Specialist doctor trainee satisfaction is most strongly linked to good supervision by specialists, enough study time, and overall healthiness, new research by UNSW medical researchers has shown.
The paper - published today in Medical Education - is the largest Australian study ever on specialist trainee satisfaction, paving the way for an evidence-based approach to improving satisfaction rates.
The pathway to becoming a specialist doctor is a demanding process that generally takes a minimum of 12 years of education from the start of medical school to the completion of fellowship.
Dr Matt Lennon from UNSW Medicine, a junior doctor in Wagga Wagga and the lead author of the study, said these findings were important, particularly given recent reports in both Australia and the UK of cumbersome workloads, burnout, trainee bullying, a lack of employment security and high rates of suicide.
“Ensuring that specialty trainees are professionally satisfied is important for trainee wellbeing – and it’s also critical for the health systems to retain doctors,” he said.
“Since 2015 there has been an intense focus on trainee distress and burnout. Despite this, we’ve seen little systematic research on specialist trainees and what contributes positively to their professional satisfaction.
“In this study, we try to shift the focus of discussion away from halting trainee distress towards promoting trainee wellness, identifying key factors to build satisfaction.”
The study used the Medicine in Australia: Balancing Life and Employment (MABEL) survey and examined 4012 hospital-based specialist trainees.
“The three most important factors associated with professional satisfaction were feeling well supported and supervised by consultants, having sufficient study time and self-rated health status,” Dr Lennon said.
“This confirms anecdotal and survey data that has pointed out that trainees feel least safe and satisfied when unsupported by supervisors.”
Overworked trainees more likely to be dissatisfied
The study also identified a number of groups who were particularly at risk of being unsatisfied with their work.
“Those that work more than 56 hours per week – which one in five respondents did – were 24% less likely to be satisfied than those working 45 - 50 hours per week, whereas those working between 51 and 56 hours a week were the most satisfied group.
“This highlights that the discussion around reasonable working hours doesn’t have to be constrained to the traditional 40-hour working week, but we clearly need to identify a point at which trainees feel unsafe and unsatisfied.
The study also showed that male trainees, those more junior and those trained overseas were less likely to be satisfied. Conversely, rural and regional trainees were significantly more satisfied than those in metropolitan centers.
“To build pathways out of the current challenges with trainee wellbeing, peak bodies and hospitals should focus on ensuring good supervision, protecting adequate study time, providing controls around work hours and encouraging healthy life choices,” Dr Lennon concluded.