Backlash after junior doctors ‘blamed for work fatigue’

NSW Health has apologised to junior doctors after an email from a hospital administrator, telling staff that struggling with workload is ‘not a great indicator for longevity’, sparked fierce backlash.
 
The email, which was sent to doctors at Nepean Hospital, has been labelled ‘deeply concerning’ by RACGP GPs in Training faculty Deputy Chair Dr Madeleine Wilkie, who says it shows a ‘clear lack of respect’ for doctors.
 
It opens with an intention to ‘clarify some trends which are merging which reflect some misunderstanding of rostering’.
 
‘Sick leave: this is intended to be used for when you are ill. As rosters are published well in advance if you are rostered and have life events or future engagements .. IT IS YOUR RESPONSIBILITY to swap out of the shifts,’ the email said.
 
‘Roster swaps: these are NOT automatically approved. The roster is designed to ensure NO ONE is exhausted and if we have some juniors who are constantly covering, they will have fatigue.
 
‘There is an implicit acceptance when entering medicine, you are going to be exposed to after hours and nights BECAUSE all doctors cover these hours because health care is 24/7.
 
‘Your careers will be hopefully long .. please come and make contact if you are struggling now as it's not a great indicator for longevity in the profession it you are already feeling the strain from rosters which unfortunately are absolutely standard for health.’
 
Dr Wilkie said the email reveals a crisis in the health system that is not exclusive to junior doctors.
 
‘The last paragraph concerns me the most. This mentality is not representative of medicine in 2026,’ she told newsGP.
 
‘It is outdated, and we should not still be perpetuating that doctors are expected to work 80-hour weeks as “standard”.
 
‘The letter is reflective of a systemic issue which we were already aware of, yet unfortunately seems not to have changed.’
 
A spokesperson for the Nepean Blue Mountains Local Health District has apologised for the email to junior medical officers (JMOs).
 
‘We know JMOs are the future of healthcare and we deeply value their contribution to our community,’ they told newsGP.
 
‘Supporting the wellbeing of our JMOs is a priority for our district, and we acknowledge this email did not reflect this.’
 
The spokesperson said senior doctors have since met with JMOs to discuss how rostering could be improved to support their welfare while ‘meeting the challenges of delivering care in a 24-hour health service’.
 
But Dr Wilkie said a ‘crisis’ is occurring in the health system.
 
‘This is not exclusive to junior doctors, but registrars on hospital-based training programs as well,’ she said.
 
‘Ultimately doctors under these conditions will either become physically unwell, psychologically unwell, or leave, and we know all of these things are already happening. Further to this, their ability to provide quality care to patients is then compromised. Everybody loses.
 
‘We need a complete overhaul of the working conditions, staff numbers, pay rates, funding allocation and culture, but a bit of respect and appreciation is a good place to start.’ 
 
Dr Wilkie said the expectations placed on doctors shows a ‘dichotomy’, with the demand to be both human and superhuman.
 
‘Doctors are expected to be human and personal in consultation with patients, however, are also expected to be superhuman when it comes to fatigueability and the impact of work on physical and mental health,’ she said. 
 
Australian Salaried Medical Officers’ Federation (ASMOF) NSW President Dr Nicholas Spooner said the email is ‘blaming [junior doctors] for fatigue’ – calling for safe working hours to be implemented across the state’s hospitals.
 
‘Given that we know excessive work, unsustainable working hours and fatigue are taking a devastating toll on doctors, it is not appropriate that NSW Health would seek to shift the blame for these systemic problems onto individual doctors themselves, often with tragic consequences,’ he said.
 
The email adds to an already strained relationship between NSW Health and the state’s doctors, stoked last year by a leaked email from John Hunter Hospital that referred to junior doctors as ‘clinical marshmellows [sic]’.
 
A 2025 ASMOF survey of more than 2600 NSW public hospital doctors reveals one in three report working 55 hours or more in the previous week.
 
Further, 32.6% of doctors in training said their roster does not allow the mandated 10 hours’ rest between shifts.
 
The report also reveals one in three doctors in the state’s public hospitals have considered resigning over excessive workloads, and of doctors in training, almost 38% are considering leaving NSW or Australia.
 
Dr Spooner said the reports shows the impact of ‘chronic underinvestment’ in the NSW hospital system, with doctors forced to make ‘life or death decisions without the resources they need to protect the health of the people who depend on them’.
 
‘The report shows a public health system starved of the resources it needs to protect public health,’ he said.
 
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