The ecology of survival for new medical graduates

The most effective strategies for preparing young doctors will operate outside the closed public hospital system

This issue of the MJA includes a report by Chanchlani and colleagues about a study of the value of peer mentoring for the psychosocial wellbeing of junior doctors; the authors conclude that the program employed in their randomised interventional study was valued by participants.1 The authors detail the negative aspects of the public hospital environment for interns, including navigating the complexity of the health care system, being required to regularly develop and implement new clinical skills, and a pervasive anxiety about future career advancement. Any program that achieves better outcomes for young doctors is praiseworthy, but it is disappointing that little has changed in the past 20 years in either descriptions of the work environment or the levels of anxiety, stress and burnout reported by junior doctors. Bullying and harassment are said to be endemic in our hospitals.