Stress and wellbeing of junior doctors in Australia: a comparison with American doctors and population norms

Abstract

BackgroundStress in doctors adversely affects decision-making, memory, information-recall and attention, thereby negatively impacting upon the provision of safe and high quality patient care. As such, stress in doctors has been subject to increasing scientific scrutiny and has amassed greater public awareness in recent years. The aims of this study are to describe stress levels and the psychological wellbeing of current junior medical officers (JMOs), and to compare this to their predecessors, American surgical residents and population norms.MethodsPost graduate years 1 & 2 doctors at a single metropolitan tertiary referral center were surveyed in 2009 and 2014 using two reliable and validated psychometric questionnaires, the Short Form-36 (SF36) and Perceived Stress Scale-14 (PSS14), with additional questions pertaining to demographics and training. The results were compared with published data from American general surgical residents and Australian age-matched population norms.ResultsMean stress levels were lower in 2014 (23 ± 7.2) than in 2009 (27.2 ± 7.6) (p = 0.017). The mean PSS-14 score was lower than that of American surgical residents, both before (26.8 ± 7.3, p = 0.003) and after (26.7 ± 8.2, p = 0.004) implementation of the safe working hour policies but higher than societal controls (p < 0.0001). Whilst JMOs in 2014 reported better overall mental health compared to those in 2009 (p = 0.02), they were significantly worse than the general population (p = 0.009). Multivariate analysis showed that JMOs were more likely to have a high PSS-14 score or to have a low mental health score if they reported higher career anxiety (p < 0.05).ConclusionsDoctors are still at risk despite an improvement in their stress levels and overall mental health. They are less likely to be stressed and to have better mental health if they have less career-related anxiety. This has implications for the medical education and training of our junior doctors.

What non-technical skills competencies are addressed by Australian standards documents for health professionals who work in secondary and tertiary clinical settings? A qualitative comparative analysis

“…Recent evidence suggests that current Australian junior medical officers’ fatigue levels are significantly worse than the general population. 33 Fatigue leads to decreased alertness and concentration, reduced motivation and productivity, impaired information processing and increased risks of accidents. 34 The importance of managing stress in relation to patient outcomes and for the health and well-being of the health professional is highlighted by the relatively high incidence of work-related stress, burnout and suicide in health professionals.…”

Determining the feasibility and effectiveness of brief online mindfulness training for rural medical students: a pilot study

“…Medical students experience high levels of stress during their training (1)(2)(3)(4) and this continues in their junior doctor years (5,6), potentially resulting in depression, anxiety (7), burnout (8), alcohol abuse (9), and suicidal thinking (10). Stress and poor mental health increase the risk of unprofessional behaviour including impaired decision-making (11), increased errors (12,13), reduced attention and concentration (13), cynicism and loss of compassion (14) and impaired interpersonal skills (15).…”

The impact on internship of a tailored intern preparation package

“…This variation in practical skills and knowledge during the first month of internship has been identified as one of the contributing factors in increased medical error, 4 , 5 risks to patient safety, as well as intern well-being. 6 The major reported knowledge gaps in interns are as follows: prescribing medications; 7 management of the acutely unwell patient; 8 non-technical skills (including communication skills, working in a team, hospital policies, politics); and managing certain procedural skills. These are, sadly, topics not usually encountered first hand by medical students.…”