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Systemic bullying that kills young doctors

Louisa L.

Some issues bubble away unnoticed by anyone except those directly affected. Twenty young people, working as resident doctors in NSW, suicided between 2007 and 2016, and the media was almost silent.

That changed on February 10, when a young doctor wrote anonymously in the Sydney Morning Herald of the crushing pressure, lack of concern or accountability, bullying and disrespect that led to three suicides in the last year. It followed the death of Dr Chloe Abbot, who worked at St Vincents Hospital, who suicided on January 9, and Dr John Moutzouris from Liverpool Hospital who died on January 2.

                               Chloe Abbot

It finally hit the Daily Telegraph’s front page when Chloe Abbot’s family went public. They said Chloe was studying 40 hours a week, on top of cruelly long hours. A culture of fear and silence was temporarily breached. 

Young doctors, with the recent agreement of the Hospital Services Union, one of the unions covering them, work 24 hour shifts on call within hospitals, often immediately following regular 12 hour shifts. This wasn’t mentioned by the Telegraph.

It’s illegal for anyone else in our country to do such hours, yet these young and vulnerable workers feel intimidated into silence. Mistakes are inevitably made which have, or could have, harmed patients. Oh, then there’s a media outcry and the hunt for blood. But it never scratches the surface. These young people feel used, but still feel guilt for mistakes.

These are some of our hardest working, academically gifted, committed and idealistic young people. Yet our system treats them like trash. 

Even in purely economic terms, it is a senseless waste of money, to educate young people to Year 12, gain the very top marks, put them through up to six years of unrelentingly difficult degrees and spit them out to a system which prides itself on toughness and on ignoring their most basic human needs, meanwhile ensuring they possess the knowledge and means to successfully suicide. 

Statistical deceit
Often the final straw is the exam, in their fourth year, if they wish to become specialists. The practical exams are accepted and generally don’t cause unmanageable anxiety, but the so-called theory exams held in March create huge angst.  

Multiple choice exams are notoriously unreliable predictors of learning, but the track record of these tests is shocking, unsurprising given the large number of possible and only marginally different answers (up to eight for each question). Marking is computerised. 
Students can pass all three formal practice exams, and fail the final one, or fail all three practice exams and pass the final exam. There’s no correlation between these supposedly similar and critically important tests. 

The pass mark varies each year and a percentage (which also varies) will fail. With only one proviso, they may as well pull the unlucky names out of a hat and be done with the whole statistical deceit.  That proviso would mean ensuring more failures among those who work in the most challenging environments, in low socio-economic or other higher pressure hospitals where need and workload are greatest, where the young doctors (unlike colleagues in some affluent area) are given no time off to study, and have the lowest pass rates. Many of those who pass feel something akin to survivor’s guilt, because friends have failed. 

Fostering deception
Chloe Abbot’s sister had begged her to give up medicine calling its workload ‘brutal’, and family members of other young doctors express outrage to their friends, including to this writer. 

The young doctors themselves are afraid to organise and speak out publicly in case they are victimised. It’s hardly surprising given how much they’ve already sacrificed. 

Bullying that kills is bullying at its worst. Yet in hospitals, it’s institutionalised and accepted. It has to change. The corporate media can’t be relied on, despite the earnest desires of some journalists. It will express outrage, but usually heads off to the news cycle’s next big thing. 

The corporate media fosters the deception that Australia is a genuine democracy. Yes, we get to vote every few years for whichever politician will misrepresent us, but if this were a democracy with the people in charge, such cruel exploitation would be outlawed, not intensified. Its protected existence mirrors the corrupt rule by corporations that underpins our whole society.

Quietly organising
In the short term, family and friends of young doctors could contact the family of Chloe Abbot, who have stood up for their beautiful and talented daughter and sister. Unlike many still in the system, they have already paid the most terrible price for Chloe’s choice to be a doctor. 

The many decent doctors and specialists in the AMA who remain silent and complicit could be urged to speak out. There are many good people in the HSU who could take a stand with less fear of consequences, and the Nurses and Midwives Association could be approached to educate the tiny minority of nurses who routinely and sometimes publicly treat young doctors with contempt. 

The young doctors themselves, through the Resident Medical Officers Associations or more informal groups, could quietly organise, and when support is in place, stand up united and determined for change.  

The small breach in this corrupt medical system that brutalises our young doctors must be widened. It will not change without struggle.



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