Working as a doctor at the Canberra Hospital and serving those that live in our city and health catchment area is a great honour.
However, with each shift I am reminded of Ben Johnson's observation that "great honours are great burdens", and whilst many may hold envy toward our vocation, we are certainly bearing both these loads living and working in our city.
As stated earlier this week by reporter Daniella White, the problems faced by junior medical staff at Canberra Hospital aren't new and are getting worse by the day.
The impact on patient care is increasingly obvious, with ample data showing we simply cannot get to those attending the hospital quickly enough to provide the level of care all Canberrans deserve. For years we have been pleading for the system to be fixed to no avail.
A friend recently analogised our circumstance to that of Sisyphus, destined to push a large boulder up a hill, only to have it immediately roll back down again, repeating the Groundhog Day process ad nauseum. However, this isn't an apt comparison.
The Greek myth that best compares to us is the punishment of Tantalus: every time we reach for safe patient care it moves further away, and each time we dip back to a safe practice the security blanket recedes.
However, there may be hope on the horizon, as Maitland Hospital may have shown what is required to motivate the government and administration to take genuine action.
Friends of mine in the emergency department are crying at the end of each shift, and those of us on the wards have panic attacks when our phones ring at home.
This week the Royal Australasian College of Physicians rescinded accreditation for junior medical officer training at Maitland Hospital due to unsafe rostering, unpaid overtime, limited or no provision of education, and inadequate supervision. This action meant that trainee physicians working at Maitland Hospital were immediately shifted elsewhere, granting them the security of safe patient care, their baseline employment entitlements, and the opportunity to realistically prepare for upcoming specialist exams.
Unsurprisingly, the hospital instantly moved to correct each of these faults, submitting an application for reconsideration to the RACP within days of the ruling. Disappointingly, years of polite requests to the hospital's medical administration achieved nothing (when they could even be safely made without the potential of ruining a junior doctor's career), and now several hospitals in NSW have shown that only the most extreme option of removing junior doctors from the hospital gives hospitals sufficient motivation to take the drastic action required to ensure patient safety.
As has been widely reported, Canberra has some of the worst specialist exam pass rates in the country, due to junior medical staff being overworked and poorly supported. I am a physician trainee, and know all too well how difficult it is to attempt to manage work and specialist training without the support mechanisms stipulated in our award.
Junior doctors don't want to be paid overtime because we want more money. Rather, we want overtime to be paid so that less of it is undertaken, as it provides a financial incentive for the hospital to recruit more staff at base rates instead of paying fewer at significant penalty rates.
We don't want extra supervision or education so we can do less work, we just want to be able to prepare for and pass exams so that we can continue to serve our community. We want to know that we are supported enough to provide safe care to all patients every day, not just the ones that happen to need our help on "quiet days".
Dr Nick Coatsworth recently stated that junior medical officer morale at Canberra Hospital has been boosted. I do not know a single colleague of mine that agrees with this. The last two weeks have seen repeat record-breaking days for the number of patients presenting to the hospital, most being seen in unsafe time frames with no beds available for them in the hospital.
Friends of mine in the emergency department are crying at the end of each shift, and those of us on the wards have panic attacks when our phones ring at home thanks to the mental association with relentlessly beeping pagers. This is happening at a time when the number of junior medical officers on staff is the lowest it has been all year, with a significant number also attempting to prepare for upcoming exams, knowing they are likely wasting their time and money.
In a year that we have had to work through smoke-filled wards, prepare for a pandemic, and have abrupt roster changes made due to ACT Health's poorly delivered screening policies, hearing the most senior doctor say it's all sunshine and rainbows is a very bitter pill to swallow.
However, ignoring the spin is easy. There is abundant evidence to demonstrate that the same conditions that have caused Maitland Hospital to lose its physician trainees - inadequate staffing, unsafe rostering, unfair pay, and lack of support - also exist at the Canberra Hospital in extremis. Perhaps a similarly extreme response from the RACP and other medical and surgical colleges will be the catalyst for the change that is so desperately required.
For me, as much as I love working and living in our city, bearing both the honour and the burden is too much. I have chosen, like many of my colleagues have this year, to continue my medical career elsewhere. We junior doctors have failed to convince the hospital to enact the changes required to ensure safe patient care simply by giving us a fair go, and we are exhausted. Maybe the colleges will finally force the hand of ACT Health, but let's not wait for that.
If you're a Canberran and care enough about our public health system, please write to Rachel Stephen-Smith, Andrew Barr, Shane Rattenbury, and Nick Coatsworth. Tell them why the nurses, allied health, and doctors working at our hospital matter to you. Tell them why our health system being properly resourced and funded is vital.
At the very least, your support will help us junior doctors to push on for that next relentless shift.
- The author of this opinion piece is a junior doctor at the Canberra Hospital and has requested to remain anonymous.