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Identification of a struggling doctor

The identification of a struggling doctor may come via a number of routes.

Prior to commencing internship, a number of characteristics have been identified as predicting a doctor who may need additional support:

  • Intern with a low Z score
  • Repeating or deferring years as an undergraduate
  • Older age at starting internship > 30 yo
  • Married
  • Male gender
  • International medical graduate
  • English as a second language

During intern year some warning signs include:

Productivity

  • Large number of discharge summaries pending
  • Poor note taking
  • Handing off a large number of uncompleted tasks

Attendance

  • Frequent sick calls
  • Arriving early and leaving late
  • Being uncontactable during the day

Reports from staff

  • Team members rumour mill regarding competence
  • Formal reports on intern training assessment forms
  • Poor communication
  • Bad behaviour

Significant concerns regarding patient safety

Intern training providers must be aware of the Health Practitioner Regulation National Law. This requires registered health practitioners and employers to make notifications about registered medical practitioners who have engaged in ‘notifiable conduct’ as defined in the National Law.

The requirement under national standard 5.2.5 to immediately address concerns about patient safety may require action beyond remediation, including possible withdrawal of an intern from the clinical context.

Refer: Medical Board-Training - National standards for programs PDF >>