Abstract
The working hours of junior doctors have been a focus of discussion in Australia since the mid-1990s. Several national organizations, including the Australian Medical Association (AMA), have been prominent in advancing this agenda and have collected data (most of which is self-reported) on the working hours of junior doctors over the last 15 years. Overall, the available data indicate that working hours have fallen in a step-wise fashion, and AMA data suggest that the proportion of doctors at high risk of fatigue may be declining. It is likely that these changes reflect significant growth in the number of medical graduates, more detailed specifications regarding working hours in industrial agreements, and a greater focus on achieving a healthy work–life balance. It is notable that reductions in junior doctors’ working hours have occurred despite the absence of a national regulatory framework for working hours. Informed by a growing international literature on working hours and their relation to patient and practitioner safety, accreditation bodies such as the Australian Commission on Safety and Quality in Health Care (ACSQHC) and the Australian Medical Council (AMC) are adjusting their standards to encourage improved work and training practices.
Highlights
As summarized elsewhere in this supplement, a significant body of evidence speaks to the negative impact of fatigue on both patient safety and the health and wellbeing of junior doctors
The working hours of junior doctors have been a focus of discussion in Australia since the mid-1990s
The available data indicate that working hours have fallen in a step-wise fashion, and Australian Medical Association (AMA) data suggest that the proportion of doctors at high risk of fatigue may be declining
Summary
As summarized elsewhere in this supplement, a significant body of evidence speaks to the negative impact of fatigue on both patient safety and the health and wellbeing of junior doctors. Pre-vocational training is usually completed by means of one to two years of generalist experience, predominantly in public hospitals This stage of training is underpinned by the Australian Curriculum Framework for Junior Doctors, which outlines the knowledge, skills, and behaviours required to work safely in a variety of health care settings [3] and provides a structured bridge between undergraduate and specialty college curricula. The number of advanced training positions for specialty trainees has increased by nearly 50% in the last five years [21] This may be expected to reduce hours of work in the medium term, a recent report to Health Workforce Australia (a Commonwealth agency) that contrasted jurisdictions with increased numbers of graduates with jurisdictions with stable numbers of graduates suggests that, at this stage, “there are few consistent changes in the working patterns of junior doctors and their supervisors associated with graduate expansion [22].”. Ensuring trainees can meet their educational goals and service delivery requirements within safe hours of work is the responsibility of all parties [26].”
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