Listening to doctors in training

Every year, AMA SA’s Hospital Health Check (HHC) selects South Australian data from the Medical Board of Australia’s Medical Training Survey of junior doctors and examines question-by-question results broken down by public hospital. The latest report, which presents data from the 2025 survey, shows some improvement. Concerningly, however, it highlights two persistent issues: heavy workloads and the reasons doctors are reluctant to report bullying and harassment in the workplace.

Let’s start with the good. In this year’s report, we can see that overall satisfaction with training and teaching continues to be high – enough that between 81 and 95% of junior doctors would recommend their hospitals as places to train. This rating is a reflection of the consultants who make time to teach, registrars who check in on their juniors and hospitals that are consistently getting something right when it comes to training junior doctors. 

As we delve a little deeper, however, the areas requiring more attention start to show through. While rates of reported bullying, harassment and discrimination are trending down compared to previous years, incidents are continuing to go unreported – and this isn’t because they aren’t happening, but rather because an alarming number of doctors don’t believe reporting will change anything. Or, worse, they worry about what it will cost them if they speak up. Almost half of the state’s trainees still classify their workloads as heavy or very heavy, with long hours remaining the norm rather than the exception. In some cases, these findings may be connected: if you’re already exhausted from your job, reporting a problem can feel like one more task that simply isn’t worth the effort if you’re not confident of the pay-off. A trainee working long weeks with a heavy roster has less capacity and energy to advocate for themselves or their peers. Fatigue doesn’t just wear people down physically – it quietly narrows what feels possible. If we want to see meaningful change in under-reporting statistics, we can’t treat it as a separate problem from workload. They go hand in hand.

Then there is the possibility of professional ramifications. When you’re only a few months or years into your career, the person you’d be reporting a workplace issue to is usually the same person who writes your reference, or may supervise you in some capacity down the line. A survey can’t fully convey the calculation that goes on in someone’s head before deciding whether something is ‘worth’ reporting.

So where to from here? It’s not all doom and gloom; there are areas in which the survey shows consistent improvement, a sign that genuine change can occur. The most glaring outcome from the 2025 report is that hospitals need to be better at closing the loop: junior doctors need to see that raising an issue can lead to an actual change or outcome. That’s where reform has to come from, and hopefully the results of the next HHC will reflect this.

I think this is exactly where AMA SA can play a part for its junior members. Junior doctors don’t have the ability, or often the time, to have a seat at the table with SA Health or the medical education units (MEUs), but AMA SA does. That access is precisely what is needed to turn these survey findings into concrete change. As the DiT representative on Council, I know I’ll be using the under-reporting data to press the MEUs on current reporting pathways – not just ensuring they exist, but that they are trusted and that those conversations can produce something tangible. If junior doctors can see that speaking up leads to action, those pathways will continue to be used and trusted, helping create a better working environment – and better care – for everyone involved. The HHC has given us the evidence, and now it’s up to us to help those who can act on it make a real difference.

Read the Hospital Health Check