Overtime claiming among Australian doctors-in-training
Andrew Coulshed
A * , Brian Fernandes A and Sanjay Hettige B
A Royal Prince Alfred Hospital, University of Sydney, 50 Missenden Road, Camperdown, NSW 2050, Australia.
B Nepean Hospital, University of Sydney, Derby Street, Kingswood, NSW 2747, Australia.
Australian Health Review 46(2) 163-169 https://doi.org/10.1071/AH21323
Submitted: 29 July 2021 Accepted: 20 January 2022 Published: 22 March 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Objective To quantify patterns of overtime among doctors-in-training in New South Wales and to explore the reasons doctors-in-training cite for not claiming overtime worked.
Methods A confidential online self-reporting survey was conducted of post-graduate doctors-in-training, working in hospitals in NSW, from post-graduate year 1 through to completion of specialist training. Questions sought to determine the average amount of overtime worked, overtime claiming patterns, and reasons why overtime was not claimed. Comparisons were made by level of training and specialty training pathway.
Results A total of 1351 valid responses were received. Unrostered overtime was extremely common, as was underpayment for work completed. Though 73.5% of respondents reported working at least 5 h of unrostered overtime per fortnight, only 15.6% of respondents reported claiming all their unrostered overtime, and among those who did claim overtime, only 45.5% reported being paid the amount in full. Common reasons for not claiming overtime included workplace cultural expectations (37.0%), and overtime not falling under approved reasons (32.6%). There were statistically significant differences (P < 0.001) in all response categories between critical care, physician and surgical training pathways.
Conclusions The survey data demonstrated a significant disconnect between expectations and reality of working hours among doctors-in-training. This is indicative of concerns regarding loss of income, impaired ability to plan workforce allocation due to hidden workload, and possibly impaired wellbeing.
Keywords: attitude of health personnel, education and training, health economics, health services administration and management, hospital medical staff, personnel staffing and scheduling, prevention and control of fatigue.
References
[1] Forbes MP, Arthur T, Manoharan B, Jones R, Kay M. Junior doctors and overtime: the Queensland experience. Intern Med J 2016; 46 635–7.| Junior doctors and overtime: the Queensland experience.Crossref | GoogleScholarGoogle Scholar | 27170246PubMed |
[2] Glasgow NJ, Bonning M, Mitchell R. Perspectives on the working hours of Australian junior doctors. BMC Med Educ 2014; 14 S13
| Perspectives on the working hours of Australian junior doctors.Crossref | GoogleScholarGoogle Scholar | 25560522PubMed |
[3] Industrial Relations Commission of New South Wales. Public Hospital Medical Officers (State) Award 2019. Sydney: NSW Health; 2019.
[4] McDougall RJ. “Don’t tell them that you’re working when you are”: safe hours and underreporting. Med J Aust 2013; 198 20
| “Don’t tell them that you’re working when you are”: safe hours and underreporting.Crossref | GoogleScholarGoogle Scholar | 23330751PubMed |
[5] Markwell AL, Wainer Z. The health and wellbeing of junior doctors: insights from a national survey. Med J Aust 2009; 191 441–4.
| The health and wellbeing of junior doctors: insights from a national survey.Crossref | GoogleScholarGoogle Scholar | 19835538PubMed |
[6] O’Grady G, Harper S, Loveday B, Adams B, Civil ID, Peters M. Appropriate working hours for surgical training according to Australasian trainees. ANZ J Surg 2012; 82 225–9.
| Appropriate working hours for surgical training according to Australasian trainees.Crossref | GoogleScholarGoogle Scholar | 22510178PubMed |
[7] O’Grady G, Loveday B, Harper S, Adams B, Civil ID, Peters M. Working hours and roster structures of surgical trainees in Australia and New Zealand. ANZ J Surg 2010; 80 890–5.
| Working hours and roster structures of surgical trainees in Australia and New Zealand.Crossref | GoogleScholarGoogle Scholar | 21114728PubMed |
[8] Forbes MP, Iyengar S, Kay M. Barriers to the psychological well-being of Australian junior doctors: a qualitative analysis. BMJ Open 2019; 9 e027558
| Barriers to the psychological well-being of Australian junior doctors: a qualitative analysis.Crossref | GoogleScholarGoogle Scholar | 31196900PubMed |
[9] Gander P, Purnell H, Garden A, Woodward A. Work patterns and fatigue-related risk among junior doctors. Occup Environ Med 2007; 64 733–8.
| Work patterns and fatigue-related risk among junior doctors.Crossref | GoogleScholarGoogle Scholar | 17387138PubMed |
[10] Tucker P, Brown M, Dahlgren A, Davies G, Ebden P, Folkard S, et al. The impact of junior doctors’ worktime arrangements on their fatigue and well-being. Scand J Work Environ Health 2010; 36 458–65.
| The impact of junior doctors’ worktime arrangements on their fatigue and well-being.Crossref | GoogleScholarGoogle Scholar | 20414629PubMed |
[11] Ahmed N, Devitt KS, Keshet I, Spicer J, Imrie K, Feldman L, et al. A systematic review of the effects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes. Ann Surg 2014; 259 1041–53.
| A systematic review of the effects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes.Crossref | GoogleScholarGoogle Scholar | 24662409PubMed |
[12] Petrie K, Crawford J, LaMontagne AD, Milner A, Dean J, Veness BG, et al. Working hours, common mental disorder and suicidal ideation among junior doctors in Australia: a cross-sectional survey. BMJ Open 2020; 10 e033525
| Working hours, common mental disorder and suicidal ideation among junior doctors in Australia: a cross-sectional survey.Crossref | GoogleScholarGoogle Scholar | 31964674PubMed |
[13] SurveyMonkey. Security Statement. 2021. Available at https://www.surveymonkey.com/mp/legal/security/
[14] NSW Government. NSW Health JMO Survey, Training & Wellbeing. Sydney: NSW Health; 2018.
[15] Ochsmann E, Lang J, Drexler H, Schmid K. Stress and recovery in junior doctors. Postgrad Med J 2011; 87 579–84.
| Stress and recovery in junior doctors.Crossref | GoogleScholarGoogle Scholar | 21441168PubMed |
[16] Moonesinghe SR, Lowery J, Shahi N, Millen A, Beard JD. Impact of reduction in working hours for doctors-in-training on postgraduate medical education and patients’ outcomes: systematic review. BMJ 2011; 342 d1580
| Impact of reduction in working hours for doctors-in-training on postgraduate medical education and patients’ outcomes: systematic review.Crossref | GoogleScholarGoogle Scholar | 21427046PubMed |
[17] Scott A. ‘The future of the medical workforce’. Melbourne: Melbourne Institute; 2019.
[18] NSW Health Workforce Relations Branch. Employment Arrangements for Medical Officers in the NSW Public Health Service. Sydney: NSW Health; 2019.
