So much needs to be done to get to the root of bullying and harassment, to secure better working hours and curb overtime, to better support junior doctors.
But at least removing trainee doctors from toxic work environments is a step in the right direction.
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