Opinion
Surgical registrar’s ‘toxic’ experiences highlight need for change
Overworking and exhaustion are common in young hospital doctors, and led Dr Yumiko Kadota to resign. GP Dr Evelyn Lewin reflects on her own training.
Like many doctors around Australia, I was appalled when I read Dr Yumiko Kadota’s story in The Age.
The 31-year-old joined Bankstown Hospital’s plastic and reconstructive surgery department as an unaccredited registrar in February 2018.
She was rostered on-call for 10 days every fortnight. This means she was on-call for 180 continuous hours before having one night off, and being on-call again for another 80 consecutive hours.
In April last year, Dr Kadota emailed the hospital administration, saying, ‘I often feel unsafe to drive and I am concerned it will start affecting the care I give to patients’.
She didn’t take the decision to voice her concerns lightly.
‘I had been trying so hard not to complain because I knew what was at stake,’ she said. ‘I needed my bosses to support my application [for the accredited plastic and reconstructive surgery program]’.
Dr Kadota’s health deteriorated until she became ‘physically unwell, overweight, stressed, dehydrated and had bowel issues’. Her GP wrote to Bankstown Hospital’s administration advising they reconsider the roster.
On 1 June last year, Dr Kadota resigned.
It was her 24th consecutive day of work, including 19 days of 24-hours on-call, and the young doctor crashed her car driving home.
As Dr Kadota wrote, her head of department rang her after she resigned, saying, ‘It’s a shame. You’re good at what you do … but if you can’t handle the hours, maybe this isn’t for you.’
Dr Kadota’s story saddened me – but it did not surprise me.
Over the years, I’ve heard numerous similar stories of young doctors being overworked to the point of exhaustion. It’s almost like a ‘rite of passage’ when you’re a young hospital doctor.
The statistics paint a bleak picture, with 2016 data published in the Medical Journal of Australia showing that female medical professionals are more likely to die by suicide than the general population, and research from beyondbue finding that doctors aged under 30 years are most likely to report burnout.
As I read Dr Kadota’s story, I couldn’t help but think back to my own experiences as a hospital trainee.
My first ever rotation as an intern saw me being posted to a country hospital, where I worked long weeks, followed by 14-hour days on Saturday and Sunday (when I was rostered on), followed by another week of work.
I remember heading back to my room after a particularly harrowing shift.
I had been rostered on overnight as the sole doctor on the grounds at the hospital. During the night I had treated a patient in cardiac arrest, seen numerous patients on the wards and in the emergency department. And, in the early hours of the morning, I was called to the hospital morgue to certify a woman who had been found in her backyard – she had been deceased for so long that she had maggots in her eyes.
Tears streamed down my face as I crumpled outside my room when I was finally finished that shift.
Following that stint in the country, I never wanted to put myself through that level of stress again. I wasn’t burnt out or overworked to the point of exhaustion like Dr Kadota, but I was disillusioned.
I wasn’t just worried about the toll it was taking on me; like Dr Kadota, I also worried about the type of care I was capable of delivering to my patients.
I started looking beyond the areas of medicine to which I was drawn (which, as a resident, were emergency medicine and obstetrics), and began searching for a field where I could engage in a meaningful job, without being worked to the ground.
There were other reasons I chose general practice, of course, but it certainly helped that it ticked those boxes. And when I started GP training, I heard the same types of reasoning from many of those around me.
While I’m happy with the path I chose, I know it’s not the answer for everyone.
I don’t think about my years of hospital training often these days. Life gets busy, and there’s so much else to focus on.
But reading Dr Kadota’s story shone a light on how far we have to go when it comes to the treatment of hospital trainees.
An anecdote included in her story for mind body miko perhaps gets to the root of the issue.
Dr Kadota writes about how she requested a ‘quick break’ after working until 3.00 am the night before, only to have her request refused by her head of department.
‘I remember doing those sorts of hours when I was at your stage. It’s good for you,’ he replied.
Until such outdated beliefs are shattered, I worry that stories like Dr Kadota’s will continue to sadden – but not surprise – me.
*Evelyn Lewin is a fully trained GP, but is currently not practising.
burnout exhaustion junior doctors overworked registrar
newsGP weekly poll
On average, how many patients do not show up for their appointment at your general practice each week?