P M C W A / / J M O F O R U M / / 2 0 2 1
THE WELLBEING GUIDE COLLATED FOR WA JUNIOR DOCTORS
BY POSTGRADUATE MEDICAL COUNCIL OF WA WITH ASSISTANCE FROM DR YASMIN SOLIMAN, DR GREER JALLAND, DR AMY KELLIHER AND DR SHANNON MARANTELLI
GPO BUILDING, Level 3, 3 Forrest Place, PERTH WA 6000 PO Box 8172 Perth Business Centre WA 6849 T: (08) 6373 2302 E: [email protected] W: www.pmcwa.org.au www.facebook.com/PMCWA
For further copies of this document, please visit the PMCWA website
Front cover photo submission: Dr Joanna Chua
DISCLAIMER
The information contained in this document is for general information only. It is not designed to take the place of professional advice based on individual situations. We urge you to seek assistance from your local doctor or one of the listed support groups.
A health and wellbeing reference for WA JMOs Page 2 PLAYING GOD
BY G.COLQUHOUN (1)
Today I do not want to be a doctor. Today I want to be a doctor.
Today I do not want to be a doctor. Today I am happy to be a doctor.
No one is getting any better. Everyone seems to be getting better.
Those who were well are sick again. And those Those who were sick are not so sick. And those who were sick are sicker. who were well are thriving.
The dying think that they will live. And the The healthy are grateful to be alive. And the healthy think they are dying. dying are at peace with their dying.
Someone has taken too many pills. Someone No one has taken too many pills. No one has has not taken enough. taken too few.
A woman is losing her husband. A husband is A woman is returning to her husband. A losing his wife. husband is returning to his wife.
The lame want to walk. The blind want to drive. The lame accept chairs. The blind ask for dogs. The deaf are making too much noise. The The deaf are listening to music. The depressed depressed are not making enough. are tapping their feet
The asthmatics are smoking. The alcoholics are The asthmatics have stopped smoking. The drinking. The diabetics are alcoholics have stopped drinking. The diabetics eating chocolate. are eating apples.
The mad are beginning to make sense. The mad are beginning to make sense. Everybody’s cholesterol is high. Disease will not Nobody’s cholesterol is high. Disease has gone listen to me weak at the knees.
Even when I shake my fist. I expect him to make an appointment.
Page 3 PREFACE - WHY DOCTORS NEED DOCTORS
Working as a junior doctor is a demanding and stressful career. The level of responsibility given to junior doctors is often very great, they work long hours and have heavy case loads – it can be both physically and emotionally draining.
2020 has been notable for the immense amount of stress that the global COVID-19 pandemic has placed on communities around the world, and the enormous toll this has taken on health care workers.
Many junior doctors are not prepared for this level Not only has this epidemic led to an unhealthy of stress when they start internship and after workforce, but it also affects patient care and repetitive exposure to stressful unsupported outcomes. Lack of empathy for patients, physical environments, they can experience “burnout”. exhaustion and lack of senior support have been linked to clinical and medical errors within the hospital. Burnout is a syndrome in which a junior doctor will become It is paramount to fight this epidemic of junior doctor burnout. A multi-modal approach is emotionally exhausted, experience required to address the many contributing factors. depersonalisation Over time, we hope to slowly change the culture of medicine, making the hospital a safe place where from patients and others and will feel junior doctors are not afraid to admit if they are a sense of reduced personal overwhelmed or struggling. Both doctors and patients will be better off if this occurs. accomplishment with work and other
activities outside of work. This Wellbeing Guide is designed to be a junior doctor’s first port of call. A resource which outlines
Studies show that there are multiple factors the support available when times get tough. contributing to junior doctor burnout. Burnout occurs when junior doctors fail to be supported by If you or a colleague are finding things overwhelming others, are working beyond their perceived abilities or are experiencing any difficulties in your personal and are not engaging in self-care. or professional life, help and support is available.
Current research indicates that, in some WA The key message is to talk to someone about it and hospitals, up to 40 percent of the total workforce is remember that you are not alone. A good junior suffering from dangerous levels of burnout (AMA, doctor is one that knows how and when to ask for 2020) (2). help.
Page 4 ARE YOU STRUGGLING & DO YOU THINK YOU NEED HELP?
Help is always available for those who are struggling and finding this job challenging and confronting.
Support services exist both within your hospital and externally to assist you if you need support or advice.
Support and advice come in many forms, have you asked yourself the following questions:
Have you told someone how you are feeling? Have you spoken to a General Practitioner regarding your feelings? Have you told your team at work that you are not coping or feeling overwhelmed? Have you talked to someone within your family or inner support network? Do you feel you can tell the supervisors of your current rotations? Should you let your directors of clinical training know that you think this is affecting your performance? Have you taken annual leave on a regular basis? Have you called in sick a lot for mental health days?
If you answered yes to any of these questions, you should think about reaching out and engaging in professional help.
Help is always available and it is healthy to clinically debrief with people who can adequately support you in constructive ways. It may be useful to seek out an accredited psychologist to assist you with debriefing in a safe space.
Page 5 DOCTORS' HEALTH ADVISORY SERVICE OF WA (DHASWA)
Find a GP!
ONE YOU LIKE AND TRUST
To be a good doctor you need to take care of yourself. Doctors need doctors.
DHASWA has a Drs for Drs page on their website. They cite 10 reasons to have your own GP as per Dr Roger Sexton, Medical Director of Doctors' Health South Australia:
1. Your GP is your independent advocate in the health system. GPs spend all their time going in to bat for their patients and are very good at it. 2. Your GP has a different set of referral networks to you and can decide who is most appropriate to see you for further specialised care. It is more than likely that your own informal network of professional friends from medical school really do not want to see you. 3. Your GP is a very broadly trained generalist and understands the broader impact of work, relationships and lifestyle on the mental and physical health of the individual. 4. GPs focus on preventive medicine including immunisation and age-appropriate health screening. This is underdone among doctors in particular. 5. GPs have recall systems and high levels of computerisation which assist with caring for patients and reducing prescribing errors. 6. GPs are confidential and understand the importance of confidential advice to the medical profession. 7. Your GP maintains your complete medical record and can coordinate clinical handover when you are travelling or moving interstate. 8. Your GP is interested in you as a person and understands what it takes to be a sustainable and successful medical professional. 9. Your GP looks at you holistically and independently. They will see things you will not. 10. Your GP will help you live longer. There is good evidence for the benefits to longevity from having a GP.
The website has lists of GPs, psychiatrists and psychologists who have expressed an interest in doctors’ health and are willing to see doctors and medical students as a priority.
Website: www.dhaswa.com.au/drs-for-drs/
Page 6 SOMETHING CREATIVE
TO HELP YOU UNWIND
Facebook Groups Doc to Doc Female-only doctor group providing support, collaboration and inspiration
Medical Mums and Mums to Be Supportive group for medical mothers and doctors thinking/trying for children
Creative Careers in Medicine Doctors paving creative paths in and outside of medicine Support available for doctors struggling with remaining in medicine
Novels by Doctors Meditation Podcasts This Is Going to Hurt by Adam Kay Meditation Minis When Breath Becomes Air by Paul Kalanithi Crappy to Happy Do No Harm by Henry Marsh The Daily Meditation Podcast Extreme Medicine by Kevin Fong The Mindful Minute A Young Doctor’s Notebook by Mikhail Bulgakov Mindfulness Mode Going Under by Sonia Henry On Being With Krista Tippett The House of God by Samuel Shem Meditation Station
Medical Podcasts Meditation Apps Docs Outside The Box The Mindfulness App Everyday Emergency Headspace Bedside Rounds Calm EMCrit Podcast Sattva Behind the Knife MyLife Meditation Legends of Surgery Breethe Broomedocs Podcast Inscape Health Report Mindfulness with Petit BamBou This Podcast Will Kill You
Page 7 ESSENCE OF HEALTH
BY DR CRAIG HASSED (3)
The idea of identifying things in your life that make you happy is also a good coping strategy. Having time away from the hospital and connecting with other interests is important for dealing with life as a doctor.
The notion of ESSENCE is based on research by Dr Craig Hassed from Monash University who focused on medical students ensuring their curriculum had a wellness-based model to improve therapeutic outcomes for both upcoming doctors and subsequently patients and to avoid burnout.
In promoting a more holistic approach to medicine it is important to incorporate the following essential domains into our everyday lives:
Education Spirituality Seeking out PDL opportunities can enrich your Spirituality does not directly mean being experience as a doctor and can also help you find ‘religious’ but means to have ‘meaning’ or an area of medicine that you are passionate ‘purpose’ within your life. Having a sense of about. Being educated and aware of the signs of spirituality enables a person to express burnout can also educate doctors regarding when themselves and their cultural background to take some “time out”. whether it is through religion, philosophy or science. Nutrition It is easy to get into the habit of eating badly on There is evidence that suggests having an element the wards but eating a healthy and balanced diet of spirituality within your life can play a part in the can improve your physical wellbeing. Being management of a range of physical and organised and bringing your lunch to work helps psychological stressors. It has the ability to help you to keep an eye on your weight and for your those cope when facing difficult situations. energy levels. Food is a key part of preventative medicine. Stress management Stress has an effect upon both physical health and Exercise recovery from illness. Our mental and emotional It is important to ensure that you are taking care state also has profound effects on our immunity of your physical health. It can be very cathartic and our ability to sleep and unwind, stress can and therapeutic to exercise during a high stress even affect us right down to the levels of our job. Exercise has the ability to assist with sleep, genes. Improving mental health is important for reduce weight and to prevent anxiety and quality of life, to facilitate other healthy lifestyle changes, and for its direct benefits for health. depression. Exercise or joining team sports can Engaging in meditation and mindfulness is a key also be a way to connect and join in with way to address stress management. community sporting teams which builds support networks outside of the hospital. Page 8 Essence of Health cont.
Connectedness Environment Social supports whether it be family, friends or Being conscious of your environment is very community groups are a vital part of one’s important for your wellbeing. Connecting with wellbeing. Having people to turn to and talk to can nature can have positive effects on your physical and be very important at preventing elements of mental wellbeing. Being present in the now, burnout. Joining community groups, helping out reducing the amount of time spent on social media with community services, joining sporting clubs is and getting into the great outdoors can also help. important at creating a well-rounded individual.
ADDITIONAL RESOURCES
Employee Assistance Program A free, professional and completely confidential counselling service is provided for public sector employees, either over the telephone or in person, and is available 24/7. Employees and immediate family members can receive three counselling sessions for any issue where counselling is required. Employers do not find out who accesses this service.
Further information is available through: Converge International LifeWorks 1300 687 327 1300 361 008 www.convergeinternational.com.au www.lifeworks.com.au
The WA Country Health Service (WACHS) Employee Assistance Program providers vary by region and information is available on the WACHS website via this PDF.
Chaplain/Pastoral Services Most hospitals offer a confidential chaplain service to staff as well as patients.
Postgraduate Medical Education Units The Medical Education Unit at your hospital is always available to provide support and discuss any personal or professional concerns or issues.
PERTH CHILDREN'S HOSPITAL
CHAPLAIN, PASTORAL SERVICES 6456 0507 After Hours: Switchboard Located in the Multi Faith Centre. 24 hour on-call service.
DIRECTOR POSTGRADUATE MEDICAL Dr Fiona Frazer EDUCATION [email protected]; 6456 5197
MEDICAL EDUCATION OFFICER Mr Robert Evans [email protected]; 9340 7099
Page 9 FIONA STANLEY HOSPITAL CHAPLAIN, PASTORAL SERVICES Via the help desk: 6152 2222 Onsite from 8:00am – 4:00pm and there is an on-call chaplain service after hours. Located on the ground floor - main hospital concourse, corridor left of Stanley Flowers, under the doctor’s common room.
DIRECTOR MEDICAL EDUCATION Prof Alison Jones [email protected]; 6152 3634
MEDICAL EDUCATION OFFICERS Ms Zoe Moran (Coordinator) Ms Kylie Reed Ms Erin Furness Ms Nerinda Bradshaw [email protected]
JOONDALUP HEALTH CAMPUS DIRECTOR POSTGRADUATE MEDICAL Dr Sue Davel EDUCATION 9400 9925
MEDICAL EDUCATION OFFICER Ms Michelle Karsdorp [email protected]; 9400 9378
KING EDWARD MEMORIAL HOSPITAL 9340 8256 CHAPLAIN, PASTORAL SERVICES 24 hour on-call service. A Block, Level 1.
DIRECTOR POSTGRADUATE MEDICAL Dr Katrina Calvert EDUCATION [email protected]; 9340 1388
MEDICAL EDUCATION OFFICER Mr Nicholas Bennett [email protected]; 6458 1181
SIR CHARLES GAIRDNER HOSPITAL CHAPLAIN, PASTORAL SERVICES 9346 3425 24 hour on-call service. Ground Floor, E Block (Gairdner & Verdun Entrance). Muslim Prayer Hall: First Floor, E Block next to the library.
DIRECTOR POSTGRADUATE MEDICAL Dr Hadley Markus EDUCATION [email protected] 9346 3330
MEDICAL EDUCATION OFFICER Ms Trish Li [email protected]; 9346 7969
Page 10 ROYAL PERTH HOSPITAL
CHAPLAIN, PASTORAL SERVICES 9224 2482 24 hour on-call service. Level 4, N Block, Colonial House, Wellington Street Campus.
Muslim Prayer Room: 9:00am to 5:00pm. Ground Floor, Ainslie House.
JMO WELLBEING OFFICER Dr Rich Read, Nicola Frew 9224 2342, 0404 039 974 DIRECTOR POSTGRADUATE MEDICAL Dr Athula Karunanayaka EDUCATION [email protected]
MEDICAL EDUCATION OFFICERS Katie Bellini (coordinator) - Erin Grasso Caroline Bentley Elise Kennedy Hannah Lyra [email protected]; 9224 2250
ST JOHN OF GOD MIDLAND PUBLIC AND PRIVATE HOSPITALS
DIRECTOR POSTGRADUATE MEDICAL Dr Tim Bates EDUCATION Tim.Bates@sjog,org.au MEDICAL EDUCATION OFFICER M s Lisa Cryer Ms Lizzie Howard [email protected]
ST JOHN OF GOD SUBIACO HOSPITAL
MEDICAL EDUCATION OFFICER Ms Tessa Jack [email protected]
WA COUNTRY HEALTH SERVICES - GENERAL ENQUIRIES CHAPLAIN, PASTORAL SERVICES Chaplain and Pastoral Services are coordinated at the hospital level. Contact your Medical Education Unit for additional details.
DIRECTOR MEDICAL EDUCATION Dr David Oldham [email protected]; 6553 0856
MEDICAL EDUCATION OFFICERS Ms Laura Humphry (JMOs) Ms Emma Bell (RGPWA) Ms Kylie Bull (EMET) Ms Victoria Civitico (Interns) Ms Natasha D'Anna (CRP) [email protected]; 6553 0925
WA COUNTRY HEALTH SERVICES - GREAT SOUTHERN, ALBANY HEALTH CAMPUS Dr Peter Kendall DIRECTOR CLINICAL TRAINING [email protected]; 9892 2209 MEDICAL EDUCATION OFFICER M s Dale Broderick [email protected]; 9892 2252
Page 11 WA COUNTRY HEALTH SERVICES - KIMBERLEY, BROOME HEALTH CAMPUS
DIRECTOR CLINICAL TRAINING Dr David Forster [email protected]; 9194 2378
MEDICAL EDUCATION OFFICER Ms Trenna Wadge [email protected]; 9194 2882
WA COUNTRY HEALTH SERVICES - SOUTH WEST, BUNBURY HOSPITAL AT SOUTH WEST HEALTH CAMPUS DIRECTOR CLINICAL TRAINING Dr Perry (James) Travers [email protected]; 9722 1490
MEDICAL EDUCATION OFFICER Ms Judi Gibbs [email protected]; 9722 1490
WA COUNTRY HEALTH SERVICES - GOLDFIELDS, KALGOORLIE HEALTH CAMPUS
DIRECTOR CLINICAL TRAINING Dr Pushpika Gunaratne [email protected]; 9080 5862
MEDICAL EDUCATION OFFICER Ms Karen Callaghan [email protected]; 9080 5870
WA COUNTRY HEALTH SERVICES - MIDWEST, GERALDTON HOSPITAL
DIRECTOR CLINICAL TRAINING Dr Jaclyn Chin [email protected]; 9956 2222
MEDICAL EDUCATION OFFICER Ms Joanne Blayney [email protected]; 9956 8740
WA COUNTRY HEALTH SERVICES - PILBARA, HEDLAND HEALTH CAMPUS
DIRECTOR CLINICAL TRAINING Dr Vafa Naderi [email protected]; 9174 1000
MEDICAL EDUCATION OFFICER Ms Crystel Coffey [email protected]; 9174 1047
If your hospital is not listed above, please visit the PMCWA website for MEO contact details: https://www.pmcwa.org.au/committee/meo-network-group/ or contact PMCWA for the contact details of your Postgraduate Medical Education Unit.
Page 12 ADDITIONAL INFORMATION
There are a vast range of support and resources available online for any challenges you may be experiencing.
ORGANISATION CONTACT DETAILS
JUNIOR DOCTOR HEALTH/HELP
AUSTRALIAN MEDICAL (08) 9273 3000 Resources, tools and information ASSOCIATION DOCTORS' www.drs4drs.com.au on doctors’ health and wellbeing. HEALTH
DOCTORS' HEALTH ADVISORY (08) 9321 3098 (available 24/7) An independent, confidential, 24- SERVICE www.adhn.org.au/contact/western hour service staffed by experienced -australia doctors for doctors in crisis or not sure where to go for help. Calls can www.dhas.org.au/resources/resour be anonymous and made by the ces-for-junior-medical-officers.html person themselves, a family member, colleague or friend. www.dhaswa.com.au/drs-for-drs/ The ‘doctors for doctors list’ – a list of doctors who have expressed an interest in doctors’ health – and willing to see a doctor (and medical student) as a priority.
HEALTH AND WELLBEING www.jmohealth.org.au Website targeting junior doctors OF JUNIOR DOCTORS and the issues that can lead to mental health problems, with self- assessment tools and advice.
EVERY DOCTOR, EVERY www.lifeinmind.org.au/every- Website guiding coordinated action SETTING doctor-every-setting on the mental health of doctors and medical students.
MENTAL HEALTH - URGENT HELP
EMERGENCY SERVICES 000 In an emergency
LIFELINE 13 11 14 (available 24/7) Crisis support with a key focus on www.lifeline.org.au suicide prevention.
MENSLINE AUSTRALIA 1300 78 99 78 (available 24/7) Supports men who are dealing with www.mensline.org.au family, relationship and wellbeing difficulties.
SUICIDE CALL BACK 1300 659 467 (available 24/7) Free nationwide telephone and SERVICE w ww.suicidecallbackservice.org.au online counselling for anyone affected by suicide, or suicidal thoughts.
Page 13 ORGANISATION CONTACT DETAILS MENTAL HEALTH AND WELLBEING Information on depression, BEYOND BLUE 1300 224 636 (available 24/7) www.beyondblue.org.au anxiety and how to help yourself, or a friend in need. Online and telephone clinic MINDSPOT CLINIC 1800 614 434 mindspot.org.au providing assessment and treatment for adults with anxiety and depression.
An online self-help program for MOOD SWINGS www.moodswings.net.au bipolar disorder. EATING DISORDERS AND BODY IMAGE MENTAL HEALTH AND WELLBEING Butterfly’s ED HOPE is Australia’s BUTTERFLY FOUNDATION 1800 334 673 - avail 8am - midnight (AEST), 7 days a week national eating disorders support https://butterfly.org.au/ service providing phone, email and web counselling as well as a range of online resources.
GAMBLING Counselling, information and GAMBLING HELP ONLINE 1800 858 858 (available 24/7) w ww.gamblinghelponline.org.au support online (email and live chat) and by phone for people experiencing gambling issues.
RELATIONSHIPS AND ASSAULT 1800 RESPECT 1800 737 732 (available 24/7) National sexual assault, domestic www.1800respect.org.au family violence counselling service.
BLUE KNOT FOUNDATION 1300 657 380 A service to adult survivors of www.blueknot.org.au childhood abuse, their friends and family and the health care professionals who support them.
RELATIONSHIPS AUSTRALIA 1300 364 277 Support groups and www.relationships.org.au counselling on relationships, and for abusive and abused partners.
SAFE RELATIONSHIPS 1800 65 64 63 (available 24/7) Provides men and women in same PROJECT www.anothercloset.com.au sex relationships with support, advocacy, referral and information.
WHITE RIBBON www.whiteribbon.org.au Male led campaign to end Women's Domestic Violence violence against women. Helpline: 1800 007 339 or (08) 9223 1188 Crisis Care: 1800 199 008 or (08) 9233 1111 Sexual Assault Res. Centre: 1800 199 888 or (08) 9340 1828 Men's Helpline: 1800 000 599 or (08) 9223 1199 Page 14 ORGANISATION CONTACT DETAILS
SEXUALITY AND GENDER
FREEDOM CENTRE (08) 9228 0354 Provides peer support services, www.freedom.org.au information, referrals and a safe social place for young people (under 26) who are LGBTI.
GENDER CENTRE (02) 9519 7599 Gender Centre provides services www.gendercentre.org.au which enhance the ability of transgender people to make informed choices. LIVING PROUD 1800 184 527 LGBTI Community services of WA. www.livingproud.org.au
NATIONAL LGBTI (02) 8568 1123 Health-related programs, services www.lgbtihealth.org.au and research focused on LGBTI and other sexuality and gender diverse people.
SUBSTANCE ABUSE
ALCOHOLICS ANONYMOUS 1300 222 222 (available 24/7) Program for recovery from www.aa.org.au alcohol abuse.
ALCOHOL AND DRUG (08) 9442 5000 (available 24/7) Confidential, non-judgemental INFO SERVICE www.mhc.wa.gov.au/alcoholand 24/7 helpline for people seeking drugsupportline assistance with alcohol or other drug use.
NARCOTICS ANONYMOUS 1300 652 820 (available 24/7) Program for recovery from drug www.na.org.au abuse.
COUNSELLING ONLINE 1800 198 024 – regional Confidential counselling and (08) 9442 5000 – metropolitan referral line for people using alcohol (available 24/7) and other drugs. www.counsellingonline.org.au
Page 15 REFERENCES
1. Colquhoun, G. (2007). Playing God: Poems about Medicine. UK: Hammersmith Press Ltd. 2. Beacroft, M. (2020). Medicus October 2020. AMA (WA) Office. 3. Hassed C. The ESSENCE of healthcare. Aust Fam Physician. 2005 Nov;34(11):957-60. 3 Hassed C. (2008) The Essence of Health: the seven pillars of wellbeing. Sydney, Random House.
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