Fatigued junior doctors paint 'dire' picture for Australian Medical Association Qld survey

Overworked junior doctors in Queensland have been resigning from their jobs and telling their families to avoid getting health care at their hospitals, an annual survey has revealed.

Almost 60 per cent of 719 junior doctors in the latest Australian Medical Association (AMA) Queensland Resident Hospital Health Check said they were concerned they would make a clinical error due to the number of hours they worked.

The proportion of junior doctors worried about fatigue-related medical errors had also increased from 51 per cent in 2021 and 48 per cent in 2020.

AMA Queensland Committee of Doctors in Training chairperson Rob Nayer said the situation facing junior doctors in Queensland hospitals was "dire".

"We know that the COVID pandemic has put our hospitals under extreme strain and junior doctors are frequently the frontline medical officers seeing patients as they come into the hospital," he said.

"So they've been working under increased pressures for the last few years at this point, and that's starting to really have an impact on their mental health and wellbeing and their safety, as well as the safety of patients.

"It's heartbreaking to the point where some people are commenting they've already put in their resignation, or that they would recommend their family avoid receiving care at the hospital they're working in."

Only 38 per cent of doctors were satisfied with formal training and 25 per cent were satisfied with their clinical training.

"So that doesn't just put people at risk in our hospitals now, it potentially impacts our ability to staff our hospitals with enough specialists to provide high-quality patient care in the future," Dr Nayer said.

"Everyone working in our public hospitals is doing the best they can to provide the best, quality patient care and high-quality patient care that Queenslanders deserve.

"But the fact is that tired, burnt-out doctors are more likely to make mistakes."

Junior doctor reps not invited

AMAQ will be sharing the results with the Queensland Health Workforce Summit on Tuesday to advocate for urgent action.

Dr Nayer said AMAQ had requested a representative of the junior doctors to attend the summit, which Queensland Health declined.

A Queensland Health spokesperson said the summit would bring together key health experts from the public and private sector, including peak medical bodies, academics, researchers and hospitals.

The spokesperson did not say whether a representative of doctors in training had been invited.

"The summit will address key health workforce issues, including how we recruit, support, train and retain staff, and identify opportunities to assist in ensuring our hospitals and health services can continue to deliver world-class health care," the spokesperson said. 

In the survey, 12 Queensland hospitals were given a grade from A to E for various work conditions. 

Hospital	Access to annual leave	Career progression & development	Hours of work & overtime	Wellbeing & workplace culture	Bullying, discrimination & sexual harassment	Overall grade 2022	Overall change
Caboolture Hospital	C	C	B+	C-	C	C	No change
Cairns Hospital	C	C+	B+	C	C+	C+	No change
Gold Coast Hospital	C	C	B+	C	C	C+	No change
Ipswich Hospital	C+	C	A-	C-	C	C+	Up from C
Logan Hospital	C+	C	B+	D+	C	C	Down from C+
Prince Charles Hospital	C	C	B	C	C	C	Down from C+
Princess Alexandra Hospital	C	C	B	C-	C	C	Down from C+
Redcliffe Hospital	B+	B-	A	C+	C+	B	No change
Royal Brisbane and Women’s Hospital	C+	C	B+	C	C	C+	Up from C
Sunshine Coast University Hospital	B-	C	A-	C	C	C+	No change
Toowoomba Hospital	C+	C	A	C+	C	C+	Down from B-
Townsville Hospital	C-	C	B+	C-	C	C	No change

There was a slight decrease in the percentage of respondents experiencing bullying, discrimination or harassment, and more confidence that incidents would be addressed.

But 75 per cent were concerned there could be negative consequences for reporting incidents, up from 71 per cent in 2021.

Only 17 per cent said they were advised not to claim overtime, down from 25 per cent in 2021 and 27 per cent in 2020.

Training challenges for doctors 

Rural Doctors Association of Queensland president Matt Masel said one of the challenges for doctors was the transition from a hospital position to general practice.

"The way they're remunerated changes and they'll often lose the entitlements they had if they were working in a Queensland Health or Hospital and Health Service position, so there's often a significant loss of entitlements, or even income, in order to go into those positions," he said.

"Some of the challenges are the same for every rural healthcare worker — there not being enough of us — and that's adding to the workload."

Dr Masel said other issues encountered while training doctors included finding them accommodation and "other parts of life … at a stage where you may be meeting a partner or have a partner and their work may not suit certain sites so you have separation from loved ones".

Stress on health systems to be discussed at national cabinet

Speaking at a press conference, Queensland Premier Annastacia Palaszczuk said the health system had felt enormous pressure during COVID-19 and acknowledged fatigue was a big issue for all health and frontline workers.

"There is light on the horizon, and that light on the horizon is that the number of people in hospitals now from COVID has dramatically come down and not only that, the number of people who are reporting sick for work that has dramatically come down," she said.

"So I think that gives the health system time to actually breathe, to recover, and then to be able to start up again."

Ms Palaszczuk said the state government would discuss the stress on health systems at national cabinet on Friday, and was still advocating for a 50-50 health funding split with the federal government.