Research released earlier this year from Massey University showed medical doctors were more at risk of burnout than any other profession in Aotearoa. 

And, anecdotally, more and more junior doctors are taking a break from the job – or leaving the profession entirely – within a health system already short on workers.

Re: News journalist Maggie Shui spoke to junior doctors about their experiences and looked into why so many of them were taking a break. 

Kai Luan decided to resign from his job in medicine at the start of this year.

“I was just feeling that sense of dread when you're at work. And that kind of progressed to apathy.”

He left New Zealand and went travelling in Asia.

He says that resigning or taking a break like he did is “a very common thing at the moment” among his younger colleagues and friends in medicine – he personally knows five people who have quit or taken a break. 

Three months into his travels, he got a text from his old workplace. They had a vacancy in their infectious diseases department, and were hoping he could fill it.

Kai, freshly recovered from burnout, decided to take the role. He enjoyed the infectious diseases specialty, liked the team he’d be working with and knew it was a really busy department which meant “if there was a vacancy, it would be very bad”.

‘A real concern’

While Te Whatu Ora does not have data on resignations from doctors or medical professionals, Bryan Betty, Chair of General Practice New Zealand, says that is also, anecdotally, a trend he’s been seeing.

“We've got examples of it occurring more so than in the past. And that is a real concern,” Betty says.

Among GPs alone, 55% of them in Aotearoa are planning to retire in the next decade – that number increases to 65% if you don’t include registrars. 

Betty says we won’t be able to replenish this at the current rate at which new doctors are being trained and retained in this country.

“It needs to be addressed not just for the profession itself, but for patients because if you allow the system to wind down, you get poorer long term patient outcomes. And that's bad for the overall health system.”

More junior doctors going on breaks mid-career

Kris, a house officer in his second year post graduation who is not using his real name for his privacy, is planning to take a break next year to travel.

“[There are] high chances that this break to go travel will ultimately result in me quitting entirely or resigning from New Zealand and working overseas.”

Kris says that, anecdotally, junior doctors going on breaks mid-career is becoming more common, “to the point where there are more of us who want to take a break or resign for three to six months than there are who want to step up immediately”.

“Within my friend group, most of us plan on taking at least three months off next year to travel and a significant portion also plan on resigning from New Zealand and moving overseas.”

Betty says “the other thing we've seen a lot of recently is doctors moving to Australia or to other countries for possibly better conditions”.

“There's no doubt that there's a differential with Australia,” he says, referring to the more lucrative pay across the Tasman.

Prudence Thomson, founder of ACCENT Health Recruitment, says there’s currently an “air of desperation” among health employers in Aotearoa as they try to keep people and get workers in. 

‘The way we work is shit’

Matilda, a registrar who is not using her real name so her comments don’t impact her work, says the growing numbers of people going on breaks or resigning comes from more awareness for wellbeing and nurturing other areas of life.

“A medical career doesn't always fit in with those goals,” she says. 

And, Matilda says, the rosters suck. 

Matilda, Kai and Kris have similar rosters where their hours can range from 50 to 70 hours a week – although this becomes hard to quantify as it is often the norm to work beyond your rostered hours and there’s usually admin work to do once you’ve finished seeing patients.

These rosters involve working a 15-hour shift at least once a week, and sometimes being on call Friday to Sunday, from 7:30am till 10:30pm (officially).

They occasionally will have a night shift where they work three to four nights a row.

Matilda says, “Even if you're not physically fatigued, because you haven't slept, you are still mentally fatigued. You can’t put the phone down, you can’t go and exercise. You can't go for a walk away from the hospital. You can't just let go.”

Kai understands the rationale for long shifts especially when it involves patients, but it comes at the cost of “quite a large amount of fatigue”, he says. 

Matilda compares it to aviation where pilots have rostered fatigue days after working a night shift or a certain number of hours. Similar protections should be implemented in Aotearoa for doctors, she says. 

“It’s like: You've overdone it, you can't work. You have to take a break. Because, obviously, aviation safety is a big thing. But there's no protection for us in the same way.” 

“If you've been on call for 72 hours over the weekend, and you had a terrible shift, and you just didn't sleep, well, that's too bad. You're back to work on Monday, and you’re operating,” she says. 

“You want your doctor to be thinking clearly.”

The workload

In addition to the hours being long, the workload squeezed into those hours also becomes overwhelming.

Kai says that sometimes he’ll show up to a shift that was supposed to have ten people but only six names are on the roster – which means those six people have to do the work of ten (which should be “more like 15” according to Kai).

The high workload is a symptom of the shortage of medical professionals everywhere and the World Health Organisation says we will be short 18 million health workers globally by 2030).

For house officers and registrars who still have training to complete, this high workload is especially taxing.

Kai says there isn’t any time for training because the demands of hospitals means “you're more shifted to service provision and then your learning is shifted to your own time”.

This learning involves studying for exams and working on research projects on top of his work hours.

Kai says that additional obligation “just compounds people getting burnt out”.

‘If you quit, it’s like, well that was it’

Despite the system being overworked and fragile, Matilda says it’s hanging on by the desire of its workers to help people.

“There's not many careers where you can tangibly see that every day.”

“I think there's also a sense of guilt that if you quit that all of your skills and training have been wasted, essentially,” she says.

“You took that Hippocratic oath at your graduation. If you quit, it's like, well, that was it. I think that sense of duty is partly what keeps healthcare afloat at the moment.”

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