Perspectives on the working hours of Australian junior doctors

Abstract

The working hours of junior doctors have been a focus of discussion in Australia since the mid-1990s. Several national organizations, including the Australian Medical Association (AMA), have been prominent in advancing this agenda and have collected data (most of which is self-reported) on the working hours of junior doctors over the last 15 years. Overall, the available data indicate that working hours have fallen in a step-wise fashion, and AMA data suggest that the proportion of doctors at high risk of fatigue may be declining. It is likely that these changes reflect significant growth in the number of medical graduates, more detailed specifications regarding working hours in industrial agreements, and a greater focus on achieving a healthy work–life balance. It is notable that reductions in junior doctors’ working hours have occurred despite the absence of a national regulatory framework for working hours. Informed by a growing international literature on working hours and their relation to patient and practitioner safety, accreditation bodies such as the Australian Commission on Safety and Quality in Health Care (ACSQHC) and the Australian Medical Council (AMC) are adjusting their standards to encourage improved work and training practices.

Nephrology training in Australia and New Zealand: A survey of outcomes and adequacy

“…2 Despite a lack of current evidence for diminished adequacy of training, future concerns regarding quality of training remain, particularly regarding reduced work hours for junior doctors, increasing numbers of medical graduates, reduced doctor-patient contact time, and increased flexible training such as part-time appointments and job sharing. 5,[10][11][12][13] Although there have been valid concerns raised, our data is consistent with other published reports of inadequate evidence that these issues (particularly reduced junior doctor working hours) have led to less adequate training. 14,15 Nephrology trainees have expressed concerns that increasing trainee numbers will impact employment opportunities; however, most respondents in our survey reported being able to secure their desired positions.…”

“…This is despite increased numbers of nephrology advanced trainees in ANZ over that time while clinical exposure and procedures performed by trainees has decreased . Despite a lack of current evidence for diminished adequacy of training, future concerns regarding quality of training remain, particularly regarding reduced work hours for junior doctors, increasing numbers of medical graduates, reduced doctor–patient contact time, and increased flexible training such as part‐time appointments and job sharing . Although there have been valid concerns raised, our data is consistent with other published reports of inadequate evidence that these issues (particularly reduced junior doctor working hours) have led to less adequate training …”

Depression and suicide among medical practitioners in Australia

“…The Australian Medical Association's ‘National Code of Practice – Hours of Work, Shiftwork and Rostering for Hospital Doctors’ responds to ongoing concerns about working hours and safe practice. The code has been instrumental in changing attitudes to the ethic of safe hours and is believed to have led to a decline in the proportion of doctors at high risk of fatigue . beyondblue's ‘Health Services Program’ aims to address the prevalence of anxiety, depression and suicide in staff working in health services across Australia, and includes a step‐by‐step guide for health services on how to develop and implement a tailored mental health and well‐being strategy to support their staff.…”

Junior doctors and overtime: the Queensland experience

“…2 Despite the absence of working hour regulations, such as those in Europe or the United States, the working hours of junior doctors in Australia have decreased over the past 15 years. 3 Notwithstanding the reductions in working hours of junior doctors over the past two decades, this study finds a significant number of doctors in Queensland is still working overtime. In this sample, junior doctors working in surgical specialties were found to have worked the longest hours.…”