Toxic medical workplace cultural change won’t happen overnight, trainees told

Medical politics

13 Feb 2019

The overwork and bullying culture facing many medical trainees is unacceptable but changing that workplace culture will take time, the Royal Australasian College of Physicians (RACP) says.

The College has released a statement mirroring concerns raised over the working conditions faced by trainee surgeons from the Royal Australasian College of Surgeons (RACS) following a media storm around accusations of the appalling registrar workloads and abuse by senior staff and managers.

RACP president Associate Professor Mark Lane said the organisation had “zero tolerance for such behaviour” and improving workplace culture involved “shared and overlapping areas of responsibility” with colleges

“While there is much that has been done to improve the working hours and culture in medicine, more needs to be done to address the untenable working hours and unacceptable behaviour in hospitals and training sites”.

Media attention has focused on hospital working practices following articles written by Dr Yumiko Kadota, a former plastic and reconstructive surgery registrar. She described how a workload of up to 70 hours per week and being on call for 180 continuous hours at Bankstown Hospital led to her quitting and leaving her “broken” physically and mentally. When she raised concerns with management about sleep deprivation and being unsafe to work she was told to “stop being an emotional female”, and that the exhaustion “was good for her”.

Her story “The ugly side of becoming a surgeon”, re-published earlier this month, led to widespread outrage at her treatment, bringing focus to the plight of unaccredited registrars without specialist college back-up. It also led to proposals from the RACS to withdraw accreditation from the hospital’s training system, not to mention a social media storm of outrage.

Doctors-in-training representatives are now calling for an independent audit of doctor works hours.

The RACS revamped its training system following media reports of the “toxic culture” prevalent in surgery and in some hospitals, prompting its own 2015 report and the launch of its “Operating with Respect” (OWR) course for those involved in training.

Dr Erica Jacobson, paediatric neurosurgeon at Sydney Children’s Hospital, has been teaching the RACS’s “Operating with Respect” (OWR) course and told the limbic there had been slow but significant improvements in workplace culture.

She noted it was now compulsory for all RACS members involved in training to take the one-day OWR course, which was peer-to-peer and “designed not to be patronising”.

While most people “approach it well” there were still instances of push-back mainly from some who felt by doing the course they were already being chastised, she said.

And besides cultural issues there were greater hospital systemic issues leading to pressure on registrars.

“There are many problems in the hospital system that stress everybody,” she said, and currently “there’s just not enough resources.”

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