Workloads on RANZCO trainees continue to weigh heavily, according to the latest 2024 Medical Training Survey (MTS), with the average working week continuing to be almost eight hours longer than other doctors in training.
And it appears to be impacting life beyond the practice, with less than half of the next generation of eye doctors able to achieve good work/life balance and a third saying unpaid overtime has impacted their wellbeing.
While long work hours remain problematic, RANZCO trainees are more likely to pass their exams, feel confident of securing employment, and are much less likely than other trainees to be considering a career outside of medicine.
Editor’s note: view RANZCO’s full results here.
Plus, 98% of RANZCO trainees intended to continue with their specialty.
The work lives of ophthalmology trainees were revealed in the 2024 MTS that received 46,440 responses at a rate of 53%. It’s the sixth nationwide survey of all doctors in training and is a confidential way to improve training across specialities and the health system.
The ophthalmology report had 52 respondents, of whom 92% were registrars, and 5% Aboriginal and/or Torres Strait Islanders. Male and female respondents were evenly split.
On average, RANZCO trainees worked 52.2 hours a week, which was slightly down from the high of 53.3 hours reported in 2023. But it is still much higher than the 44.8 hours a week for the average doctor in training.
“For RANZCO trainees, 91% were working 40 hours a week or more, compared to the national response of 62%,” the report also added.
When asked to rate their workload, 31% of ophthalmology trainees said it was moderate (vs. 49% nationally), but 58% said it was heavy (38% nationally), and 11% (9% nationally) very heavy.
As such, the amount of work ophthalmology trainees are expected to do adversely impacted 35% of respondents (vs 25% nationally). So did unpaid overtime (30% vs 18%), and having to relocate for work (40% vs 24%).
Further drilling into workplace and culture, 56% of ophthalmology trainees said their workplace supports them to achieve a good work/life balance against a national average of 71%. And 46% (vs. 65% nationally) said they had a good work/life balance.
RANZCO censor-in-chief Dr Andrew Thompson said the college closely reviewed the MTS and conducted its own surveys and reports, as well as training post inspections.
“RANZCO sets the training program for ophthalmology trainees and works closely with the training jurisdictions and trainers to ensure the trainees are supported to complete their training,” Dt Thompson said.
“There is an obvious tension between this and the need to provide service delivery to patients. The college will continue to advocate for protected training time and work-life balance for our trainees, as well as for trainers, tutors and supervisors.”
In other more positive findings, just 12% of trainee ophthalmologists were concerned about securing employment versus a 41% national response rate.
Plus, 56% of RANZCO trainees were interested in rural practice – seven percentage points above the national average – despite just 6% training regionally and 2% rurally.
Other results showed 94% felt the RANZCO training program was relevant to their development, 84% would recommend their current training position to other doctors, and of those who received exam results, 91% passed.
“I think a combination of factors gives trainees confidence about their future employment prospects,” Dr Thompson said.
“Certainly, the close-knit nature of the [ophthalmology] profession makes networking easy and there is a culture of mentoring and supporting one another. The flexibility to find work across public and private and through mixed models – solo practice, joining a group practice, working as a locum, doing outreach, etc. – gives trainees confidence that there is always something available to them.
“The existing workforce maldistribution highlights the many opportunities to work in regional, as well as rural and remote, settings. Finally, the diversity of ophthalmology itself means trainees have a wide choice of remaining as generalists or subspecialising or doing a combination of these.”
‘We can’t risk losing talent’
One of the big headlines to come out of the 2024 survey was that 33% of all trainees had experienced and/or witnessed bullying, discrimination, harassment, sexual harassment and/or racism. This figure spiked to 54% of Aboriginal and Torres Strait Islander trainees.
For ophthalmology trainees, the number was 26% and, somewhat encouraging, they were more likely to report these instances if witnessed (40% vs 26%).
There has also been alarm at the one in five doctors in training considering a career outside of medicine. This was much lower for RANZCO trainees at 12%.
Australian Medical Association president Dr Danielle McMullen said these results were disappointing and unacceptable.
“This survey should be a major wake-up call to tackle the systemic issues that impact the training experience and wellbeing of doctors in training,” she said.
“We are disappointed doctors in training are still experiencing racism and sexual harassment, and we are particularly alarmed that 19% of all doctors in training are considering a career outside of medicine.
“Doctors in training are the future of our profession and we must ensure their training experiences are valuable and enjoyable so we do not lose their talent to other professions.”
Medical Board of Australia chair Dr Anne Tonkin was ”appalled” that 38% of Aboriginal and Torres Strait Islander trainees reported experiencing or witnessing racism, compared to 17% of other trainees.
“Clearly, our efforts to strengthen cultural safety in medicine and the health system more widely are urgent and well targeted,” she said.
But there were some bright spots, with the national quality of trainee supervision, orientation, teaching, education and training on patient safety again high. Broadly, 2024 results are stable compared to previous years.
“The value of the MTS is rock solid. What remains is a challenge to our collective ability – and will – to apply MTS data to shape strategies for positive change,” Dr Tonkin said.
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