Junior doctors pressured to fudge work hours prompts push for audit

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Plastic and reconstructive surgeon Dr Neela Janakiramanan said she had been contacted by several trainee surgeons in the past week describing outrageous work hours.

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One surgical registrar told Dr Janakiramanan they had worked 86 hours in the previous five-and-a-half days, but they were only allowed to record 40 hours on their timesheet, effectively leaving 46 hours unpaid.

Another surgical registrar was rostered to work 42 out of 47 days, with a 19-day-straight stretch.

Both trainees said they could not complain to their hospitals because they didn’t want to be seen as “troublemakers”, Dr Janakiramanan said.

“They’re worried they’re killing themselves to get onto training programs and their bosses won’t even notice how hard they’re working,” Dr Janakiramanan said.

Last week, Dr Kadota, 31, brought to national attention the exploitation of trainees. She described being dismissed as an “emotional female” and her pleas for support were ignored as she worked up to 70 hours a week and on-call 10 out of 14 days in Bankstown Hospital’s plastic and reconstructive department.

Dr Yumiko Kadota gave up her ambitions of becoming a reconstructive surgeon after being worked to breaking point at Bankstown Hospital.

Dr Yumiko Kadota gave up her ambitions of becoming a reconstructive surgeon after being worked to breaking point at Bankstown Hospital. Credit:James Brickwood

Dr Janakiramanan is one of many doctors calling for an external audit of trainee doctors’ rostered shifts, rostered overtime, unrostered overtime and on-call hours.

“I don’t think anyone in hospital management appreciates the amount of work their registrars are doing,” Dr Janakiramanan said.

The 2018 Hospital Health Check survey of doctors in training found more than one third did not claim any of their unrostered overtime.

The majority fudged their timesheets because they were advised not to make the claims by a superior or hospital administration, believing it would negatively impact their careers, or due to workplace expectations.

Vice president of ASMOF Dr Tony Sara.

Vice president of ASMOF Dr Tony Sara.

President of ASMOF Dr Tony Sara strongly supports calls for a robust independent audit if governments commit to acting on the findings, including adding relevant award protections to ensure hospitals adhered to fair rostering.

Without this assurance, any audit would be “tokenism”, Dr Sara said.

Dr Chris Wilson, deputy chair of AMA’s Council of Doctors in Training said an audit needed to be conducted at the highest levels. “These are employment issues that hospitals and health services should be making a priority,” he said.

Dr Wilson said the “lost tribe” of unaccredited registrars needed the same level of protections as their accredited counterparts.

“If that happens, we will very quickly see practices like people having 10 out of 14 days on-call disappear because it’s not safe for the individual or patients.”

NSW Health Minister Brad Hazzard said the ministry had been finding it “very challenging” to ascertain the extent of the problem, because many trainees were “scared witless” of correctly logging their hours.

Mr Hazzard said an external audit may be necessary and he would consider raising it with other state and territory ministers at COAG.

But he said specialist colleges also needed to bear some of the responsibility for the hours they expected trainees to work.

Kate Aubusson is Health Editor of The Sydney Morning Herald.

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