Abhary has been awarded a grant-in-aid under Avant’s Doctor in Training
Research Scholarship Program 2015 to lead the first pilot qualitative study to
analyse personal and workplace enablers and stressors among registrars in
speciality training programs. The study aims to provide key qualitative data to
inform the development of evidence-based health care strategies to improve
support for young doctors and patient
Advocating for young doctors
informed by personal experience
A registrar herself, Dr Abhary’s
personal frustrations in medicine and training ignited a passion to explore the
health and wellbeing of doctors in training.
“I decided to leave the
profession for a while and travelled overseas for a year and kind of found
myself,” she says.
During her sabbatical, Dr Abhary, 35, (pictured)
developed a passion for mountaineering and has fond memories of helping a
Women’s Shelter in Iran to organise mountaineering trips.
“I helped the
shelter raise funds to do mountaineering trips because the women are either
homeless or they have come out of abusive homes and can’t afford education or
the equipment,” she says. “I realised the power and satisfaction in helping
disadvantaged people live their dreams and there is nothing more empowering
than conquering a mighty mountain!”
Upon returning to Australia, Dr
Abhary decided to pursue a career in medical administration and use her
extensive background in quantitative and qualitative research after completing
a clinical PhD. In addition to her roles as an Australia Medical Association
(AMA) Victoria Board Director and AMA Victoria Doctors in Training
representative to the AMA Victoria Council, to advocate for her fellow doctors
Unique stressors faced by young doctors in the
Dr Abhary, who is currently undertaking a Medical
Administration Fellowship with The Royal Australasian College of Medical
Administrators at Monash Health, Melbourne, says the results of the 2013
Beyondblue National Mental Health Survey of Doctors and Medical Students
precipitated the pilot study.
“The survey revealed some pretty shocking
statistics and found that Australian doctors reported significantly higher
rates of psychological distress, anxiety, attempted suicide and suicidal
thoughts compared with other professionals and the rest of the Australian
population,” she says.
“Importantly, there is a lack of data
regarding these issues for registrars in speciality training, who face
additional unique stressors associated with training demands, exams, college and
speciality related factors and first on-call.”
Dr Abhary, who also holds
a Graduate Certificate in Health Management from the University of New South
Wales, Sydney, says research conducted by the AMA found 69% of residents and
registrars reported burnout and 71% voiced concern about their own health.
In 2015, the importance of safeguarding the health
and wellbeing of junior doctors was widely recognised after the deaths of
three registrars and an intern in Victoria, as well as extensive media coverage
of bullying and harassment in speciality training, particularly in surgical
However, Dr Abhary is quick to point out that AMA
Bullying and Harassment Survey data showed rates of bullying and harassment
were similar across all specialties.
“Bullying and harassment is
rampant and not just unique to surgery,” she says. “The surgeons were unlucky,
but it was fortunate for the rest of us as at least it highlighted this issue
in medicine and the Royal Australasian College of Surgeons had to do something
about it and put some solutions forward.”
Qualitative data a key
step in developing targeted support
Dr Abhary anticipates that
the research will provide critical qualitative data to create more targeted
evidence-based health care strategies to assist junior doctors to successfully
complete their training.
“We have a reasonable amount of survey data
and many health care strategies have been created, but the critical step in the
qualitative research hasn’t been undertaken at all in Australia,” she says.
The study aims to interview 20 specialist registrars across medicine
and surgery to elucidate workplace and personal factors that may contribute to
psychological stress or enable successful completion of training.
date, Dr Abhary has conducted six confidential interviews with registrars
across a range of specialities including surgery, physician training, emergency
medicine, ICU and obstetrics and gynaecology.
“We are delving into the
impact of a variety of workplace factors, for example, hours and whether you
are being paid overtime, workload, being on-call, supervision that’s available,
college support, exams, bullying and harassment, absenteeism and private versus
public training,” she says.
The study will also explore personal
factors including relationships and family life, work-life balance, financial
impacts, major life events and mental and physical health issues. As well as
analysing registrar use, awareness and perceptions of support programs.
Preliminary results highlight key trends
Early results have
mirrored previous results showing registrars in speciality training programs
experience significant forms of stress.
“Between 60 to 70% of
registrars are experiencing serious stressors within their workplace and
training, which is having a significant impact on their personal lives,” Dr
Abhary says. “Exams, poor supervision, on-call and bullying harassment and
relationship strains have been repeatedly highlighted as major sources of
“Bullying and harassment is definitely rife and they don’t
feel that there are any appropriate services to be able to report these issues
without recrimination, leading to them suffering in silence,” she says. “The
majority are completely unaware of the support services that are available and
there is only a minority utilising any support services.”
transparency is also an issue for doctors in training in terms of clear
pathways to securing a place on a training program or finding a job once they
have completed their training program, she adds.
funding a win for doctors
Dr Abhary is extremely grateful for the
Avant scholarship and describes it as a win for doctors’ voices to be heard.
“Avant has supported me in my plight to have our doctors in training heard in
order use the results to push for a fairer system, better working and training
conditions, more support services and ultimately better patient safety,” she
Due out in late 2016, Dr Abhary will present the research to Avant
to support Avant’s advocacy on the prevention of bullying
and harassment for doctors. She will also share the results with the AMA
and The Royal Australian College of Medical Administrators and use her roles
within these organisations to drive awareness and the necessary changes within
the health sector.
“Australia’s health care system is multi-faceted
and complex. There is a long way to finding solutions for fairer training and
working conditions and the support systems necessary. Research like this brings
this one step closer to making it happen”
In the future, Dr Abhary is
aiming for the pilot study to be used as a platform to expand the scope of the
research to include medical students, interns, resident medical officers and
Read Avant’s submission to the Royal Australian College of Surgeons (RACS) –
Expert Advisory Group Issues paper on discrimination, bullying and harassment on
For advice and information on maintaining your health
and wellbeing, visit Avant’s Health and
Wellbeing website or the Doctors’
Health Advisory Service in your state or territory.
You can also access Avant’s Personal Support Program free on 1300 360
364 which provides a range of support options for members who are suffering
health issues, including a confidential counselling service.
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