Hospital dysfunction behind Canberra’s failing trainee doctors

Ian Bushnell 11 November 2020 15
Canberra Hospital

Canberra Hospital: overworked trainee doctors had little time to devote to study and training. Photo: File.

Canberra Health Services is confident an overhaul of doctor training and working conditions in Canberra’s public hospitals will remedy unacceptable pass rates.

CHS ordered an external review after exam results went backwards in 2018 and 2019, with pass rates of just 37 per cent in 2019 and 36 per cent the year before.

The year-old review, revealed after a journalist’s freedom of information request, exposed a dangerous workplace culture in which trainee doctors were overworked and subject to capricious roster and leave changes that left little time for training.

Trainee doctors reported high levels of burnout and low morale, as well as insufficient teaching contact including limited outpatient training and practice case opportunities.

They also said most of the training program was scheduled after hours.


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The review found a delay in the appointment of a new ACT Network Director of Physician Education led to a breakdown in the training structure, a lack of mentoring and disengaged senior clinicians.

The review identified a lack of pride in the training program, poor communication between the training team and clinicians, no teaching champions, and no incentives or rewards for teaching, mentoring or examining.

Some of the review’s findings echoed that of the wider workplace culture review in Canberra’s hospitals and notes a period of instability and conflict preceding the decline in doctor training.

CHS has assured the public that patient care had not been compromised and that 38 of the 54 recommendations have been implemented including leave management plans, two hours of protected and guaranteed teaching time a week, trial exams, increased mentoring and greater involvement from senior clinicians.

Dr Nick Coatsworth

Dr Nick Coatsworth: ”I’ve come back to an improved culture, and if that’s not being felt by our physician trainees I personally want to know about it and act to fix that.” Photo: Dominic Giannini.

Executive director of medical services Dr Nick Coatsworth said the exam results were clearly unsatisfactory and the review’s recommendations were not unexpected.

He said Canberra’s hospitals had all the right ingredients to have excellent pass rates and continue to provide excellent care to patients.

”We want to be a preferred employer of excellent physician trainees but to have that we’re going to have to have several years of consistently improving exam results,” he said.


READ MORE: Dr Nick Coatsworth takes on his toughest appointment yet


Dr Coatsworth said it was just not possible to study and work 150 hours a fortnight, as well it not being safe.

”If that happens we are in direct contact with that unit making sure that work is more equitably distributed,” he said of the safety net implemented to stop excessive work hours.

The review recommended more teaching staff and Dr Coatsworth said the number of staff required for the physician training program was being reviewed.

He said clinician engagement had improved with an increasing number of physicians actively involved in the exam process.

”Amongst all our physicians there is an expectation that they contribute to the teaching program at Canberra Hospital,” he said.

Dr Coatsworth said there had been significant cultural changes at the hospital, and frequent checks were being made to see how trainees were going.

”I’ve come back to an improved culture, and if that’s not being felt by our physician trainees I personally want to know about it and act to fix that,” he said.

Canberra’s trainee doctors have not yet sat their 2020 exams due to the pandemic, but will do so in coming months.


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15 Responses to Hospital dysfunction behind Canberra’s failing trainee doctors
Catherine Flynn Catherine Flynn 8:09 pm 12 Nov 20

Val Kuta this was the article I was talking about

Ol L Ol L 4:43 pm 12 Nov 20

If nearly 20% of Canberra hospital users come from NSW this is hardly a simple Canberra issue, do NSW pay us there fare share of the costs?

Josephine Bresnik-Kaminskas Josephine Bresnik-Kaminskas 4:01 pm 12 Nov 20

And yet it healthcare costs more in the ACT than in any other state in Australia. One has to wonder where the money is going

Kay Selmes Kay Selmes 10:24 am 12 Nov 20

tell me about it. anyone who has lost someone asks themselves that... when they go in alive and get sent home to die some 6 hours later. even ringing the after hours nurse does not help. saddens me to see this still happening, and those people not up to scratch on signs symptoms and looking at evidence, test results, presented with another family member in Canberra Hosp having eaten the same meal.

Lisa de Waal Lisa de Waal 7:00 am 12 Nov 20

Rachel Hetényi it’s intrinsic

Peter McDonald Peter McDonald 10:02 pm 11 Nov 20

I’m only aloud to drive 12hours with a 1/2hour break every 5hours. I can’t imagine trying to think clearly making life decisions after that time. Criminal.

Jenny Adams Jenny Adams 7:08 pm 11 Nov 20

Last night was very busy. These poor doctors. We arrived before midnight and not seen by a doctor for over 4 hours. Then needed to see another who wasnt available until after 8am. Not their fault, but not ok

Rhonda Meiksa Rhonda Meiksa 6:43 pm 11 Nov 20

Canberra hospital could be and should be a very high ranking hospital but for years it has had lots of problems. If it’s common knowledge a hospital has a bad reputation then no one will want to come and train here and your can’t blame them. It needs a complete overhall

Christopher Stuart Veilands Christopher Stuart Veilands 6:41 pm 11 Nov 20

Nice work Labor

    Patrick J Pentony Patrick J Pentony 5:01 pm 12 Nov 20

    Christopher Stuart Veilands 19 years of Labor greens gov

Tammy Britt Welsh Tammy Britt Welsh 6:36 pm 11 Nov 20

How can it be safe to have tired doctors making life and death decisions

    Melissa Hobbs Melissa Hobbs 10:15 pm 11 Nov 20

    Tammy Britt Welsh it’s not safe - that’s why people go to Sydney or Melbourne for good health care

Sharen Petrovsky Sharen Petrovsky 6:25 pm 11 Nov 20

So nothing as changed in 16 years

    Jason Metz Jason Metz 6:58 pm 11 Nov 20

    Sharen Petrovsky and nothing will change in the next 4 years either

    Lee McDowall Lee McDowall 7:05 pm 11 Nov 20

    Sharen Petrovsky yup and look which party's keep getting voted in, nothing will chang in our health systm while they govern the ACT

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