Safe rostering practices are a critical part of ensuring a safe work environment

6 Feb 2019

The story of a young surgical trainee who felt so fatigued and burnt out that she could no longer continue her training highlights a number of real, significant and current issues for doctors the AMA is working on.

Gender equity is one of those and the AMA is holding a Gender Equity Summit on the 23 March 2019 in Sydney to discuss the cultural and practical barriers to achieving gender equity in medicine and what practical recommendations could be implemented to address the underlying systemic and cultural barriers and contributors that impede our progress towards achieving gender equity.

Safe rostering practices are also a critical part of ensuring a safe work environment. The 2016 AMA Safe Hours Audit confirmed that doctors at higher risk of fatigue typically work longer hours, longer shifts, have more days on call, less days off and are more likely to skip a meal break. These are red flags that public hospitals need to urgently address in their rostering arrangements.

Public hospitals in conjunction with medical colleges need to urgently review training and service requirements and implement rostering arrangements that create safe work environments and provide for high quality patient care. This includes implementing and supporting safe rostering practices and staffing levels, providing appropriate access to rest and leave provisions, and for clinicians, protected teaching and training time, organised within working hours.

There are significant numbers of doctors in training working in hospitals who work in ‘unaccredited’ or ‘service registrar’ positions to get additional clinical experience to improve their chance of gaining entry into a specialist training program.

In contrast to trainees in accredited vocational training positions, trainees in unaccredited positions often lack access to structured education and training opportunities, clinical oversight, professional development and professional support. Concerns have been expressed before about the health and wellbeing this cohort, who may be more vulnerable to exploitation, work-related stress, and workplace harassment and bullying.  This case reinforces those concerns.

The medical profession has a professional and social responsibility to provide doctors in training with a safe and educationally valid training experience that promotes specialist qualification within a realistic time frame, and delivers safe, efficient and effective patient care. Employers also have a responsibility for providing support to trainees in unaccredited training positions.

The AMA has a position statement on Support for non-vocational trainees prior to entering a vocational training program – 2016. It articulates the training, professional development and welfare needs of non-vocational trainees working in public teaching hospitals in Australia. Read it here

If you would like advice on your employment conditions talk to your State or Territory AMA at

If you are concerned about the hours you work complete the AMAs Fatigue assessment tool at

If you would like to talk to a doctor about your health contact the Doctors health advisory service in your state at