'The hardest job I've ever done': a qualitative exploration of the factors affecting junior doctors' mental health and well-being during medical training in Australia

Katherine Petrie; Mark Deady; Deborah Lupton; Joanna Crawford; Katherine M Boydell; Samuel B Harvey

doi:10.1186/s12913-021-07381-5

'The hardest job I've ever done': a qualitative exploration of the factors affecting junior doctors' mental health and well-being during medical training in Australia

BMC Health Serv Res. 2021 Dec 14;21(1):1342. doi: 10.1186/s12913-021-07381-5.

Authors

Katherine Petrie^{1

2}, Mark Deady^{3

4}, Deborah Lupton⁵, Joanna Crawford⁴, Katherine M Boydell⁴, Samuel B Harvey⁴

Affiliations

¹ School of Psychiatry, University of New South Wales, Sydney, NSW, 2000, Australia. katherine.petrie@unsw.edu.au.
² Black Dog Institute, Hospital Rd, Randwick, NSW, 2031, Australia. katherine.petrie@unsw.edu.au.
³ School of Psychiatry, University of New South Wales, Sydney, NSW, 2000, Australia.
⁴ Black Dog Institute, Hospital Rd, Randwick, NSW, 2031, Australia.
⁵ Vitalities Lab, Centre for Social Research in Health and Social Policy Research Centre, University of New South Wales, Sydney, NSW, 2000, Australia.

Abstract

Background: Medical practitioners can experience considerable stress and poor mental health during their careers, with doctors in training known to be particularly vulnerable. Previous research has documented work-related factors that may play a role in the mental health status of junior doctors. However, these and additional factors, need to be explored further by considering theory-driven, social, structural and contextual issues. This qualitative study aimed to explore the experiences of junior doctors working in Australian hospitals to identify factors that impact their mental health during medical training.

Method: Semi-structured interviews were conducted with 12 junior medical officers (JMOs) employed across six hospitals in Australia. Transcribed de-identified interviews were analysed thematically using a data-driven inductive approach.

Results: Four interrelated main themes were identified: i) professional hierarchies; ii) occupational stress; iii) emotional labour, and iv) taking distress home; which detail the complex affective, relational and professional experiences of JMOs. The accounts demonstrate how the social, professional and organisational dimensions of these experiences impact upon trainee's well-being and mental health, both positively and negatively. Together, the findings document the dynamic, nuanced aspects of junior doctors' experiences of medical training and practice and highlights the importance of relational connections and the workplace environment in shaping JMOs' social and emotional well-being.

Conclusion: The current study adds to the understanding of how junior doctors navigate medical training in Australian hospitals and highlights the complexities of this experience, particularly the ways in which mental health and well-being are shaped by different elements. These findings have important implications to inform new strategies to improve JMO mental health and to leverage work and non-work contexts to better support JMOs during medical training.

Keywords: Emotional labour; Junior doctors; Medical training; Mental health; Occupational support; Professional hierarchies; Qualitative research; Transition; Work stress.

MeSH terms

Attitude of Health Personnel
Australia
Humans
Medical Staff, Hospital
Mental Health*
Physicians*
Qualitative Research