VICDOC Winter 2022 - Magazine - Page 51
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s medical students, we completed our
psychiatry rotations in the midst of
the Royal Commission into Victoria’s
Mental Health System. We have seen
the challenges faced by our current systems and
resources in supporting our mental health workforce
to deliver quality care to those living with mental
illness. Our Council advocated to the Royal
Commission for greater, more consistent education
about mental health presentations across the
curriculum and in a variety of clinical contexts.
Our generation of medical students is also
particularly concerned with intersectionality, and
our Council’s submission particularly noted students’
desire to be better prepared to meet the mental
health needs of minority groups such as Indigenous
Australians, refugees and asylum seekers, and gender,
sexual and romantic minorities (GSRM) including
the LGBTQIA+ community.
Looking to the future, as junior doctors, we will
be at the forefront of navigating the implementation
of the Royal Commission’s recommendations. We
want to make sure that we are prepared with the
skills, knowledge and support to undertake our
terms in psychiatry as junior doctors, and are ready
for our roles in shaping how a reformed Mental
Health and Wellbeing Act will be applied in the
settings we work in.
Our understanding of mental health has been
particularly shaped by COVID-19. For many of us,
our transitions from preclinical study to clinical
placement – a challenging and isolating time for any
cohort – coincided with the onset of the COVID-19
pandemic, a time when the importance of self-care
and social support have been brought into sharp
focus for everyone. We are keenly aware of the
potential for fatigue and burnout in our careers, and
do not accept that patients’ health should come at
the expense of health practitioners’ wellbeing.
We believe that safe patient care can ultimately
only occur if doctors are able to ensure their
own wellbeing first. Since 2017, the Declaration
of Geneva has included a pledge as a medical
professional to ‘attend to my own health [and]
well-being’, in order that one may then provide
care to others. We take this pledge with us into the
workforce as junior doctors.
As a corollary, medical students know that
a precondition of safe patient care is a work
environment that supports doctors. Addressing
bullying, harassment and discrimination have
been advocacy priorities of the Australian Medical
Students’ Association (AMSA) for at least as long
as I have been a medical student. This year, our
Council joined with AMSA and the medical student
councils in each other state to launch a ‘Culture of
Medicine’ campaign, to expand our advocacy on
workplace culture. We believe that everyone has the
right to be treated with dignity at work. Similarly,
medical students follow with interest AMA Victoria
and ASMOF Victoria’s junior doctor class action
lawsuits. We know that the danger posed to patient
safety by excessive workloads and understaffing is
unacceptable in any healthcare setting.
Finally, as these issues have come into the
spotlight, so too have the frameworks that govern
their application to medical students and junior
doctors. Professionalism, as a function of our ethical
obligations and duty to act properly in the interests
of our patients, is a principle that must underlie our
practice as medical professionals. At the same time,
students appreciate that “professionalism” can also
be improperly wielded to silence juniors who speak
out appropriately in good faith about inappropriate
or unsafe practices, or their own needs. Our Council,
alongside the AMA, has advocated for reform to
current mandatory reporting requirements for
doctors seeking help for their mental health.
Similarly, our Council has expressed concerns
about processes for transferring information about
health and academic progress from students and
universities to employers, on the basis that blurring
the lines between education, healthcare and
performance management may chill students from
seeking help. Having a healthcare workforce that can
provide safe, effective patient care demands systems
that view speaking up and seeking help as integral
parts of, rather than barriers to, professionalism.
For the time being, the medical student mind
fills variously with relief at completing internship
applications or apprehension at uncertainty of the
pending outcome, but as we turn our minds to 2023,
we look forward to joining our senior colleagues and
navigating the future of mental health and of our
practice as doctors, together.
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