Fresh findings from the 2021 Medical Training Survey (MTS) show one in five ophthalmology trainees have experienced bullying, harassment and discrimination, with 92% opting not to report it. Long work hours also remain an issue, with the average RANZCO trainee working 49.7 hours.
The latest survey also found that the trainees in states and territories worst hit by the pandemic were more likely to report COVID-19 had adversely impacted on their medical training.
The findings have prompted the Australian Medical Association (AMA) to call on policymakers to immediately tackle systemic issues impacting the training and wellbeing of doctors in training (DiT).
The 2021 MTS is the Medical Board of Australia’s third nationwide survey of all doctors in training and is a confidential way to obtain national, comparative, profession-wide data to strengthen training. More than 21,000 trainees participated in the 2021 survey at a 55% response rate. Seventy-five trainee ophthalmologists responded, similar to the 2020 survey.
The latest snapshot revealed ophthalmology ranks highly in terms of trainees recommending their position to other doctors – 94% of RANZCO trainees versus the 80% national average.
However, bullying, harassment, discrimination and long work hours remain a concern for the profession.
While 82% of RANZCO trainees (versus 78% national average) said bullying, harassment and discrimination is not tolerated at their workplace, 22% (22% national average) said they had experienced it and 30% (31% national average) witnessed it.
A PDF of the full RANZCO trainee response can be accessed here.
In ophthalmology, the person responsible was most likely senior medical staff (46%), nurse (46%) or patient and/or patient family/carer (31%).
Concerningly, 92% of ophthalmology trainees who experienced bullying, harassment or discrimination did not report it, considerably higher than the 67% national average, while 89% who witnessed the behaviour did not report it (76% national average).
89% working over 40 hours
In terms of hours worked, on average, RANZCO trainee doctors worked 49.7 hours per week compared with 45.5 hours on average across all medical specialties. For RANZCO trainees, 89% were working 40 hours a week or more, compared to the national response of 67%.
In total, 31% of ophthalmology trainees rated their workload as ‘heavy’, while 11% said it was ‘very heavy’. Nationally, these numbers were 39% and 9%, respectively.
Unsurprisingly, trainees across all disciplines from places hardest hit by the pandemic reported their medical training overall had been impacted negatively, while trainees in states and territories less affected reported the pandemic had a mixture of positive and negative impacts on training overall. Broadly, 41% of respondents indicated COVID-19 had negatively impacted their medical training in 2021.
In ophthalmology, 58% said COVID-19 had impacted their training opportunities negatively versus 45% nationally. However, the figures were more encouraging for RANZCO trainees in terms of how the pandemic influenced their exam preparation, research opportunities, career progression and medical training overall.
AMA President Dr Omar Khorshid said the survey demonstrated the need to act now to tackle systemic issues impacting the training and wellbeing of DiTs.
“The 2021 survey again finds doctors in training reporting unacceptable levels of bullying, discrimination and harassment and a reluctance to report it. Seven out of 10 DiTs experienced bullying, discrimination and harassment saying it had adversely affected their medical training,” he said.
“It’s time for state and territory health departments to get serious about valuing the time doctors in training spend learning and providing excellent patient care by reviewing and providing appropriate staffing and adopting better rostering practices.
“They also need to take concrete steps to guarantee a safe working environment for doctors and other staff in public hospitals.”
According to the AMA, 45% of trainee doctors (28% RANZCO trainees) said they never/sometimes got paid for unrostered overtime and 49% rated their workload as heavy/very heavy (42% ophthalmology).
“Turning a blind eye to practices that allow doctors to work excessive unpaid, unrostered overtime is not only inefficient and unproductive, but it puts patient care and doctor wellbeing at risk,” Khorshid said.
“Very disturbingly, Aboriginal and Torres Strait Islander doctors in training reported higher levels of bullying, discrimination and harassment, including racism, compared to non-Indigenous colleagues.”
Khorshid said the AMA wanted legislative changes in all states and territories to improve health service leadership, governance and accountability to provide a culturally and psychologically safe work environment for all employees.
Dr Hash Abdeen, chair of the AMA Council of Doctors in Training, said the survey found despite interruptions to training because of COVID-19, many trainees rated their training experience highly in the 2021 survey.
“This is a testament to the high quality of training in Australia and commitment from supervisors, Colleges and senior medical staff to supporting trainee during this challenging time,” Abdeen said.
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