Trainee health and wellbeing

By doctors, for doctors

There are 24-hour helplines such as the Doctors Health Advisory Service, staffed by doctors, for doctors and medical students.

Region	Service	Contact	Operating hours
NSW	Doctors Health Advisory Service NSW Medical Benevolent Association of NSW	(02) 9437 6552 (02) 9987 0504	24 hours
VIC	Victorian Doctors Health Program AMA Victoria Peer Support Service	(03) 9495 6011 1300 853 338	9am – 5pm weekdays Clinical services also available 8am to 10pm daily
QLD	Queensland Doctors' Health Programme	(07) 3833 4352	24 hours
SA	Doctors' Health SA	(08) 8366 0250	24 hours Clinical services also available
	Rural Doctors Workforce Agency, Dr DOC program	(08) 8234 8277 0417 082 411 E [email protected]	Clinical services also available
WA	Doctors Health Advisory Service WA	(08) 9321 3098	24 hours
NT	Doctors' Health SA	(08) 8366 0250	24 hours Clinical services also available
ACT	Doctors Health Advisory Service NSW	(02) 9437 6552	24 hours
TAS	Victorian Doctors Health Program AMA Tasmania Peer Support Service	(03) 9495 6011 1300 853 338	9am – 5pm weekdays Clinical services also available 8am - 11pm
New Zealand	Doctor’s Health Advisory Service (Wellington) Resident Doctor’s Support Team (Canterbury District Health Board)	0800 471 2654 Christchurch	24 hours

It is appreciated that the nature of the work and study commitments of doctors in emergency medicine can often be difficult to balance while maintaining a personal quality of life.

ACEM has partnered with EAP provider Converge International to offer its services to trainees to support their wellbeing. Converge International is Australia’s oldest and most experienced EAP provider. Its counselling services offer support to you for professional, educational or personal matters, including:

• Managing heavy workloads
• Conflict and conflict resolution
• Resilience
• Relationships (personal and professional)
• Workplace changes
• Finance
• Motivation and self-esteem
• Nutrition
• Sleep and fatigue.

The College is offering four funded EAP sessions per calendar year to its trainees/members. This service is completely confidential. Participant information is de-identified and the College has no access to your records.

Converge International’s services can be accessed over the phone, via their website or on the Converge International app (EAP Connect). To access the service, please identify yourself as a trainee. All trainees are eligible to access this service.

The College encourages you to utilise these support services as required. Appointments are available Monday to Friday 8.00am to 6.00pm.

Emergency telephone counselling is available 24/7. 

Find more information here.

Converge International:
1300 687 327 (Australia)
0800 666 367 (New Zealand)
[email protected]
www.convergeinternational.com.au *
Get the EAP Connect app on Google Play or the App Store.
*Login details for the Converge International online portal are available on your My ACEM Resources page.

The Wellbeing Network is a space for members and trainees to discuss topics relating to the wellbeing of people working in Emergency Medicine. It has been set up to facilitate the sharing of information, ideas, stories and initiatives.

Best of Web EM is an ACEM resource hub, linking you with peer-reviewed resources including those relating to doctor health and wellbeing .

There is an Australian website and service dedicated to helping junior doctors make their way in the profession. Check out jmohealth.org.au

If you are experiencing clinical performance issues, contact your Director of Emergency Medicine Training (DEMT) or Director of Emergency Medicine (DEM) in the first instance. If you feel uncomfortable in doing this or if an issue remains unresolved, you can contact the ACEM Trainee Advocate who can provide advice and help you take any further steps if necessary:

Trainee Advocate
t +61 3 9320 0444
e [email protected]

You can also contact your Local Trainee Representative. For details, visit the Member Portal for details.

If you are concerned about an upcoming exam and require guidance, contact your DEMT or FACEM mentor. For more information on mentoring, visit the ACEM Mentoring Resources. 

For general exam advice, please contact the ACEM assessments team or visit the Examinations page.

If you are concerned about meeting your training and assessment requirements and require guidance, contact your DEMT. There are several options to help address your circumstances and meet the necessary training and assessment requirements.

Interruption of Training

You may interrupt your training for a maximum period of two years accumulated over the course of your training program. More time may be granted for parental leave or exceptional circumstances at the discretion of the College. For more information, view the Exceptional Circumstances & Special Consideration Policy.

Special Consideration

Trainees undergoing formal assessment may apply for special consideration for circumstances that adversely affect their performance. For more information, view the Exceptional Circumstances & Special Consideration Policy.

Working part-time

Some of your training may be completed on a part-time basis, provided that at least 50 per cent of the full-time commitment is completed and the placement meets accreditation requirements in all other respects.

Take leave

Your allowable annual leave, study leave, and sick leave is calculated in relation to your training time:

• Up to 5 weeks in every 13 week In-Training Assessment period (40% ITA period)
• Up to 10 weeks in a 12 month period (19% annually).

For more information regarding your WBA and FACEM Training Program requirements, contact the ACEM Training Team.

Issues with your supervisor or colleagues

The ACEM Training Team is available to assist you with any concerns or issues you have with your workplace supervisor or colleagues.

We also encourage trainees to speak with the human resources department in their workplace to discuss these types of concerns.

Conflict

After resolving the conflict, you are encouraged to engage with your Local Mentoring Program. It is compulsory for all ACEM-accredited EDs to have a mentoring program in place. Trainees are encouraged to develop a mentoring relationship with a trusted colleague.

For more information, contact your local Mentoring Program Coordinator.

First steps

The following resources can help you to identify whether you may be developing an alcohol use disorder:

• The National Health and Medical Research Council (NHMRC) publishes Australian Guidelines to Reduce Health Risks from Drinking Alcohol
• The AUDIT Tool, written by doctors in the UK, is a trusted self-assessment questionnaire.

Next steps

It is important to seek help if you are developing an alcohol use disorder. This may be from your own trusted general practitioner, an addiction medicine specialist or a doctor-friendly Alcoholics Anonymous (AA) group in Australia or New Zealand. Alternately most university psychology departments administer interactive web-based counselling programs that can be accessed anonymously.

Recovery

Lifetime prevalence studies indicate that one in 10 people will develop alcohol strife. There is no need to feel shame if it is affecting you. Lifestyle changes such as replacing alcohol consumption with alternate habits such as exercise, hobbies and satisfying social interactions have been shown to assist. Fortunately, the prognosis for doctors who develop alcohol use disorder is favourable, especially where the problem is both recognised and managed early.

Up to 50 percent of Australian junior doctors have experienced bullying in their workplace, and a New Zealand study found that 50 percent of doctors had experienced bullying in the past three to six months (Australian Medical Association). Bullying can happen to anyone, from medical student to senior specialist.

Support

If you have encountered discrimination, bullying or sexual harassment in your workplace, we encourage you to seek confidential support from either your workplace Employee Assistance Program (EAP) or your local Doctors’ Health Advisory Service.

If your experience is related to any College-associated activity, you can contact Converge International, which has been engaged by ACEM to provide additional support to our members and trainees. The service is completely confidential:

Australia: 1300 687 327
New Zealand: +61 3 8620 5300

Converge International also offers online resources that provide you with information to deal with on work-related and personal issues. The portal contains information on the latest news and events from Converge International, newsletter inserts on various topics, research papers and tip sheets.

Complaints

If you would like to make a formal complaint to ACEM about the conduct of any College member or trainee or to enquire about the College’s complaints process, you can email [email protected].

Also see the Complaints Policy and the Procedures for Resolving Discrimination, Bullying and Sexual Harassment Complaints.

Mind Tools is a website that helps you learn the management, leadership and personal excellence skills needed for a happy, successful career. It provides a collection of strategies for reducing and managing stress.

In emergency medicine, there are likely to be times when practitioners are involved in situations that are stressful. It is not unusual to find yourself affected an adverse incident or particularly confronting case. Therefore it is important to have some coping strategies.

You are not alone. There are times when you can feel hopelessly inadequate, and others around appear self-confident and assured. These outward appearances can be quite different from how other people feel. Anyone working in this challenging environment feels like this some of the time, particularly after a critical incident.

Talk to others about how you are feeling after any stressful event. You may be surprised about how they have had similar experiences, and can often share details of their failures and successes to help you maintain perspective. This might be with a colleague whom you respect, admire and can talk to.

Some departments and organisations have a formal structure in place for debriefs, sometimes with professional facilitators. If one is offered where you work, and you think it would be beneficial, ensure you know when they are occurring and can have the time from other duties to attend.

In Australia

If you believe a doctor is unwell and may be unable to practice safely, you are required by law to notify the Australian Health Practitioners Regulatory Agency (AHPRA). Your employer will have specific reporting rules.

Your concerns should be escalated to a line manager, the Director of Emergency Medicine Training (DEMT), Director of Emergency Medicine (DEM) or the Director of Clinical Training. Providing that you do this in good faith, there are legal protections from civil and administrative liability.

In New Zealand

If you believe a doctor is unwell and may be unable to practice safely, you are required by law to notify the Medical Council. If you have a reasonable belief that a doctor may be unable to perform the functions required for the practice of medicine, the obligation to notify takes effect.

If you haven’t notified the Medical Council of New Zealand, this could be seen to be a breach of professional obligation and give rise to disciplinary proceedings. Supporting the obligation to notify, the Health Practitioners Competence Assurance Act 2003 protects whistleblowers.

The Australian Medical Association offers doctors a web-based tool that enables you to evaluate the safety of your roster, track your work, on-call, recreational and sleeping hours over a week, and determine whether your work arrangements are placing you at risk of serious fatigue.

Ensure you are aware of the ACEM G26 Infectious Disease and Biohazard Exposure in the Emergency Department guidelines.

The following resources provide support and services for those experiencing mental health issues:

• Beyond Blue Doctors Mental Health Program aims to address the prevalence of anxiety, depression and suicide in staff working in health services across Australia." 
• The Beyond Blue Mental Health Checklist measures whether you may have been affected by depression and anxiety during the past four weeks
• The Black Dog Institute provides information and resources including online self-testing information on current treatments
• For New Zealand-based support and service, the Mental Health Foundation's Get Help website has a full range of associated resources.

Learning more about mental health issues

The following online resources can help you learn more about mental health issues:

• The Centre for Clinical Interventions provides access to self-guided online modules about depression, perfectionism, panic attacks, assertiveness and much more
• The Australian National University developed the eCouch platform contains online exercises and strategies
• The University of Auckland's CALM website contains podcasts on resilience, managing stress, anxiety and depression, healthy relationships, and finding meaning in life.

Mindfulness and meditation resources

There are many freely available mindfulness and meditation resources. Not-for-profit organisations, Headspace and Smiling Mind, both have apps for Apple and Android. The Auckland-based CALM website has online meditation modules.

Building resilience

The Resilience Project teaches positive mental health strategies and has developed a daily well-being journal app.

Relationships Australia provides a range of services including what to do when your relationship breaks down and resolving a conflict.

The Australian Centre for Grief and Bereavement provides helpful information about grief, supporting grieving children, adolescents and adults.

WRaP EM is a group of ordinary but passionate clinicians and medical educators who want to promote the concepts of Wellness, Resilience and Performance, from being considered ‘the soft stuff’ to becoming a core part of Emergency Medicine practice. 

WRaP EM is creating an expanding Free Open Access Medical Education (FOAMEd) curriculum and blog to help achieve these goals, and aims to facilitate tangible cultural growth in work spaces through connection with other like-minded clinicians.