‘The hardest job I’ve ever done’: a qualitative exploration of the factors affecting junior doctors’ mental health and well-being during medical training in Australia

Abstract

Background Medical practitioners can experience considerable stress and poor mental health during their careers, with doctors in training known to be particularly vulnerable. Previous research has documented work-related factors that may play a role in the mental health status of junior doctors. However, these and additional factors, need to be explored further by considering theory-driven, social, structural and contextual issues. This qualitative study aimed to explore the experiences of junior doctors working in Australian hospitals to identify factors that impact their mental health during medical training. Method Semi-structured interviews were conducted with 12 junior medical officers (JMOs) employed across six hospitals in Australia. Transcribed de-identified interviews were analysed thematically using a data-driven inductive approach. Results Four interrelated main themes were identified: i) professional hierarchies; ii) occupational stress; iii) emotional labour, and iv) taking distress home; which detail the complex affective, relational and professional experiences of JMOs. The accounts demonstrate how the social, professional and organisational dimensions of these experiences impact upon trainee’s well-being and mental health, both positively and negatively. Together, the findings document the dynamic, nuanced aspects of junior doctors’ experiences of medical training and practice and highlights the importance of relational connections and the workplace environment in shaping JMOs’ social and emotional well-being. Conclusion The current study adds to the understanding of how junior doctors navigate medical training in Australian hospitals and highlights the complexities of this experience, particularly the ways in which mental health and well-being are shaped by different elements. These findings have important implications to inform new strategies to improve JMO mental health and to leverage work and non-work contexts to better support JMOs during medical training.

Well-being of family physicians during COVID-19 pandemic in Slovenia

“…The need to follow instructions and rules that are perceived as inadequate, the lack of resources to meet patients' needs, excessive numbers of patients and poor personal relationships between staff, worn-out practice software were cited as the most serious stress factors [23,24]. The results of our study show that physicians with fewer years of work experience report poorer well-being, which has also been shown in other studies [25][26][27]. This finding is probably a consequence of the impact of work on the private and family life of physicians, in particular a conflict between the professional role and the role as a parent [23].…”

Work-related factors and the risk of common mental disorder 1 year later: A prospective cohort study among junior doctors

“…supervisor, co-worker, fellow junior doctor) for mental health among doctors and junior doctors and any available findings have generally supported the importance of social support in general for the mental health of doctors (Dunning et al, 2022;McLuckie et al, 2018;Mikkola et al, 2018;Riley et al, 2021b). Supervisors hold positions of power, and within medical training, are often in charge of making decisions regarding entry into specialist training programmes (Petrie et al, 2021b). As a result, junior doctors may be more reluctant to disclose problems or seek support from supervisors for fear of negative repercussions on their career progression.…”

“…Our second finding concern the a total number of hours worked and work-life balance, with junior doctors experiencing work-life imbalance having more than six-fold greater odds of CMD one year later than their counterparts with work-life balance. The balance between one's personal and professional life has long been recognised as important in employee well-being (Haar, 2013;Kossek et al, 2014), with emerging evidence from cross-sectional studies demonstrating an association between work-life imbalance, mental ill-health and burnout within the medical profession (Compton and Frank, 2011;Dyrbye et al, 2011Dyrbye et al, , 2013Humphries et al, 2020;Parida et al, 2023) and in qualitative studies with junior doctors (Petrie et al, 2021b;Rich et al, 2016;Riley et al, 2021a). The medical profession has traditionally prioritised work over other commitments and normalised a culture of overwork and a lack of self-care (Center et al, 2003), which, alongside growing time pressures and an increasingly stretched healthcare system, generate structural and professional barriers to a healthy work-life balance for all doctors.…”

A scoping review of mental health status in Australian medical students and doctors‐in‐training (DiT)

“…The common themes identified as barriers to psychological well‐being include the amount of workload, rostered hours, and bullying by patients and colleagues contributing to poor workplace culture 18–20 . To quantify the impact of workload on mental health outcomes, a subgroup analysis of 2706 junior doctors surveyed as part of the broader Beyond Blue National Mental Health Survey of Doctors and Medical Students in 2013 was conducted 21 .…”