The ACT is "bleeding out" disrespected and exhausted doctors who are sick of stepping in to save "systems that are right on the precipice of failing," representatives say.
Australian Salaried Medical Officers Federation (ASMOF) ACT executive officer Tom Fischer said despite retaining more ANU students, doctors were leaving the capital due to low pay and working conditions.
"The cohort has been shrinking because it's bleeding out to [other] places ... the sheer number of hours that each one of those [junior medical officers] is being asked to do seems to be on the increase," Mr Fischer said.
"For senior doctors ... many of them don't receive any payment for doing out-of-hours work, and all of these things are to the convenience of Canberra Health Services but they don't make doctors feel respected."
Members of the doctor's union have been taking industrial action since Friday, May 22, over stalled enterprise agreement negotiations.
ASMOF ACT president and respected haematologist Professor Dipti Talaulikar said staff shortages and overworked doctors could impact patient care.
"Doctors that we are training here are choosing to work elsewhere because it's better staffed, remuneration is better and workloads are a lot more manageable," Professor Talaulikar said.
"We have chronic-short staffing, positions take so long to be filled, you can't find the right people and when we do have the right people, they move on for better pay or better conditions.
"Doctors are doing a lot more overtime than they were about 10 years ago, so that's had a huge impact on overworked, exhausted doctors, and that ultimately affects patients and the community.
"It is not just about pay, it is about actually having a sustainable health system that works for the patients and for the community."
A Canberra Health Services spokesperson said "the ACT continues to attract medical graduates and has recently seen positive signs in intern recruitment.
"Movement between jurisdictions is a normal part of medical training and career progression, and the ACT also benefits from senior [junior medical officers] and post-fellows in other jurisdictions moving to the ACT.
"We are focused on strengthening career pathways, training opportunities and workplace culture to support more doctors building long-term careers in Canberra."
Professor Talaulikar said Canberra Health Services, the directorate that runs the hospitals, has relied on the goodwill of self-sacrificial doctors to survive.
"We are trained to take care of patients, so even when we are not asked to do something ... if doctors see a need, they will step in and do what is required for the community," she said.
"Fundamentally, [Canberra Health Services] understands this. They know that doctors are here because they're people who care for others, who look after others, and they rely on it, they lean on it, they build systems that are right on the precipice of failing, and when they fall over, the doctors step in and make sure that it doesn't collapse.
"They've done this repeatedly over the past few years, and they've shown no signs of stopping."
A Canberra Health Services spokesperson said "medical officers work hard every day to provide care to the Canberra community" and they were in good faith negotiations with unions during enterprise bargaining.
Mr Fischer said there were many examples of how the ACT treated doctors as "disposable" by having different systems compared to other states and territories.
For example, junior doctors are put on 12-month contracts instead of being permanently employed.
"In the ACT, quite unusually, every single year you're applying for a new position, and it causes problems when they go to other jurisdictions because other jurisdictions aren't recognising them as having permanent employment," he said.
"That's just one example of the ways in which Canberra Health Services treats junior and senior doctor as inconvenient and puts its own administrative processes ahead of their wellbeing."
The Canberra Health Services spokesperson said "the current employment model for Doctors in Training is consistent with arrangements in other jurisdictions".
Doctors in training are not allowed to access feedback on why a supervisor has failed them.
"In other states there's a level of transparency and feedback, within Canberra Health Service again quite unusually, doctors aren't permitted to know what's been put into the process about them or they don't know what they're allowed to do or not to do," Mr Fischer said.
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"At the end of the process, they don't know what's been said about them or what kind of evidence has been put on or whether they're allowed to do something or not."
Canberra Health Services said the union was trying to prevent "referees, nominated by the applicant for credentialling, to provide confidential feedback. Applicants nominate their own referees, and recent changes enable referees to consent to their reports being shared. Maintaining an appropriate level of confidentiality supports the integrity of clinical governance processes".
The union also disputes the government's interpretation of an on-call clause in the enterprise agreement which pays senior doctors who do on-call hours an extra 17.4 per cent on top of their base salary.
If a doctor is on-call, it means they are not at the hospital premises but able to be contacted by phone to offer advice and come into work if needed.
Mr Fischer said the allowance is used to boost low salaries, and is treated like "a buffet lunch", meaning that senior doctors can be made to work unlimited overtime.
Doctors may be taken off the on-call roster, leading to a significant pay cut, as punishment.
The last enterprise agreement set up a working group to try and address the on-call system.
