It’s time to Change the Rules for Doctors in Training



The story of Yumiko Kadota and her heartbreaking account of her time as an unaccredited surgery registrar is just the latest example of doctors working unsafe hours with extended shifts, onerous on-call rosters and call-backs.

The Australian newspaper this week reported on its analysis of data from the 10th MABEL (Medicine in Australia: Balancing Employment and Life) survey, finding that more doctors-in-training are being compelled to work excessive hours, despite the potential risks to staff and patients. Doctors-in- training across Australia are working, on average, over 44 hours a week and the proportion working 50 hours, or more is over 39 per cent.

Our own ASMOF/AMA Hospital Health Check Survey provides clear evidence that doctors-in-training are working too many unsafe hours.

The Australian and international evidence about the damaging effects of excessive hours of work is undisputed. The risks of onerous rosters are far-reaching, with the potential to affect not only the health of doctors but their patients as well.

A literature review conducted by NSW Health in 2017 found, among other things, that unsafe working hours and practices are a significant risk factor in the health and wellbeing of doctors-in-training.

The evidence clearly shows that reducing excessive work hours, increasing available resources and exploring new rostering initiatives are three prevention solutions that should form part of a broader range of wellbeing and support mechanisms for doctors-in-training.

ASMOF has been campaigning for over four years to get the NSW Government to agree to the necessary changes to improve the working lives of doctors-in-training and to meet its obligations under work health and safety legislations.

Despite increasing recognition of the extent of the problem, the NSW Government has been too slow in implementing solutions.

Enough is enough. We call on the Government to implement the necessary change to ensure that tragic and preventable cases of fatigue-related illness and deaths do not occur.

ASMOF President Tony Sara has thrown down the gauntlet to both sides of politics. If you care about patient safety, and doctors-in-training, then change the rules to let us achieve enforceable and long-lasting change to the way doctors-in-training work.

What needs to change?

ASMOF demands the following:

  1. An Award that is up to date and fit for purpose and which includes the following conditions:
  • an enforceable mechanism to prevent hospitals from making doctors-in-training work unsafe hours.
  • a 14-hour cap on shift length.
  • a mandatory 10-hour minimum break between shifts
  • a cap on the number of consecutive days a doctor-in-training can work.
  • a cap on the number of consecutive night shifts that a doctor-in-training can work.
  • rostering protections so that rosters must be arranged such that time for rest and sleep is maximised between shifts.
  • improvements to unrostered overtime.
  • protections to ensure that unaccredited registrars will be rostered no less unfavourably than accredited registrars.
  • workload monitoring provisions.
  1. A commitment from both sides of politics that whoever wins the March State election will change the unfair wage’s policy which prevents us running work value cases, or even work health and safety cases in the NSW industrial relations commission.
  2. A boost in funding for the recruitment of extra registrars where necessary, or, where relevant and justified by an LHD
  3. A formal external review of rostering, on call, and call backs, for all registrars in NSW at one year after an initial assessment and implementation period.

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