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Working hours, common mental disorder and suicidal ideation among junior doctors in Australia: a cross-sectional survey
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  • Published on:
    RE: Working hours, common mental disorder and suicidal ideation among junior doctors in Australia: a cross-sectional survey

    Petrie et al. examined the relationship between average weekly working hours and junior doctors' mental health (1). Common mental disorder (CMD) was assessed using a cut-off of 4 as a threshold on General Health Questionnaire 28-item scale score. Suicidal ideation (SI) was assessed with a single item. Adjusted OR (95% confidence interval [CI]) of working over 55 h/week against working 40-44 h/week for CMD and for SI were 2.05 (1.62 to 2.59) and 2.00 (1.42 to 2.81), respectively. I have some concerns about their study.

    First, Soares and Chan described stress levels and the psychological wellbeing of current junior medical officers (JMOs) (2). They used the Short Form-36 and Perceived Stress Scale-14 (PSS14), and JMOs were more likely to have a high PSS-14 score or to have a low mental health score if they reported higher career anxiety. Working hours are closely associated to sleeping time and other lifestyle behaviors, and these factors should be considered for the risk assessment of stress and psychological wellbeing of JMOs.

    Second, Rosta and Aasland conducted a survey to experienced doctors to examine the perception of working hours for postgraduate training doctors (3). The question is “How do you think that self-reported total weekly working 45 hours is too short, sufficient, or too long to meet the quality requirements of obligatory postgraduate training for junior doctors?” Although the majority perceived as sufficient for obligatory postgraduate...

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    Conflict of Interest:
    None declared.
  • Published on:
    Characterising ideal trainee working hours - A Response Letter to “Working hours, common mental disorder and suicidal ideation among junior doctors in Australia: a cross-sectional survey”
    • Matthew J Lennon, Junior Doctor University of New South Wales
    • Other Contributors:
      • Claire Mok, Junior Doctor

    Petrie et al. asks the interesting question of where optimal weekly work hours lie for junior doctors, which is ultimately the question policy makers and advocates want to answer, with the aim of safeguarding the wellbeing and promoting satisfaction of junior medical doctors. Having recently (Dec 2019) published a large study (n=4012) in Medical Education examining factors related to Australian specialist trainee doctors we thought that there were several points of discussion made that may be distilled by our findings.

    There are a number of salient points to discuss:

    1. Satisfaction and Mental Illness - Our study examined specialist trainee’s satisfaction rather than mental illness or suicidal ideation with the idea being that a shift in the drive for policy from illness avoidance to promotion of satisfaction may be considered. In our Australia wide study, we found that one in five respondents worked more than 56 hours per week and, corroborating Petrie et al., that they were 24% less likely to be satisfied than those working 45 - 50 hours (median working hours).

    2. Optimal work hours - In contrast to the findings of Petrie et al. we found that those working 51 - 56 hours were the most satisfied group, 21% more satisfied than those working 45 - 50 hours (p=0.006). The demands and priorities of a trainee undertaking a specialist pathway, which include: taking time with patients to build a sufficient case load to become proficient, taking time to study,...

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    Conflict of Interest:
    None declared.