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Volume 177 Issue 1 Supplement · 1 July 2002

eMJA: Supplement: The student and junior doctor in distress

The Student and the Junior Doctor in Distress — "Our Duty of Care" Proceedings of a Conference of the Confederation of Postgraduate Medical Education Councils 19–20 July 2001 MJA 2002; 177 (1 Suppl): S1-S32 CONFEDERATION OF POSTGRADUATE MEDICAL EDUCATION COUNCILS Postgraduate Medical Council of Victoria The Postgraduate Medical Institute of Tasmania The Northern Territory Postgraduate Medical Council The Postgraduate Medical Council of New South Wales Council for Early Postgraduate Training in South Australia The Postgraduate Medical Education Foundation Queensland The Prevocational Training and Accreditation Committee in Western Australia Supported by the Commonwealth Department of Health and Aged Care through the Medical Training Review Panel Organising Committee     Tamsin K Cockayne, MB BS, Prevocational Doctor, Royal Darwin Hospital, Darwin, NT 0810 Geoffrey W Dahlenburg, MD, FRACP, Chairman, Confederation of Postgraduate Medical Education Councils, 71 Edward Street, Norwood, SA 5067 Martha M Finn, BSc, MD, MRCOG, MRCPI, FRANZCOG, Director of Clinical Training, Royal Darwin Hospital, Darwin, NT 0810 Richard Hays, MB BS, PhD, FRACGP, Dean, School of Medicine, James Cook University, Townsville, QLD 4811 Stefan C Kane, President, Australian Medical Students Association, 161 Ward Street, North Adelaide, SA 5006 Alison M Reid, MB BS, MHA, FAFPHM, Medical Director, New South Wales Medical Board, PO Box 104, Gladesville, NSW 1675 Faye E Stephens, BA, BSc, MA(Psych), Assistant Director, Medical Training Review Panel Secretariat, Department of Health and Ageing, GPO Box 9848, Canberra, ACT 2601 David G Thomas, MD, FRACP, Director of Physician Training, Women's and Children's Hospital, North Adelaide, SA 5006 Simon M Willcock, MB BS(Hons), FRACGP, Chairman, Postgraduate Medical Council of New South Wales, PO Box 422, Gladesville, NSW 1675 Conference Participants     Dr Stephen Addis Ms Anita Alps Dr George Anasson Dr Adrian Anthony Ms Margaret Banks Ms Lisa Barrow Dr Michaela Baulderstone Ms Joan Benjamin Dr Jane Birks Mr Bob Bradford Dr Wilton Braund Prof Richard Burns Prof Alan Carmichael Mr Rajeev Chalasani Dr Szu Chan Dr Thomas Chan Dr Cleo Cheng Dr Anthony Clarkson Dr Tamsin Cockayne Dr Mary Cohn Ms Judy Conroy Mr Graeme Cox Miss Jackie Cunningham Ms Samantha D'Cruze Prof Geoffrey Dahlenburg Ms Michele Daly Ms Libby Davidson Mr Fletcher Davies Dr Anne Egan Dr Jillann Farmer Dr Rodney Fawcett Dr Martha Finn Dr Eleanor Flynn Ms Helen Fraser Dr Andrew Gardner Dr Matt Gaughwin Ms Karen Grace Dr Mitra Guha Ms Jennifer Hadley Dr Sue Hampton Mrs Jennifer Harlen Mrs Kaye Harnwell Dr Joanna Hely Dr Patrick Hertnon Ms Vanessa Hewson Ms Eve Hiland Ms Jane Hosking Mrs Gemeah Howarth-Hockey Dr Jaspal Hunjan Dr Imre Hunyor Mr Robert Indrigo Dr Michael Jelly Mr Greg Jemsek Ms Penelope Johnston Mr Gregory Jones Dr Jo Jordan Ms Carol Jordon Prof Ross Kalucy Mr Stefan Kane Ms Tanya Kelly Miss Bronwen Koenders Dr Christine Lai Prof Lou Landau Mr Mitchell Lawlar Ms Adrienne Lewis Ms Rebecca Licastro Ms Siobhan Lockwood Dr Cathy Love Dr Andrew Lovett Mr Cameron Mackay Dr Anne Martin Dr Helen McArdle Prof Barry McGrath Ms Helen McKeering Dr Sally Middleton Ms Jacqueline Milne Dr Patricia Molloy Dr Gisele Mouret Dr Catherine Muggeridge Ms Anne-Marie Murray Ms Rosalind Nagoroka Miss Sarah Nunan Dr Susan O'Brien Dr Elizabeth O'Driscol Prof Gary Phillips Ms Anne Powell Dr Luis Prado Ms Penelope Purslow Mr Evan Rawstron Mr Hesom Razavi Dr Deborah Read Dr Alison Reid Prof Geoff Riley Ms Helen Ritchie Dr Darren Roberts Dr Lindy Roberts Dr Stuart Roberts Miss Michelle Rodrigues Prof Peter Roeser Dr Elizabeth Rozenbilds Dr Stuart Salfinger Ms Susie Sangas Dr Anthony Sangster Dr Vino Sathianathan Dr Michael Schirripa Mr Tyler Schofield Dr Narelle Shadbolt Prof Ian Simpson Dr Andree Salter Ms Faye Stephens Dr Margaret Sturdy Dr Mary Surveyor Ms Melissa Sweet Dr Brenda Tait Dr Richard Tarala Prof Christopher Tennant Dr David Thomas Dr Lloyd Toft Assoc Prof Anne Tonkin Dr Andrew Turner Dr Angus Turner Dr Jane Vernon-Roberts Dr Alistair Vickery Prof Alan Walker Dr Naham Warhoft Dr Bruce Warton Dr Richenda Webb Dr Sarah Whitelaw Mr David Wilde Assoc Prof Kay Wilhelm Dr Simon Willcock Mr Owen Williams Mr Simon Wilson Prof Lindon Wing Mr Jason Yates Dr Michele Yeo Ms Anita Yuen

Supplement 1 July 2002 Open Access

Conference overview: a duty of care

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

Supplement 1 July 2002 Open Access

The student and junior doctor in distress

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

Supplement 1 July 2002 Open Access

A student mental health and welfare program in a medical faculty

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

Supplement 1 July 2002 Open Access

Stress in a graduate medical degree

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)

Supplement 1 July 2002 Open Access

Tasmanian University Medical Students Society student mentor scheme: a model to help students in distress

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

Supplement 1 July 2002 Open Access

Examining stress and responses to stress in medical students and new medical graduates

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

Supplement 1 July 2002 Open Access

Registration of medical students by medical boards

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

Supplement 1 July 2002 Open Access

Overview: the experience of the Health Committee of the South Australian Medical Board

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

Supplement 1 July 2002 Open Access

Attitudes to healthcare and self-care among junior medical officers: a preliminary report

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

Supplement 1 July 2002 Open Access

The junior doctor in distress: the role of a medical education officer at the systems level

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

Supplement 1 July 2002 Open Access

The junior doctor in distress: the role of a medical education officer at the individual level

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)

Supplement 1 July 2002 Open Access

Overview: the experience of the New South Wales Medical Board

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

Supplement 1 July 2002 Open Access

Changes to the South Australian Medical Practitioners Act 1983

[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

Supplement 1 July 2002 Open Access

Return to work for junior doctors after ill-health

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

Supplement 1 July 2002 Open Access

Reports from breakout groups

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

Next Issue Volume 177 Issue 2

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