Determinants of trainee satisfaction: An Australian national study


Matthew J Lennon^1,2, Amelia Tan^1,2, Claire Mok^1,2, Matthew R. McGrail^3,4, Joseph J Suttie^1,2,5, and John Preddy^1,2,5

1. Rural Clinical School, University of New South Wales, Wagga Wagga, NSW
2. Wagga Wagga Base Hospital, Murrumbidgee Local Health District, New South Wales Department of Health, NSW
3. Monash Rural Health, Monash University, Churchill, VIC
4. University of Queensland, Rural Clinical School, Rockhampton, QLD
5. Wagga Wagga Clinical School, Notre Dame University, Wagga Wagga, NSW

Objectives

Worldwide specialist trainees wellbeing has become an issue of great concern with reports of overburdensome workloads, burnout, trainee bullying, a lack of employment security and a number of high profile suicides. Ensuring that trainees are satisfied and progress well through their training should be a priority of any health system that seeks to have a future. Despite this there has been little systematic research on specialist trainees which identifies policy-amenable factors and correlates with professional satisfaction. Our project aims to examine potential predictors of trainee professional satisfactions in a national Australian cohort.

Methods

This study used 2008 - 2015 data from the Medicine in Australia: Balancing Employment and Life (MABEL) survey, a national study of doctor demographics, characteristics and professional and personal satisfaction. Our study examined specialist trainees using a repeat cross sectional method pooling first responses across all waves we performed a multivariate logistic regression analysis assessing correlates with professional satisfaction.

Result 

The three most strongly correlated factors to specialist trainees being professionally satisfied were feeling well supported and supervised by consultants (OR 2.59; 95% CI 2.42 - 2.77)), having sufficient study time (OR 1.54; 95% CI 1.40 - 1.70) and self-rated health status (1.65; 95% CI 1.53 - 1.80). Those working >56 hrs/wk were significantly less professionally satisfied (OR 0.76; 95% CI 0.70 - 0.84) compared to the median number of work hours (45 – 50 hrs/wk). Those earning in the lower quintiles, earlier in their training and trained at an overseas university were also significantly less likely to be satisfied.

Conclusion 

Our study suggests that focus on good clinical supervision and support, workload and ensuring trainees have sufficient personal and study time would improve trainee satisfaction, increase training quality, morale and thus the quality of care. It also suggests that a particular consideration of those trainees earlier in their training, those graduating from overseas universities and working >56 hrs/week may be appropriate when considering the development of trainee wellbeing programs and policies.