Volume 177 · Issue 1 · Supplement

At the 3rd and 4th National Forums on Prevocational Medical Education, held in 1998 and 1999, it was realised that the issues surrounding students and junior doctors who are distressed warranted further attention. As a consequence, this Conference, The student and junior doctor in distress — "our duty of care", was arranged with the aim of formulating recommendations to educational bodies, health departments and medical ...

Geoffrey W Dahlenburg MD, FRACP

A recent article noting that "unhappy doctors are a worldwide phenomenon" imputes this to ongoing changes in relationships with patients and society.1 Despite this phenomenon, many young people, for a variety of reasons, still wish to study medicine. The reasons include: parental pressure — "you've got the marks" . . . "it's a secure income" . . . "doctors are well respected" . . . ...

Kay A Wilhelm MD, FRANZCP

It has been long recognised that the practice of medicine is stressful and that doctors are prone to anxiety, depression, drug and alcohol problems, and even suicide.1,2 Similarly, the process of medical education is stressful and medical students, too, are at risk of psychological problems.3 In New South Wales, in 1997, after a report on doctors' mental health, the NSW Medical Board convened an independent Doctors' ...

Chris C Tennant MD, MPH, MRCPsych, FRANZCP

Medical courses are inherently stressful because of the nature of the course, the workload and, for some students, financial issues. These stressors can lead to impaired judgement, reduced concentration and self-esteem, and increased anxiety, manifesting in turn in depression and even suicide. In 1997, as a first-year medical student of the graduate program at Sydney University, I attended the conference of the Australian and New Zealand ...

Gisele M L Mouret MB BS (Hons), BAppSc(Physiotherapy)

The Tasmanian University Medical Students Society (TUMSS) and the Tasmanian Branch of the Australian Medical Association (AMA) have jointly run a mentor scheme linking students with doctors since 1994. However, the scheme was not meeting the needs of students. In particular, there was a lack of support for students who were distressed or affected by adverse life events, such as mental or physical illness and ...

Lisa M Barrow BSc(Hons), MPsych (Clinical), MAPS

Most members of the medical profession feel stressed at some time. If stress is ongoing, impairment may occur (defined as being unable to safely or reliably perform one's role). A continuum appears to exist between functioning well, being distressed and becoming impaired, with external (environment-related) and internal (personal-related) stressors determining where an individual will lie on the continuum. We are conducting a study which aims to ...

Michele G Daly MSc · Simon M Willcock MBBS, FRACGP

Medical Boards throughout Australia are considering amending their respective Medical Acts so that all students in each State or Territory are required to be registered with their Medical Board as a prerequisite for studying medicine. Such amendments have arisen from the increasingly litigious environment, the growing role of clinical education in traditionally preclinical years, and the recognition that medical students enjoy many of the doctor–patient ...

Stefan C Kane

Identifying the characteristics of doctors with health problems that disrupt their ability to practise medicine may help to identify young doctors and students at risk. I describe here the experience of the Health Committee of the South Australian Medical Board, which has been active for 18 years, in the hope that this might assist in formulating a prevention and early intervention program. Four main types of ...

Ross S Kalucy AM, MB BS, FRANZCP

There is compelling evidence that doctors are an at-risk group. Their high rates of mental illness and stress-related illness are of particular concern, and are reflected in tragically high suicide rates, high levels of drug abuse, and decreased job satisfaction and "burnout".1,2 All of these are powerful indicators of poor self-care. Junior medical officers, in particular, are at risk. The New South Wales Medical Board has ...

Narelle E Shadbolt MB BS, FRACGP, MFM

The training of junior doctors requires a delicate balance between "on the job" experience and quality training. . . . The preregistration year is a time in which training, skills and working role are consolidated under supervision, and it has been suggested that it may be the most stressful period in medical practice.1 In South Australian teaching hospitals, the education and training of doctors in their ...

Anne A Martin BSc(Hons), PhD

Despite our best efforts to create systems and organisational supports to facilitate optimal development for all junior medical officers (JMOs), some will continue to perform suboptimally and experience distress. It then becomes necessary to take an individualised approach to these JMOs. It must be emphasised that there is a clear distinction between distress and impairment. Distress does not imply impairment, although prolonged and unalleviated distress ...

Karen Grace BA, MSSc(Counselling)

All medical boards have as their primary objectives protection of the public; and maintenance of the highest possible standards of medical care. The Boards are state-based and constituted under Acts of Parliament. However, they are independent, operating at arm's length from government, and are self-funded through medical registration fees. While it is often stated that the medical profession is self-regulated, the reality is that the profession, community groups, ...

Alison M Reid MB BS, MHA, FAFPHM

[The comments made in this article and given at the conference were appropriate at the time. Since then, the South Australian Parliament was prorogued and an election held. The proposed new Medical Practitioners Act had not passed both Houses of the Parliament and has therefore lapsed. At this time, I am not aware of what the new Government may include in a Bill it ...

David H Wilde BA(Hons), JP

The Medical Board of Queensland, through its Health Assessment and Monitoring Program, provides active support to the medical profession, particularly to doctors recovering from impairment (ie, illness which has been serious enough to affect their capacity to practise). There are about 50 new referrals to the program each year — 37% have a psychiatric illness, 45% involve drug misuse (other than alcohol), and 7% alcohol ...

Jillann F Farmer MB BS, FRACGP

The first two breakout groups comprised medical students and prevocational trainee doctors, and the third delegates from medical boards, postgraduate councils and hospital administrators. The groups reported back on student issues, prevocational and trainee doctor issues and medical board issues. This is a condensed summary of the reports from each group. Student issuesIdentifying the distressed or impaired student is not the problem; peer groups are usually the ...

Simon M Willcock MB BS, FRACGP