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Burning Bright without Burning Out Scenarios

Scenario 1

Lucy Arden is a PGY 4 unaccredited registrar who is currently working in an
Orthopaedics unit at a large metropolitan hospital. For the past three months of her rotation, one of the Orthopaedic Consultants, Dr Lance Wu, has been humiliating her in front of other members of the unit. At morning ward rounds, Dr Wu constantly puts her in the hot seat without giving her time to answer fully; he uses condescending language towards her and often makes jokes at her expense to bond with other members of the team. On the rare chance that she gets asked to assist with a procedure, he gruels her with anatomical questions, which is noticeably different to the conversations he engages in with the male intern who shares his interest in golf. Even when she does know the answer, she is made to feel so small that she cannot think at that moment due to the stress he puts her under. The cycle feels vicious. On two occasions, he has actually shouted at her in theatre when a surgery list was delayed due to theatre administrative issues, making her feel further incompetent.

Lucy decided that she could no longer withstand this bullying and spoke privately and separately with three other consultants on the team. Lucy initially felt supported as they all acknowledged that this behaviour was indeed happening and that it was accordingly inappropriate. Despite an attempt by the spokesperson of these kinder consultants to advise Dr Wu of his unprofessional behaviour, the harassment continued, making Lucy feel invalidated. Consequently, Lucy decided to approach HR, who actually made her feel further unsupported and unappreciated. Specifically, HR informed her that she could leave her position if she couldn’t put up with the demands of the unit. However, they simultaneously discouraged her from resigning as they stated it would be difficult to replace her and fill the position in view of the pandemic.

Scenario 2

Fatima Abboud is a BPT2 General Medicine Registrar at a hospital in Melbourne. On multiple occasions during this last rotation she has felt the need to work overtime, and has been called in to fill extra shifts.

On night shift, she routinely works extra hours when the morning handover runs overtime; on weekend shifts she often has to cover two roles and fulfill both the ‘admitting’ and the ‘ward’ registrar jobs due to sick leave; and on weekday shifts, given she is aware of how short-staffed the unit is at night, at the end of the day shift she always works overtime to minimize handing over jobs to the night registrar.

Fatima is constantly pressured to take on shifts to cover sick leave, especially when the Head of Unit directly calls her to inform her of a new on-call shift. The Head of Unit at this hospital is responsible for writing the rosters. Her roster is released with only 1-2 weeks’ notice, making it very difficult for her to plan her life outside the hospital when she does get it. Additionally, she is constantly finding herself questioning whether she should submit her overtime forms or whether this may affect her end of term feedback and future job prospects as she wants to apply for Advanced General Medicine training the following year.

After 5 months of this rotation, Fatima is feeling incredibly exhausted, both mentally and physically, and would like to seek support from the unit and medical workforce, however she does not want to be seen as ‘weak’ and as a doctor who is not able to ‘handle the workload and demand’.

Scenario 3

Two applicants for the Medical Oncology Advanced Trainee Position at a cancer center in Australia are reviewed based on their CV and Cover Letter. Both candidates disclosed their reason for a year off of medicine in their cover letter. No interviews have been conducted yet.

Who is more likely to get the job?

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