Medical training highly rated – but bullying still a problem

Four in five doctors in training would recommend their current training position to peers – but bullying and harassment is still a real concern for a sizeable minority, according to a major survey.

RACGP President Dr Karen Price has welcomed the positive feedback on training, but also called for further action to stamp out mistreatment of doctors in training.
 
More than half of all doctors in training in Australia – 21,851 participants – took part in the 2020 Medical Training Survey run by the Australian Health Practitioner Regulation Agency (AHPRA). This is substantially up from 2019, when only 27% of doctors in training responded.
 
The 2020 results are broadly consistent with the previous year, though the number who would recommend their training position rose from 78% to 81%, while the number who recommended their current workplace increased more, from 76% to 81%.
 
The most common general practice training program was run by the RACGP, accounting for 85% of GPs in training.
 
Over the whole cohort of doctors in training, more than a third (34%) reported having witnessed bullying, harassment or discrimination, and 21% reported having directly experienced mistreatment.
 
GPs in training reported witnessing this behaviour half as much (17%), but 14% still directly experienced mistreatment and Dr Price reaffirmed that any bullying or harassment is unacceptable.
 
‘While it’s welcome news that this is less of a concern for specialist GPs in training than other doctors in training, it is still a problem and we need to do more to stamp it out,’ she said.
 
‘Bullying, harassment and discrimination doesn’t belong in any workplace or training environment.’
 
Dr Price said that with the RACGP on track to lead the Australian General Practice Program, the transition offers a ‘once in a lifetime opportunity’ to improve training for future GPs.
 
‘Combatting bullying, discrimination and harassment is the highest priority,’ she said.
 
Chair of the RACGP’s National Faculty for GPs in Training, Dr Sean Black-Tiong said the survey shed welcome light on where medical training was operating well and where improvements ‘can and should be made’.
 
‘The COVID-19 pandemic has highlighted the importance of general practice in Australia for the health of our communities,’ he said.
 
‘High quality training is essential for Australia’s future GP workforce.’
 
Of the international medical graduates who responded, 83% said they were very satisfied with their training experience.
 
However, doctors in training who identified as Aboriginal and/or Torres Strait Islander rated their training slightly lower than average and reported higher levels of discrimination, bullying and harassment.
 
Medical Board of Australia Chair, Dr Anne Tonkin, said the survey data shows there is ‘a lot going well’ in Australian medical training, but improvement is still needed.
 
‘We’re doing a lot of things right to keep producing doctors who can provide patients with high quality care,’ she said.
 
‘But there is serious work for agencies across the health sector to do to improve the culture of medicine.’
 
Overall, almost half of Australia’s interns (47%) experienced or witnessed bullying, harassment or discrimination, followed by 39% of prevocational and unaccredited trainees, 36% of specialist non-GP trainees, 23% of international medical graduates and 21% of specialist GP trainees.
 
Who was responsible for the bad behaviour?
 
According to survey respondents, consultants and specialists were cited as a source of bad behaviour by 51% of respondents who personally experienced it, followed by nurses or midwives at 36%, patients or patients’ family and carers at 34%, and then colleagues at 33%.
 
Two thirds of trainees said they did not report the incident they experienced, and 78% did not report the incident they witnessed.  
 
‘For the future of our profession, we must all listen to what the thousands of trainees have told us and work together to build a culture of respect,’ Dr Tonkin said.
 
‘We must keep our trainees safe and make it safe for them to speak up. An urgent and shared commitment to this across medicine and the wider health sector will lead to safer patient care.’
 
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