Junior doctors face specific pressures related to their professional stage and development and can be at risk of poor health. A confidential survey conducted in 2008 by the Australian Medical Association Council of Doctors in Training investigated the health and wellbeing of junior doctors. There were 914 completed surveys: 71% of junior doctors were concerned about their own health, and 63% about the health of a colleague. A majority of junior doctors met well established criteria for low job satisfaction (71%), burnout (69%) and compassion fatigue (54%). The early stages of a medical career are demanding, and the health and wellbeing of junior doctors must be a personal priority, as well as the responsibility of the medical profession in general, to ensure a healthy medical workforce in the future.

Background Junior doctors experience high rates of psychological distress and burnout. System‐level interventions are one strategy to reduce psychological distress in junior doctors. Unfortunately, few of these interventions have been evaluated. Aim To evaluate the acceptability and effectiveness of a resilience and well‐being programme designed for junior doctors. Methods A prospective cohort study of 24 medical interns at a teaching hospital in regional Queensland with a control group of 29 medical interns at a second teaching hospital in regional Queensland. Survey instruments to assess psychological distress, the ProQOL and K10, were completed at baseline, at the completion of the well‐being programme, and 3 months after the completion of the well‐being programme at both sites. Results The intervention site had an older cohort and fewer participants had a regular general practitioner compared to the control site. Both groups had moderate levels of psychological distress. Insufficient numbers of participants completing the instruments at the two sites meant that it was not possible to demonstrate differences between the groups; however, the trends were promising. Qualitative evaluation data supported these trends, indicating that the Resilience on the Run programme was positively received and provided useful skills to junior doctors. Conclusion Well‐being programmes benefit medical interns; introducing new knowledge and skills for effectively identifying and managing personal and workplace stressors that can contribute to psychological distress.

EDs fulfil a frontline function during public health emergencies (PHEs) and will play a pivotal role during the COVID-19 pandemic. This perspective article draws on qualitative data from a longitudinal, ethnographic study of an Australian tertiary ED to illustrate the clinical and ethical challenges faced by EDs during PHEs. Interview data collected during the 2014 Ebola Virus Disease PHE of International Concern suggest that ED clinicians have a strong sense of professional responsibility, but this can be compromised by increased visibility of risk and suboptimal engagement from hospital managers and public health authorities. The study exposes the tension between a healthcare worker's right to protection and a duty to provide treatment. Given the narrow window of opportunity to prepare for a surge of COVID-19 presentations, there is an immediate need to reflect and learn from previous experiences. To maintain the confidence of ED clinicians, and minimise the risk of moral injury, hospital and public health authorities must urgently develop processes to support ethical healthcare delivery and ensure adequate resourcing of EDs.

ObjectiveTo review domestic and family violence (DFV) and non‐lethal strangulation (NLS) presentations to an ED with 24‐h social work.MethodsRetrospective cohort study of 12 months of DFV presentations comparing demographics, perpetrator relationship, social work review, injuries and NLS incidence and assessment.ResultsWomen represent 90% of DFV presentations. In 26% of DFV presentations NLS was identified, with 47.5% clinically assessed appropriately. Social work did not review 34% of DFV presentations, 64% due to no referral.ConclusionsSocial work referral for DFV is regularly missed despite 24‐h access. Assessment of NLS in ED requires improvement and standardised national guidelines.

In order to address the challenges associated with ED overcrowding and access block, governments in the UK then Australasia have implemented time-based access targets for emergency presentations.

No abstract

No abstract

No abstract