Disturbingly, three quarters of doctors-in-training surveyed for the 2018 Hospital Health Check said they were concerned there might be ‘negative consequences’ if they reported inappropriate workplace behaviours.

Wollongong was one of two NSW public hospitals to score a failing ‘F’ grade in the staff well-being category of the survey, which checks the pulse of junior doctors at hospitals statewide.

Across NSW, 1351 doctors were surveyed – accounting for more than 20 per cent of all doctors-in-training working in the state.

Sixty of Wollongong Hospital’s junior doctors participated in the survey, with the facility scoring a ‘C’ average across five categories.

Average ‘C’ grades were given for the categories of overtime and rostering; access to leave; and education and training. The hospital received a decent ‘B’ for morale and culture, however it was the well-being category that pulled down the total score.

In that section, four out of 10 doctors rated the hospital’s support for their mental health and well-being as ‘poor’. Meantime 45 per cent said they had felt unsafe at work due to verbal or physical intimidation or threats from patients or staff.

Fifty-five per cent said they’d witnessed a colleague being bullied, discriminated against or harassed. And 42 per cent said they didn’t know how, or whom, to report bullying or harassment.

It’s the second year in a row the survey has been run by The Alliance – which incorporates the Australian Medical Association and the doctors’ union ASMOF.

In 2017, Wollongong also received an overall grade of C. However it scored D for overtime and rostering and well-being; C for morale and culture; and Bs for access to leave and education and training.

Illawarra Shoalhaven Local Health District Executive Director Medical Services and Clinical Governance, Dr Mark Bassett, said the survey outlined opportunities to improve their performance.

“The district does not condone bullying, aggression or violence in the workplace,” he said. “We have a zero tolerance approach to bullying and harassment and we are constantly working to develop a workplace culture whereby any staff member who is bullied or witnesses bullying, feels comfortable and safe to report that activity.”

Dr Bassett said the district was in the process of developing a code of conduct to promote better relations between senior medical officers and junior doctors.

They were also about to appoint to a newly created position, Manager Medical Education and JMO (Junior Medical Officer) Well-being.

“A key component of their role will be to facilitate and support the development of JMO education and training, and to promote programs to improve JMO well-being including mentorship and support for JMOs experiencing difficulties or stress,” he said.

Locally, forums have been held offering junior doctors a chance to voice concerns to the district’s executive – and an additional forum is scheduled for the middle of November.

A workshop for medical leaders was held at the end of October – which aimed to strengthen the role of managers in promoting the welfare of junior doctors. 

Dr Bassett said the district also participated in a range of statewide initiatives to support junior doctors’ health and well-being. These included a junior medical officer support line and confidential anti-bullying line.

Anti-bullying management advisors were also available to coach senior staff on effective complaints management, and training in people management skills was also provided.

“We acknowledge that there are areas relating to our doctors in training that we can improve and the district continues to focus on specific areas where concerns have been expressed in the past,” Dr Bassett said.

He encouraged staff to talk to their supervisor, or contact the director of medical services or hospital general manager.

“We greatly value our JMO staff, as we do all staff,” he said. “We know that JMOs often feel that they are working under pressure and experience stress due to the responsibilities of being a junior doctor, we are fortunate to have a talented medical workforce of senior and junior medical officers who are committed to excellent care for patients.”

In other survey categories, almost a third of junior doctors said their rostered hours ‘never’ matched the hours they were expected to be at work at Wollongong Hospital.

Ten per cent felt their workload was ‘far too heavy’ and a further 55 per cent thought it was ‘somewhat too heavy’.

Almost a quarter of staff surveyed claimed they did 10 to 15 hours of rostered overtime per fortnight, while 20 per cent said they did 15 to 25 hours of unrostered overtime.

More than three-quarters said they had been concerned about making a clinical error due to fatigue caused by the hours worked. A similar percentage had been concerned about their personal health and safety due to fatigue.

Four out of 10 doctors rated the overall quality of ward-based teaching at Wollongong as ‘poor’ or ‘very poor’; while almost a quarter rated the quality of clinical supervision as poor.

In terms of morale and culture, the hospital fared better with a third of doctors rated the work culture as ‘good’ or ‘very good’ – although around 20 per cent felt it was poor. 

One quarter of doctors also said staff morale was poor, though 43 per cent felt it was ‘fair’ and 28 per cent rated it ‘good’.

Meantime 19 doctors said they’d experienced discrimination or bias from staff at the hospital due to gender; seven over issues related to pregnancy or being a carer; two over marital status, one for their sexuality and four due to race.

Seventy per cent though said they would recommend the hospital to other doctors-in-training.