The doctor-in-training memoir of 2020

The COVID 19 pandemic has thrown up a multitude of new challenges for junior medical practitioners. During these unprecedented times in health care, we have seen doctors grappling with many new questions as well as facing new and unchartered issues in their own workplaces.

Never has there been a more important time to take care of yourself and read the fine print. While no corner of the world has been untouched by this pandemic, our junior doctors – with exam worries, young families, mortgages, distance from extended families, and fears of falling sick – have certainly taken their fair share of the strain.

In this article, we look at some of the more frequent concerns we have been discussing with our early career Members.

One of the earliest and most frequent requests was from GP Registrars who were being asked to write a certificate to declare a patient as either unfit to work due to COVID 19 or fit to return to work during the pandemic. It was virtually impossible for practitioners to really know one way or another with any certainty.

Sometimes, patients put unreasonable pressure on practitioners, usually unintentionally, due to their own stress. Regardless, practitioners ultimately need to follow peer-accepted practice. In particular, we would refer them to the Medical Board Code of Conduct (at 10.9) which sets out the requirement to ensure a signed statement is reasonably true, not misleading, accurate, and that they have not omitted relevant information deliberately.

Patients may ask for things you can’t necessarily give them. In such cases, we suggest it may be a situation where a letter of support is more appropriate. And it’s always okay to say no.

Next, in some states, came face masks being made compulsory. Doctors, young and old, faced requests from patients for a letter to say they were exempt from wearing a mask. These were unknown waters that led to uncertainty about the best course of action.

For junior doctors, new demands and little guidance from established mentors only increased their already high stress levels. It’s no wonder we’re all looking forward to the end of 2020.

Although the Federal Government did what they could to make life easier, in the short term the unclear messaging and constantly changing goal posts had us all scrambling. This included the introduction of the new MBS items to enable increased provision of telehealth medical services. For any doctor in training, the MBS is a minefield to get your head around, let alone having to cope with weekly changes.

In hospitals, rotations were frozen. This was wonderful for some, but heartbreaking for others – stuck in departments they didn’t enjoy, with night shifts and difficult consultants. In private practice, sudden drops in income led to job uncertainty and dark clouds for the future.

Throughout this time, we have continued to support our junior doctor Members with their individual stressors – from employment uncertainty to exam delays.

Be prepared and seek support

• When faced with changes and challenges in your work conditions, keeping calm and being prepared to listen is a good starting point. You can ask that any proposed changes be provided in writing, to give you the opportunity to consider and obtain advice.
• It’s useful to familiarise yourself with your employer’s policies and procedures, and the terms of your contract, so you know what’s expected of you in relation to rosters and how much notice you need to give of any application to change the roster. Knowing who to talk to about these things is also important.
• Take leave and avoid burnout. Make sure you have your own GP and a good support network around you, even if that means via Zoom or FaceTime!
• What’s that old saying about an ounce of prevention being better than a pound of cure? Wherever you are and however your year has been, make sure you also take care of the paperwork in your life. When staying, leaving or graduating to a new role, read your contract carefully to ensure you’re familiar with the terms around (in particular) the period of notice you should provide and any restraint provisions.
• Useful sources of support include the AMA in your state and your professional associations and, of course, MDA National. Don’t hesitate to contact our Medico-legal Advisory team if you have any concerns, big or small. We are here to help you.

Contracts – what you need to know
https://www.mdanational.com.au/advice-and-support/library/articles-and-case-studies/2017/02/contracts-what-you-need-to-know

Contemplating change
https://www.mdanational.com.au/advice-and-support/library/articles-and-case-studies/2017/02/contemplating-change-gp-practice

How restrained are you?
https://www.mdanational.com.au/advice-and-support/library/articles-and-case-studies/2012/06/how-restrained-are-you