Junior doctors outraged by ‘thinly veiled threat’ regarding rosters and sick leave
Updated ,first published
Junior doctors at a Sydney hospital are furious after receiving a note from their boss in what they described as a thinly veiled threat to their careers saying they were not tough enough to work in the state’s health system.
The letter Nepean Hospital management sent to junior medics last week symbolizes the ongoing tensions (expressed in all caps) between public hospitals’ efforts to adequately staff increasingly busy emergency departments and inpatient units in NSW and overworked junior doctors expected to work unpaid overtime.
Meanwhile, a report published by the doctors’ union on Thursday claimed one in three doctors working in NSW public hospitals is considering resigning due to working up to 70 hours a week.
The stated purpose of the memo to Nepean’s junior doctors was to “clarify some trends” and “misunderstandings regarding staffing” and appeared to address inappropriate use of sick leave, reminding junior physicians that this leave should be used when sick and not for life events or future assignments.
“IT IS YOUR RESPONSIBILITY to change shifts” [sic]Read the letter posted on Reddit.
“Collegiality should result in offers of help to those who help you,” he said.
The memo acknowledges the risk of fatigue, stating that “staffing is designed to ensure NO ONE gets tired” and suggests that some junior doctors are constantly covering colleagues’ shifts.
“[T]”There is an implicit acceptance here when entering medicine, you will be exposed outside working hours and at nights, because healthcare is 24/7, all doctors cover these hours,” he continued.
“I hope your career will be long..[sic]” The memo concluded: “If you’re struggling right now please come and get in touch, because unfortunately if you’re already feeling the pressure from staffing that’s absolutely standard in terms of health, that’s not a good indicator of longevity in the profession.” [sic].”
In a statement, a spokesperson for the Nepean Blue Mountains Local Health District apologized to junior medical officers (JMOs) for the email.
“We know JMOs are the future of healthcare and we deeply value their contributions,” the spokesperson said. “Supporting the wellbeing of our JMOs is a priority for our region and we recognize this email does not reflect that.”
The spokesman said senior doctors had met with JMOs to discuss staffing practices and that staffing was in line with safe working standards and fatigue management guidelines.
A staff specialist from Nepe who was not authorized to speak publicly said junior doctors’ colleagues were deeply disturbed by the note, which “amounts to a thinly veiled threat.”
“This actually implied that they would be blacklisted,” the personnel expert said. “We already have a recruitment and retention problem… these [junior doctors] those who choose to stay when the vast majority leave, and they are being punished for it.”
The staff expert said junior doctors agreed that sick leave should be used appropriately. But the tone of the email was derogatory, given that many people expressed concerns about being overworked or understaffed in their units and was met with a slow response.
“In every cohort there will be people who report being sick when they are not, especially if they are disgruntled because they are being mistreated…it is a very old story,” they said.
The Australian Salaried Medical Officers Federation (ASMOF) NSW said the statement was indicative of managers blaming doctors for systemic failures, including ongoing recruitment and retention problems.
Last year, NSW Health apologized after a manager at John Hunter Hospital mistakenly sent an email to junior doctors describing them as a “workforce of clinical sweets”. [sic]” In response to rostering issues.
President of the union Dr. “NSW Health does not impose any maximum limit on the number of hours a doctor can work in a day,” Nicholas Spooner said. “A bus driver is legally prohibited from working more than 12 hours a day.”
Doctors in Nepean reported working up to 17 hours a day, often for up to two weeks in a row.
Failures to manage fatigue have serious psychological impacts on doctors and risk compromising patient care, Spooner said.
Junior clinicians and senior specialists have repeatedly warned that unpaid overtime has been added to Australia’s hospital system as a band-aid against understaffing, and that overworking junior staff to the point of exhaustion could lead to medical errors.
A spokesperson for NSW Health said situations may arise where doctors may need to work additional hours to ensure patients are confident they are receiving the highest quality medical care and staff can carry out their duties without being adversely affected by fatigue.
The spokesperson said that from June, NSW Health will meet regularly with ASMOF and the Health Services Alliance to develop additional standards, controls and strategies to support fatigue management for JMOs.
ASMOF and NSW Health are adjudicating before the Industrial Relations Commission and the union is seeking pay parity with other states for doctors working in public hospitals in NSW.
Some key findings from a survey of 2681 NSW public hospital doctors
- One in two people worked more than 50 hours in the previous week
- One in three people worked more than 55 hours
- One in eight people worked more than 70 hours
- 63.5 percent said excessive workload affected their health and well-being
- 69 percent said they were working sick or injured
- 32.6 percent said their staff did not allow the mandatory 10-hour rest between shifts (overtime and on-call duties meant the actual prevalence was likely higher)
- 32.1 percent said they were considering resigning
- Staff shortages were routine and poorly managed
Source: ‘Results of the ASMOF Award Arbitration Survey 2025’, Dr Sarah Wise et al, School of Public Health, UTS. Commissioned by ASMOF NSW
A 2020 Black Dog Institute survey of just under 43,000 Australian doctors found one quarter Junior doctors were working unsafe hours, doubling the risk of developing mental health problems and suicidal thoughts.
