INTERNSHIP 101 what you need to know 2020 - AMA (WA)
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
INTERNSHIP 101
what you need to know
2020
INTERNSHIP 101 – WHAT YOU NEED TO KNOW
Contents
Page
1. A Compassionate Science – Dr Andrew Miller
2. Support each other – Dr Megge Beacroft
3. Own your experiences – Dr Tessa Kennedy
4. 10 things I wish I’d known – Dr James Charleson
5. Top tips to survive your internship – Dr Alma Corker
6. Strive for five – Dr Naomi Avital and Dr Gary Avital
8. The power of one voice – Dr Katharine Noonan
10. 2019 Hospital Health Check Survey Results
12. Packing a Punch
13. Member benefits for DiT – professional and industrial services
14. Key Entitlements – what you need to know
16. Doctors in Training – Salary Guide
17. Salary packaging explained
18. Understanding Your Payslip
20. Prescribing 101
22. Looking after your mental health and wellbeing
25. The value of AMA (WA) membership –
Amanda Kaczmarek and Hayley Elkin
27. AMA (WA) Junior Doctor of the Year – Dr Camille Michener
Legacy Award
28. AMA Membership: Bang for your buck – Dr Jason Laurens
INTERNSHIP 101 – WHAT YOU NEED TO KNOW 1
A Compassionate
Science
DR ANDREW MILLER
AMA (WA) President
Hello and welcome to your papers that give you both privilege – Stay current and involved in
profession of Medicine. and responsibility. Your license to continuing education, and study
You are here to replace practise medicine is your greatest as much extra stuff as you can in
me which is the natural asset and you must protect it. any discipline you are interested in.
order of things. I have seen many careers end too – Focus on the job satisfaction
early or in circumstances that the and if it makes you some money,
I am sure that you are pleased to be great. If it doesn’t, make as much
doctor would not have wanted,
finished with the study, and excited as others get, then remember
indeed that no one wanted. A few
to be getting on with the next phase how as a student you never
tips if I can be so bold on how to
of your life. needed as much as you will
avoid common problems and fulfil
All those who care about you will be the promise of that internship into have now.
rightly proud of your achievement, the future: – Do something humanitarian any
which has come at no small cost. – Don’t feel entitled – every day time you get an opportunity –
we can practise is a privilege not much more fun than paid work
Our occupation, or calling, enjoys
a right, so stay humble. No one usually.
a special place in society because
misses even the greatest doctor – Contribute to the AMA – lots of
it is at the intersection of the best
for more than a few weeks after fun to be had there.
available science with caring for
people. we retire. Have fun and don’t worry – there is
– Treat every patient and co- a lot of negativity because social
It is 30 years since I was an intern.
worker, everyone, with respect media has given every loud mouth a
From here I can see way down the
and compassion – easy when you megaphone. Times have never been
slope to slowing down and passing
like them, much harder when you better though, and if you are not
on the baton, and look back down
don’t, so keep a sense of humour. too busy when you get to my ripe
the hill I climbed which was steep in
– Stay connected to colleagues old age, you will see again no doubt
places but well worth it.
through the AMA and other that things have improved. Science
The AMA is the family home of our organisations. Be a participator in combined with compassion always
profession – it is collectively yours your medical community because improves things over time.
to inhabit and to renovate and to if you are in trouble it is much
inherit and finally to pass on to better when you are in an army
those who will come, all too soon, than on your own.
after you. The AMA is here to look – Avoid drug and alcohol problems
after our tribe and represent our and get help early if that starts to
grand tradition and all that is good emerge.
about it, but to do it in a responsive – Avoid conflict in all aspects of life.
and flexible and modern way that
– Find another way around if you
can adapt to the times.
can. If in the middle of trouble,
You now enjoy a legislated slow down on work and seek
monopoly and will carry registration support.
2 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
Support
each other
DR MEGGE BEACROFT
Co-Chair
AMA (WA) Doctors in Training (DiT) Committee
Congratulations on Support each other. The While others will discuss the
surviving medical school! relationships you form this year many industrial and professional
Now starts a career that will shape your career. From the advantages of joining the AMA (WA),
is both challenging and orderlies to department heads, a for me it’s about shaping the future.
hospital doesn’t function unless we
extremely rewarding. Please do not forget to take part
all pull together. A casual joke with
in the AMA (WA) Hospital Health
All of that hard work has paid off the orderlies, nurses who bring you
Check. This has become one of
and your first pay check is on its a cup of tea or a bickie when you’re
the most significant influences
way. There will be a lot of advice exhausted or years later, picking up
on a junior doctor’s choice of
flying around between now and day the phone on a night shift to make
workplace. I strongly encourage you
one so I’ll keep mine brief! a referral and seeing one of your
all to complete the survey when it is
old co-intern’s names on the roster.
Medicine is the most rewarding released in 2020 and see the 2019
Learn people’s names; be part of
caree. We earn a decent wage to results later in this guide.
the team.
surround ourselves with some of the
The AMA is the coordinated and
best and brightest, to see people in Enjoy the pre-vocational years,
public voice of all doctors in
what can be the worst moments of before the exams start again, where
Australia and we need you to help
their lives – and be there to help. To leave is more readily available and
us shape a message and agenda
fall back on all of those late-night PDL isn’t controlled by the colleges
worthy of our times and the patients
cram sessions and pathology notes or taken up with frantic CV buffing.
we represent.
and history-taking practice to make Take leave, travel, learn things for
a real difference in the lives of our fun, read fiction. I look forward to meeting you at one
patients. of our intern events in 2020.
Join the Australian Medical
It is a privilege and a pleasure, Association (WA). Both medicine
and sometimes we need to take and medical training are rapidly
a moment between the endless evolving as we face technological
paperwork and discharge expansion, budget crises, specialist
summaries to appreciate just how training bottlenecks and public
lucky we are to be in this position. health emergencies. Come
along to our monthly Doctors in
Get to know your patients. Learn
Training meetings (all members
from them and their journey. Even
welcome) where we discuss issues
if you get all of your cannulas in
around education, advocacy,
and all of your DC letters done on
doctor wellbeing and industrial
time, it’s the genuine gratitude and
entitlements.
relationships with patients that will
get you through the tough bits.
INTERNSHIP 101 – WHAT YOU NEED TO KNOW 3
Own your
experiences
DR TESSA KENNEDY
Chair, AMA Council of Doctors in Training
Congratulations on a high-stakes college exam. I’ve sat inequity and discrimination to
levelling up from student in my car and cried inconsolably onerous requirements for vocational
to intern, and welcome to after a near miss with a patient for training entry and completion.
the medical profession! which I felt culpable.
I’d strongly encourage you to get
A lot of things are about to change. I’ve worked with a consultant involved, either in the AMA (WA), or
First up, you get paid to be at for three months who never any other avenue that allows you to
hospital. Flip side – you actually remembered my name. help shape our professional world
have to be at the hospital. You will for the better.
Any doctor can tell you there’s
be given responsibility for patient nothing terribly remarkable about Despite its many challenges and
care, perhaps the most satisfying these stories. I don’t share this frustrations I love my job. I can’t
part of the job – but with it comes to scare or depress you, but to imagine doing anything else and
the potential to do patients harm. encourage you to take ownership of I believe it to be a privilege to care
You will be pushed to your limits: are your experiences. for my community. But doctors are
you ready? part of that community, and we are
No doubt there are certain stressors
deserving of the same care and
I truly believe it is the challenge of inherent to the practice of medicine:
compassion we afford our patients.
our work that makes it worthwhile, dealing with death and suffering,
but to avoid burnout, it’s critical to high-stakes decision making and As you enter your internship with a
balance work with life. unpredictable workloads. However, hard-earned ‘Dr’ before your name,
many others are not inevitable, here are 10 things that will help you
The Hippocratic Oath tells us to more the result of health systems thrive:
first do no harm. But the practice of under strain, being asked to do 1. You are not alone.
medicine isn’t just capable of inflicting more and more with less and less. 2. When and where to get help.
harm on patients, doctors can also This is unhealthy not only for us, but 3. Your rights (this is where AMA
suffer in its pursuit. In the last few for our patients, who are placed at and ASMOF come in handy).
years, there has been a spotlight increased risk of harm.
on the epidemic of psychological 4. Your limits.
distress and mental ill health which The various State AMA Doctors in 5. Your supports and safety nets.
may be created, or perpetuated by Training Committees have quantified 6. It’s okay not to have a 10-year
the culture of medicine and the way many of the concerns of doctors in plan.
we work as doctors. training through our Hospital Health 7. There is no wasted experience.
Check surveys. This has allowed
Personally, I’ve worked back to back 8. Things can change – but you
us to drive long-overdue change
16-hour shifts, 90-hour weeks and need to drive it.
to common issues like unpaid
then gone home to study. I’ve felt 9. Eat, sleep and exercise before
overtime, difficulties accessing
unable to call in sick because there saving lives (and you’ll be better
leave, unsafe working hours,
is no one to cover me. at it).
working when sick, service provision
eclipsing training and more. The 10. Our job is so amazing!
I’ve regularly stayed back only to
be told I can’t claim overtime. I’ve Federal AMA Council of Doctors The next few weeks and months will
caught myself falling asleep driving in Training of which I am Chair are be full of challenges, but also rich
home with 90km to go. I’ve had a working to address a number of rewards. I wish you all the best.
sleep-deprived panic attack before broader issues for DiTs, from gender
4 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
10 things I wish
I’d known
DR JAMES CHARLESON
WACHS Intern, Bunbury Regional Hospital
I
remember reading this guide “I have no idea how to do that”. had died unexpectedly. At times
prior to starting my internship At the outset, I wanted people like this you will need someone
with all the butterflies and nerves to think I was competent at to de-brief with.
of making the leap from ‘senior everything but the reality is you 6. Get your finances in order early.
medical student’ to ‘bottom of the can’t be and there’s no shame You will be paid well, but we’re
barrel intern’ that I am sure many of in that. The longer you pretend really behind those professionals
you are feeling. to know how to do something who start working at an earlier
and you don’t, the worse it is age. I would recommend setting
For me that prelude was a collage
when you do have to admit it. up salary packaging before you
of emotions: fear that I would forget
This goes for suturing, ABGs, start working. Also, If you do get
everything I had learnt at medical
discharge summaries, writing any choice, it’s advantageous
school, excitement to finally get good notes or even examining
paid, terror I would miss a STEMI, from a tax point of view to do
patients properly. your higher earning terms in
trepidation at leaving student life
3. You can never have too many the first half of the year (usually
behind and exhilaration that I might
friends. You would not believe surgical and ED). I would also
actually be able to help some
how hard colleagues can make examine your pay slips – it’s
patients. Fortunately most of my
your job if you’re rude, abrupt amazing how frequently they
fears were unfounded and those
or condescending to them. are wrong. Finally, for what it’s
hopes were realised. It’s been a
Conversely, you can’t overstate worth, I found The Barefoot
fantastic year of growth, challenge
how much easier your job Investor a really helpful guide if
and learning – and I’m sure it will be can be when you have people
for you too! you are new to adulting.
on your side, this includes
7. Having said that, in my opinion
As you get set to embark on your doctors on other teams, nurses,
some things are worth spending
own journey, here’s my best attempt radiographers, PCAs, ward
on. I get a cleaner in once a
at 10 things I wish I’d known, and clerks and medical admin.
fortnight and the laundromat
things you probably know already 4. Collaborate with the other interns, down the road does all my
but might need to hear again. especially early on – you’re washing – it leaves me time to
all in the same boat. I am not actually reset and enjoy my time
1. First and foremost, you will be
a naturally organised person off.
fine. It’s much harder to fail your
and there are many things my
internship than it is to fail medical 8. If you do know what area you
colleagues do better than me, but
school – and you’ve passed that want to specialise in, then
you should never be afraid to ask
three times already. Aside from find a mentor early to identify
how you could do things better.
that, the internship is a lot more opportunities and some kind of
5. While I’m confident your
fun in many ways, the burden clinical road map early on.
internship will be a great year
of knowledge is lower, you have 9. If you don’t know what you
I know there will be awful
very little actual responsibility want to do, and even if you do,
moments. On a ward cover shift,
and at the end of each day, you consider a rural term. I have had
I was managing someone with
get to go home not worrying a great time in Bunbury.
an NSTEMI, a delirious patient
about studying for exams. 10. Enjoy that last holiday before
trying to jump out of bed on a
2. The most useful phrase during total knee replacement and I work starts!
your internship (except with also had to call a woman to tell
patients!) is some variation of, her that her husband of 60 years
INTERNSHIP 101 – WHAT YOU NEED TO KNOW 5
Top tips to survive
your internship
DR ALMA CORKER
Intern, Fiona Stanley Hospital
Doctors in Training Committee or Even if it’s only 10 minutes, you
the PMCWA JMO symposium. will thank yourself later.
These opportunities will be • If working night shifts, catch
1. Be organised promoted at your orientation week, public transport or Uber to work.
• Download the Australian so be sure to listen out for them! No matter how many coffees you
Medicines Handbook (AMH), • If research is more your thing, drink at 5am, you will still likely
Therapeutic Guidelines (eTG) approach the medical education microsleep behind the wheel,
and UpToDate on your phone. team, your supervisors and endangering yourself and fellow
They are your best friends when colleagues (particularly registrars drivers!
you are unsure what to chart, if on training programs) to find out
what opportunities are available 5.Be kind and assertive
there are any contraindications
in your hospital network. • Hospitals can be highly stressful
or if you are unsure of the correct
environments and bring out (at
management. Hopefully you have 3.Maintain a good work- times) the worst in individuals. Be
received the “Intern Cheat Sheet” life balance mindful of your own interactions
from your predecessors. If not, • You need to determine what your with others and understand the
make sure to ask around! priorities are this year. As the cliché impact they may have.
• Prior to each term, check your goes, it is a marathon not a sprint • If you are calling a specialty
roster to ensure you are aware and this can be one of your most after hours for advice, make
of your schedule and familiarise enjoyable years as a doctor. Do not sure you have all details at hand,
yourself with the orientation become consumed by your work. especially the medication chart.
material as this will make your The wonderful thing about working
This will make your life a lot
first week as smooth as possible. in the hospital system, is there will
easier and prevent (as much as
It’s always a good idea to get a always be someone to hand over
possible) any irritation from the
handover from your predecessor! to. Ensure you are familiar with who
individual you are waking at 2am!
• Arrive at least 15 minutes before this is on each term, so that you do
each shift to get to know your not do unnecessary overtime. 6.Seek help early
patients. It will make your day • You have limited time outside of • On ward rounds, make sure to
run a lot smoother and ensure work, so use it wisely. Whether clarify any queries you have.
you identify any issues that you’ll that includes maintaining your Often consultants have other
need to flag with the consultant sporting commitments, learning a commitments and it will make the
on the morning ward round, and new language or simply hanging day much more straightforward if
most importantly, help you get out with your family and friends! you raise issues whilst reviewing
out on time! 4.Look after yourself a patient.
• As an intern, you are not
2.Pursue your passions • Stay well hydrated. If you are
working at Fiona Stanley, there expected to have all the answers
• You have dedicated many years
is usually room on the WOWs at hand and it is expected that
of study to get to this year. Make
for your water bottle. Otherwise you will have lots of questions.
sure you enjoy it by allocating
have a small bag that you take on Don’t be afraid to ask them!
your spare time to areas you have
wanted to pursue but did not rounds. Medical rounds can go This is your apprenticeship, so use
have time as a student. all morning, if not all day. it to your advantage and seek help
• Always take a break to eat and from those more experienced than
• If you are interested in advocacy
relax. I can promise you now, the you as much as possible. There are
work and enjoy being a part of a
jobs will never stop and you will no dumb questions, only those that
committee, consider joining your
be less productive if you decide go unasked!
JMO committee, the AMA (WA)
to push through.
6 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
Dr Gary Avital and Dr Naomi Avital with
their children Mendel and Chaya.
Strive for five
DR NAOMI AVITAL AND DR GARY AVITAL
Interns, Fiona Stanley Hospital
1. Work-life balance Internship is an ideal time to do this. general ward-based management
Much has been said about work-life Carefully consider any additional type and helps with day-to-day
balance and it is a complex, evolving work-related activities you do. common ward-based calls such as
area of thought in the medical doses for common electrolytes or
Naturally there will be a range
profession. After many years of managing a low urine output.
of professional development
study leading up to internship, now opportunities that arise. Think There are many of these around –
is a good time to take stock and carefully about how far you are either grab a hold of one of those
revaluate what you want your career stretching yourself and what the long- or make your own based on things
to look like. term benefits will be. Take time to that start coming up a lot – you can
Internship will provide you with the consolidate and reflect on your time save useful documents like this in
necessary clinical experiences to at work. Make sure you take time to the ‘Notes’ app so that you can have
help decide what you want to do spend with your family and do the the answers on hand quickly. The
in the future and it is important to things that are important to you. next is calculators such as Medcalc
come to each term with an open which will allow you to quickly
mind. 2. Be efficient calculate a wells score or a total
You can’t possibly know the equivalent morphine dose.
The best advice we were given was
answer to everything that you’ll be
not to make any important decisions Lastly, there is information on
confronted with this year, but having
about the future this year. As the specific sub-specialties – it can be
a well-chosen selection of useful
years go on, work will become useful to get handover from previous
apps, documents and reference
more demanding and you need to interns or ask your registrars what
texts can help save a lot of time
rejuvenate and re-energise for the the go-to guidelines/ apps/texts are
and stress. There are three types of
years ahead. for that specific specialty.
useful material. One set is the more
INTERNSHIP 101 – WHAT YOU NEED TO KNOW 7
Make sure you take 4. B
e present – quality 5. D
on’t set
not quantity unreasonable
time to spend with One of the best things about expectations
your family and do internship as compared to medical Don’t let any preconceived notions
school is that instead of feeling of what you should be doing in
the things that are guilt about not studying, now when your extra-curricular time cause
important to you. we are home, we are really ‘home’. any additional stress. Sometimes
Whilst there are inevitably long it’s okay to just take time off and
hours spent away from home and relax. For the parents out there,
3. Be kind the kids at times, we try to make the it’s important not feel guilty about
One of the personally rewarding time we do have count. In a similar occasionally skipping a school
aspects of internship is the vein, we try to plan ahead in terms function or extracurricular event if
collegiate relationships you develop of shopping and meals so that we you feel you need to.
with your fellow interns. Looking out have more time to spend together as
Finally, enjoy the year because it will
for your colleagues and knowing a family. For us, online shopping has
be over before you know it.
that they will support you at work been a huge help, as has cooking in
can be an immense source of batches.
professional satisfaction and reduce Outsourcing jobs around the house
stress and anxiety. can save a lot of time and give you a
Help each other out, look out psychological and emotional break
for each other and share your when work is really busy.
experiences – both the good
and bad.
Clinical Excellence Specialist Workforce Capacity
Office of the Chief Medical Officer
Medical Workforce Branch Program (SWCP) summary sheets
Email: medicalworkforce@health.wa.gov.au
The SWCP summary sheets have been developed to provide
an overview of the WA medical workforce based on the SWCP
2015.
Each SWCP summary sheet provides the following information:
The projected workforce 2015 to 2025
Projected consultant supply and demand 2015 to 2025
Workforce distribution 2015
Trainees and new fellows
Consultant age distribution 2015
Workforce planning and risk rating 2015 to 2025
The SWCP summary sheets should be read in conjunction with
the User information: Specialist Workforce Capacity Program summary sheets.
https://ww2.health.wa.gov.au/Articles/S_T/Specialist-Workforce-Capacity-Program-SWCP/Specialist-Work-
force-Capacity-Program-SWCP-2015-summary-sheets
8 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
The power
of one voice
DR KATHARINE NOONAN
Head of Strategy, END RHD, Telethon Kids Institute
RMO, Perth Children’s Hospital
AMA (WA) Councillor
F
irst, let me be the hundredth Whether it’s chasing regular Step back from time to time and
or so person to congratulate medications or a recent discharge realise how amazing your job is.
you on joining the medical for an inpatient, treating the endless You get to help people at the times
profession. It’s going to be a wild supply of patients scourged by they are most in need. Medicine is
and bumpy ride. drugs and alcohol during the ED challenging, stimulating, complex,
“disco shift”, or observing the and most of all, very rewarding.
The good news is that if you don’t
injustice of a mental health patient
want to think too hard from now Take responsibility for your actions.
waiting days for an acute bed –
on, you don’t need to. That’s not to If you haven’t ordered a test or
doctors witness the issues firsthand.
say that working as a doctor isn’t performed an examination –
mentally and physically tough, or Sometimes it all feels overwhelming admit it.
that any future exams won’t be and insurmountable, and frustration
Take the time to establish rapport
gruelling – sorry! can morph into apathy. I would
and trust with patients, their families
strongly recommend that you
The hours can be long, your sleep and your colleagues throughout the
harness that frustration, coupled
patterns get out of whack and the hospital system.
with the sense that things can
realities of illness, life and death
be done better and your fresh If you’re sick, take sick leave.
weigh heavy on the shoulders of
perspective on the long-running
anyone with the slightest empathy. If you come to work, you will be
issues, and channel it into a pursuit
expected to perform at 100 per
At the same time, the option is there outside of your day job.
cent. If you can’t, you will only cause
to keep your head down, enjoy
One way to do this of course, is to yourself and your patients grief and
the paycheck, and get through
become a member of the Australian you may also infect your colleagues.
internship and training as unscathed
Medical Association (WA).
as possible. Questioning the way If you encounter problems in the
things are done is a very optional As well as representing the interests workplace, don’t let them fester.
extra. and welfare of doctors, the AMA
Talk to a trusted senior colleague,
(WA) advocates on behalf of the
However, I guarantee you that as your peers, hospital administration
community and our patients,
interns and RMOs, at the frontline or the AMA (WA). Our Doctors in
aiming to improve the health of
of providing care (read: bottom of Training Committee representatives
all Western Australians. Whether
the food chain), you will become and staff are there to assist
you’re contributing towards
acutely aware of the inefficiencies members with workplace issues.
policy submissions to Parliament,
and gaps in the system. It also
engaging in a symposium on end-
becomes apparent to doctors that a
of-life choices, or completing a
large proportion of health problems
survey on weight management in
could be avoided with sustained
the community, there are endless
and coordinated efforts to improve
opportunities to have your voice
prevention, health promotion and
heard and contribute to advocacy
provision of primary care.
on behalf of the medical profession.It’s here...an unsurpassed
Medical Products Supply Solution
If you are in the market for a Stethoscope, Diagnostic Set,
Sphygmomanometer, Doctors Bag, Medical Publications or
anything else medical and if a professional, reliable and genuine
sales experience is important to you, then look no further than
AMA Medical Products for your next purchase.
As a WA Medical Intern you have access to Medical Products
from all the leading brands with the latest technology all at the
lowest prices! Let us show you that great value and amazing
service are not a thing of the past. Find out why AMA Medical
Products is your complete medical solutions provider.
AMA Medical Products
14 Stirling Highway
Nedlands WA 6009
Ph: (08) 9273 3022
Fax: (08) 9273 3017 amamedicalproducts @amamedicalprods
Email: sales@amawa.com.au2019 HHC Survey Results
2019 Hospital Health Check
Over 750 doctors in training from across WA
hospitals have answered our annual survey into
education, wellbeing, morale and industrial issues.
For feedback, comments & questions on the 2019
By the AMA (WA) Doctors in Training Committee HHC Report Card contact us: dit@amawa.com.au
2019
Grading: A>80, B70-79, C60-69, D50-59, F39
35-39
5%
7%
49% 25-29
demographics Registrar discipline:
age 25%
7%
15%
Physician
Anaesthetics
Emergency Medicine
30-34 29%
intern
advanced trainee
157 women 61% sex 37% men
3%
9%
14%
ICU
OBGYN
Paediatrics
and fellow 96 1% Pathology
2% other
7%
level
Psychiatry
basic trainee 93 1% Radiology
service registrar 96 16% Surgery
2% Other
RMO 335concerned for your job if reporting inappropriate
feel unsafe returning to work workplace behaviour
Registrars who work on call overnight, when returning to work the next morning.
sometimes often always
!
36% !
15%
!
8%
61%
have experienced have experienced
bullying sexual
harassment
30% 6%
believe advanced trainees and fellows concerned about
part time job security should be in
their specialty
94% 39%
agree
strongly agree
45%
burnout level Reported levels of burnout using Professional Quality of Life Scale
SJOG Midland 64% SJOG Midland 42%
SCGH 47% SCGH 71%
RPH 35% RPH 48%
SCGH 21% PCH 13% PCH 34%
RPH 26% KEMH 12% KEMH 23%
JHC 19% JHC 22% JHC 25%
FSH 26% FSH 25% FSH 49%
high burnout high burnout high burnout
intern rmo registrar
%
45
40 ProQOL burnout
35
30
25
analysis raw scores
20
15
10
5 Low 57
0
FSH JHC KEMH PCH RPH SCGH SJOG Midland12 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
Packing a Punch
Australia & New Zealand Junior Doctor of the Year Dr Jasmin Korbl is determined
to shine a light on the under-recognised issue of junior doctor welfare
Dr Korbl’s work in the areas of junior
medical officer welfare, community service
and teaching was acknowledged last year
when she was named 2018 CPMEC Australia
& New Zealand Junior Doctor of the Year.
E
arlier this year, the issue of “The ideas and structure for the “I have often needed reminders
dangerous workloads and program came from the junior that small interventions can make a
untenable rosters was once doctors who voiced the need for large-scale impact and can build a
again highlighted following a searing opportunities to talk about clinical platform for further change.”
blog by young Sydney surgeon and non-clinical issues that they
Dr Korbl says there are male and
Dr Yumiko Kadota. face at work, in a supported and
female doctors who have supported
facilitated environment.”
Dr Kadota was on call for 180 and mentored her but she is keen
continuous hours and worked up Dr Korbl says it is crucial that to point out the many women in
to 70 hours a week. She repeatedly doctors find time to look after the hospital who inspire her on a
raised concerns about her themselves and one another. daily basis.
untenable hours, which included
“Contemporary literature suggests “There is the medical education
being rostered on 24 days in a row
that a third of junior doctors are officer at Charlie’s who knows every
and over 100 hours of overtime in
suffering from burnout and over the single junior doctor by name and
a month.
last few years, we have witnessed provides a nurturing environment
Across the country, there are junior the tragic consequence of this for anyone to seek assistance; a
doctors experiencing, if not in equal with the suicides of some of our hard-working female cleaner in
measure as Dr Kadota, certainly colleagues who have suffered alone, the C-block who has been doing
shades of great strain and stress as in a silent crisis.” the same job for 30 years and still
a result of their demanding training takes so much pride in her work and
Dr Korbl’s work in the areas of
schedules. of course, the women behind the
junior medical officer welfare,
scenes who unwaveringly support
One Western Australian junior community service and teaching was
the men in medicine and enable
doctor, however, decided to do acknowledged last year when she
them to flourish.”
something about it. was named 2018 CPMEC Australia
& New Zealand Junior Doctor of Even as Dr Korbl works towards
Dr Jasmin Korbl, a resident medical
the Year. acceptance into a specialty, she
officer at Sir Charles Gairdner
plans to continue advocating for the
Hospital, developed a new program Humbled by the recognition,
wellbeing of junior doctors.
for clinical debriefing at SCGH Dr Korbl says she is eager to use the
as well as an escalation pathway award as a platform to bring to light “I am also adamant not to let my
to assist junior doctors in crisis. the important and under recognised chosen career define who I am.
Project Pow Wow has been running issue of junior doctor welfare. I am a mum and have many interests
successfully at the hospital and a outside of the hospital – it just so
“One of the biggest challenges
formal evaluation of the program’s happens that I am also a doctor.”
when we think about junior doctor
impact is underway.
welfare is that there are just so many
“To be honest the idea was not problems and the sheer volume in
mine, I was simply the curator,” itself can seem too daunting and
Dr Korbl says. discouraging for anyone to tackle.INTERNSHIP 101 – WHAT YOU NEED TO KNOW 13
Member benefits for DiTs
professional and industrial
services
M
embership of the Australian This approach leads not only Industrial
Medical Association to junior doctors not being paid Representation
(WA) gives you access correctly but also means that hours AMA (WA) Industrial Officers can
to a comprehensive range of of work are “hidden” and this can provide specialist advice and
professional and industrial services lead to a misrepresentation of assistance to junior doctors on a
including: what practitioners are working and range of issues including:
ultimately fatigue which impacts • Interpreting your legal
• Industrial advice and
on the wellbeing of individuals and employment entitlements;
representation
service delivery.
• Access to Doctors in Training • Disputes which arise during the
(DiT) Committee meetings course of your employment;
Agreement Negotiation
• Opportunity to contribute to the • Accessing your industrial
The AMA (WA)’s proud history
profession’s political and public entitlements such as leave;
of negotiating significant
health advocacy improvements to salary rates, • Assistance and support with
• Agreement negotiation allowances and employment disciplinary processes;
• Member-only communications conditions has benefited junior • Renewing your contracts of
• Social and networking events doctors over many years. You will employment.
• Commercial benefits. now be a beneficiary of the work of
our dedicated staff. Exclusive Member
Political Advocacy Events and Seminars
As a result of the 2016 Industrial Confirmed dates for these events in
The AMA (WA) advocates on Agreement negotiations, WA
behalf of doctors in training 2020 will be available on the AMA
interns were the first intern cohort (WA) website www.amawa.com.au
(interns, residents, registrars and in Australia to receive three-year
senior registrars) on a wide range appointments. As an intern, having • Intern Event
of public hospital issues. Our satisfactorily completed your • Medico-legal Seminars
priorities for 2020 include access internship and achieved general • Volunteering and Working Abroad
to leave, improvements in rostering, registration, you will progress • Intern/RMO Application
ensuring hospitals understand directly to resident medical officer, information evenings
their obligations for dads wanting resulting in greater job security • Clinical Seminars
to access parental leave and and guaranteed professional
portability of entitlements as • Leadership and Management
progression. Prior to 2016, interns
doctors move across the WA health Training
would have been required to apply
system as part of their training. • CPR Training.
for an RMO position.
The DiT Committee Hospital Health New events monthly. Keep an eye
In 2019, the AMA (WA) commenced
Check 2019 survey revealed a on your emails and the AMA (WA)
negotiations for replacement
number of ongoing workplace events page for notifications about
Agreements. Key issues for junior
concerns affecting junior doctors. additional topics and events.
doctors include the preservation of
The issues identified by the survey, entitlements such as leave when Member Only
coupled with the AMA (WA)’s doctors move between healthcare Communications
advocacy, has been a driving force providers as part of their training and AMA (WA) members receive:
in the hospitals implementing development as a doctor in training. • Medical Journal of Australia
change.
• Medicus
A key concern has been the ongoing • Australian Medicine
problems with excess working
• Industrial Updates
hours and non-payment of overtime.
• e-DiT (National e newsletter for
May junior doctors are consistently
doctors in training).
advised that they should not claim
overtime or that overtime worked
will not be approved.14 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
Key Entitlements
what you need to know
What are the ordinary What penalty rates apply How much sick leave am
hours of work under the under the Agreement? I entitled to?
Agreement? • Hours worked between 6pm and A full-time practitioner shall be
Under the WA Health System 12 midnight on any weekday shall entitled to 80 hours’ paid sick leave
– Medical Practitioners – AMA attract a penalty of 20 per cent. for each year of service. Leave
Industrial Agreement 2016, a full- • Hours worked between accrues pro rata on a weekly basis
time doctor in training’s ordinary 12 midnight and 8am on any and any unused leave carries over
hours of work are an average of 40 weekday shall attract a penalty into the next year.
hours per week. Rostered hours of 25 per cent. A practitioner, in their first year
worked shall not exceed 75 hours • Hours worked on Saturday shall of service, may take sick leave in
in seven consecutive days and not attract a penalty of 50 per cent. advance of the entitlement having
more than 140 hours in any 14-day • Hours worked between midnight accrued.
period. Saturday and 8am Monday shall
Sick leave in excess of two
Practitioners shall be rostered for a attract a penalty of 75 per cent.
consecutive days requires a medical
minimum period of three hours and • Hours worked between
certificate or reasonable evidence of
can be rostered for a maximum of 12 midnight at the
the illness or injury.
15 hours for a day shift. However, commencement of a public
practitioners starting work after holiday and 8am on the day after
What is a meal allowance
12 noon shall not be rostered for a public holiday shall attract a
and when does it apply?
more than 12 consecutive hours. penalty of 150 per cent, or if
A practitioner, who works more
agreed, a penalty of 50 per cent
Practitioners cannot be rostered to than 10 hours (exclusive of breaks)
with time off in lieu of the public
work split shifts. or is required to work overtime
holiday worked.
which means the practitioner takes
How is overtime paid? a meal away from the usual place
How do I calculate the
Hours worked in excess of 80 hours of residence, is entitled to a meal
applicable penalty rate?
in any two-week pay cycle shall be allowance of breakfast $10.80,
If a practitioner works hours which
paid at the rate of 150 per cent. lunch $13.30 and dinner $15.95 and
would entitle that practitioner to
supper $10.80*.
Hours worked in excess of payment of more than one of the
120 hours in any two-week pay monetary penalties payable (i.e.
What are the parental
cycle shall be paid at the rate of public holidays, overtime, on-call
leave provisions under
200 per cent. and call back, shift and weekend
the Agreement?
work), only the highest of any such
What rest break 52 weeks of unpaid parental leave
penalty shall be payable.
entitlements apply under which may include:
the Agreement? How much notice is the • 14 weeks’ paid leave for the
A practitioner shall be entitled to a hospital required to give primary care giver with at least
paid rest break of 30 minutes within for rosters? 12 months’ continuous service.
each rostered period of duty. If a Practitioners shall be given a • Eight weeks’ concurrent leave
roster period exceeds 10 hours, the minimum of 14 days’ notice (both parents allowed to be on
practitioner shall be entitled to a and where possible 21 days’ leave at the same time).
second paid rest break of 30 minutes. notice, of rosters prior to their A practitioner must provide 10 weeks’
commencement. Except in cases notice if seeking to take leave.
of emergency, or if the practitioner
agrees, rosters shall not be Unpaid parental leave and
amended during their currency. concurrent leave cannot be refusedINTERNSHIP 101 – WHAT YOU NEED TO KNOW 15
by your employer if you have met all Please note that when you are What are the notice
necessary notice and evidentiary paid for a call-back, you will be provisions under the
requirements. deducted the on-call allowance for Agreement?
the corresponding hours. • For contracts of 12 months or
What are the long service less – four weeks’ notice.
leave provisions under Payment for public
• For contracts of more than
the Agreement? holidays
12 months but equal to or less
A practitioner is entitled to Hours worked on a public holiday
than two years – six weeks’
13 weeks’ long service leave after shall attract a penalty of 150 per
notice.
10 years’ continuous service, cent, or, if the practitioner and
employer agree, a penalty of 50 per • For contracts of more than
with a further 13 weeks after each
cent and the practitioner shall be two years but equal to or less
completed seven years of service
entitled to a day in lieu for the day than three years – eight weeks’
thereafter.
worked. notice.
• For contracts of more than three
How much annual leave If a practitioner is rostered off duty
years – 12 weeks’ notice.
am I entitled to? on a public holiday, the practitioner
A full-time practitioner shall be shall be paid as if it was an ordinary
working day, or if the employer Are there any differences
entitled to a minimum of 160 hours’
agrees, be allowed to take a day off if I am employed by
annual leave for each year of
in lieu at a mutually agreed time. WACHS or seconded to
service. Leave accrues pro rata on
WACHS?
a weekly basis. A practitioner may
also accrue a maximum of 40 hours’
How much Professional Yes. We recommend that you
Development Leave contact the AMA (WA) to discuss
additional leave per year associated
(PDL) am I entitled to? this further.
with performance of on-call or
A doctor in training is entitled to
working ordinary hours on Sundays/
three weeks of PDL: What if I am employed
public holidays.
• one week is accruing by St John of God?
What are the on-call • two weeks are non-accruing Generally employment conditions
entitlements under the for St John of God interns are similar
Accruing leave carries over each
Agreement? to WA Health. Please be aware that
year if not taken.
you will have a two year contract
Practitioners rostered on call
Non-accruing leave is lost if not instead of three.
shall be paid an hourly allowance
taken. However if you apply for the
of $11.68* (from 1/10/2018). No Please refer to the St John of God
leave and it is not granted by your
practitioner shall be required to be Health Care – AMA WA – Medical
employer, it converts to accruing
on call more frequently than one day Practitioners Enterprise Agreement
leave. For this reason, it is important
in three. 2016 for further information.
that you apply for your leave.
What are the call-back
How long is my contract
entitlements under the
of employment?
Agreement?
In WA, interns are offered a three-
Practitioners who are recalled to
year contract extending into their
work shall be paid a minimum of
RMO terms, subject to successful *Current rates are subject to ongoing
three hours as follows: negotiations for a replacement agreement.
completion of their internship.
• For any work between 6am and
midnight at the rate of 150 per
cent.
• For work on Sunday between
6am and midnight at the rate of The responses detailed above are provided as a general guide only
175 per cent. and must NOT be taken to be a definitive statement of the Agreement.
• For any work between midnight Whilst every attempt has been made to ensure the contents of this
and 6am at the rate of 200 per summary are accurate, AMA (WA) and its Officers expressly disclaim
cent. liability for any act or omissions done in reliance on the information
• If the call-back period exceeds provided or for any consequences whether direct or indirect of any such
three hours, the practitioner shall act or omission. Please contact Amanda Kaczmarek or Hayley Elkin on
be paid at the rate of 200 per (08) 9273 3000 to discuss your specific queries.
cent for each additional hour.16 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
Doctors in Training
Salary Guide
Public
Base and PDA
Overtime Shift Loading Holidays
(1 Oct 18)
Worked
Hrs >80
Salary PDA PDA and Hrs Hrs
Pay per Hourly per fort- 120 in
Level annum rate annum nightly fortnight fortnight 20% 25% 50% 75% 250%
Intern 1 $78,479 $37.60 $5,742 $220.14 $56.41 $75.22 $7.52 $9.40 $18.80 $28.21 $94.02
RMOYr1 2 $86,328 $41.37 $5,742 $220.14 $62.06 $82.74 $8.27 $10.34 $20.69 $31.03 $103.43
RMOYr2 3 $94,960 $45.50 $5,742 $220.14 $68.26 $91.02 $9.10 $11.38 $22.75 $34.13 $113.77
RMOYr3 4 $104,456 $50.05 $5,742 $220.14 $75.09 $100.12 $10.01 $12.51 $25.02 $37.54 $125.15
Registrar Yr1 5 $109,678 $52.56 $10,048 $385.23 $78.84 $105.12 $10.51 $13.14 $26.28 $39.42 $131.40
Registrar Yr2 6 $115,163 $55.19 $10,048 $385.23 $82.78 $110.38 $11.03 $13.80 $27.59 $41.39 $137.98
Registrar Yr3 7 $123,800 $59.32 $10,048 $385.23 $88.99 $118.66 $11.86 $14.83 $29.66 $44.49 $148.32
Registrar Yr4 8 $129,990 $62.29 $10,048 $385.23 $93.44 $124.59 $12.45 $15.57 $31.14 $46.72 $155.74
Registrar Yr5 9 $136,489 $65.41 $10,048 $385.23 $98.11 $130.82 $13.08 $16.35 $32.70 $49.05 $163.53
Registrar Yr6 10 $143,314 $68.68 $10,048 $385.23 $103.02 $137.36 $13.73 $17.17 $34.34 $51.51 $171.70
Registrar Yr7 11 $150,479 $72.11 $10,048 $385.23 $108.17 $144.23 $14.42 $18.03 $36.05 $54.08 $180.29
Senior 12 $161,766 $77.52 $14,354 $550.31 $116.28 $155.05 $15.50 $19.38 $38.76 $58.14 $193.81
Registrar Yr1
Senior 13 $169,854 $81.39 $14,354 $550.31 $122.09 $162.80 $16.28 $20.35 $40.69 $61.04 $203.50
Registrar Yr2
Composite Salary
(Base + PDA) 1 Oct 18 Queries regarding
Intern $84,221
your payslip, including
underpayments, should be
Resident Medical Officer $92,070–$110,198 directed to your employer in the
Registrar $119,726–$160,527 first instance.
Senior Registrar $176,120–$184,208 The Industrial Relations Team at
the AMA (WA) is able to provide
* PDA – Professional Development Allowance support and advocacy on your
All figures used in the above table are based on the rates prescribed in the 2016 AMA Agreement. behalf if the matter remains
A replacement Agreement is currently being negotiated. All figures used in the above example
have been rounded and should be used as a guide only. unresolved.
Please contact either
Amanda Kaczmarek or
Hayley Elkin on 9273 3000.INTERNSHIP 101 – WHAT YOU NEED TO KNOW 17
Salary packaging
explained
Salary packaging can be What About Fringe
a great way for doctors to Benefits Tax?
get ahead financially but Fringe Benefits Tax is specifically
many don’t get around to designed to tax salary packaging
arrangements.
organising it, or simply
don’t realise how much If you’re considering salary
they are missing out on. packaging, make sure you
seek advice to make sure your
Salary packaging is a process where arrangement is exempt from Fringe
you restructure the way you take Benefits Tax or the resulting tax
your salary in order to save tax. bill will most certainly wipe out any
This process can effectively convert potential savings.
your current cash salary into a
‘package’ which includes both cash
salary and payment of other benefits.
Salary packaging doesn’t change
the amount you’re entitled to, just the
way in which you get paid.
HERE’S AN EXAMPLE:
The first step involves giving up a An employee at a major hospital, earning approximately $70,000 per
portion of your regular cash wage year who chooses to sacrifice $10,000 out of their annual salary will get
each pay period. Don’t panic! a total yearly tax saving of $3,450! (Based on the individual income tax
It’s a sacrifice that reaps rewards. rates 2018/2019)
By reducing your cash wage each
pay cycle, you are entitled to a Details No Salary
reduction in the amount of income Package Package
tax you pay on your wage.
Salary 70,000 70,000
Next, you convert the amount of
Less: Amount Sacrificed – 10,000
cash salary that you have sacrificed
into other benefits such as rent Taxable Income 70,000 60,000
payments, car lease, utility bills –
this makes up the difference for the Tax Payable 15,697 12,247
amount of cash salary you sacrificed Net wages paid by hospital 54,303 47,753
out of your regular wage.
Add: Reimbursement of amount sacrificed – 10,000
The result is that you still get the
same total amount of salary, but pay Total $54,303 $57,753
less tax – leaving more money in
your back pocket!
In Western Australia, there are two packaging providers who administer
the arrangement on behalf of your employer and yourself. Specific
information about how to sign up and what can be packaged can be
obtained from these providers.
Need more information?
HCN 6444 5000; hcn@health.wa.gov.au
Paywise 1300 132 532; info@paywise.com.au; www.paywise.com.au
Smart Salary 1300 476 278; www.smartsalary.com.au18 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
Understanding your payslip
As an intern, deciphering your payslip may seem like the least of your worries.
However, the AMA (WA) recommends that you check your payslip each fortnight
to ensure that you are being paid correctly.
NORTH METRO AREA HEALTH SERVICE (GUIDE ONLY)
Employee Name Emp No: CGNM123456
Smith, Joe Payroll Date Address
Send to
11/01/2019 4 STIRLING HIGHWAY
1
SMITH, JOE
NEDLANDS WA 6009 The intern base salary
14 Stirling Highway
NEDLANDS WA 6009
is $78,479 as at
ABN No: 123456789101
1 October 2019.
Are your base hours correct? Check against your Period No: 536
roster. The AMA (WA) advises that you keep copies HR Contact:
of your rosters in case of any pay dispute. HSS PAYROLL SERVICES Full-Time Salary
Telephone: 1300 553 927 $78,479.00
1. TAXED EARNINGS This Pay Year to Date 4. TAX This Pay Year to Date
Hours Rate Description Amount Description Amount
72 37.60 BASE HOURS 2,707.20 TAXATION 870.00
8 37.60 P/HOL OBSERV 300.80
Have you been paid appropriately
4 18.80 O/T 1.5 75.20 for public holidays?
10 11.68 O/CALL DIT 116.80
4 7.52 PENALTIES AT 20% 30.08
Have your shift 8 18.80 PENALTIES AT 50% 150.40
penalties been
8 28.21 PENALTIES AT 75% 225.68
calculated correctly?
2 9.40 PENALTIES AT 25% 18.80
Professional Development Allowance for interns is
0 0 PROF DEV ALL 220.14
Are you salary $220.14 per fortnight as at 1 October 2019.
0 0 SMART SALARY –384.48
sacrificing?
Total 3,460.62 3,460.62 Total 870.00 870.00
2. UNTAXED EARNINGS This Pay Year to Date 5. DEDUCTIONS This Pay Year to Date
Description Amount Description Amount
TOTAL 0.00 TOTAL 0.00
*Untaxed Earnings Total 0.00 0.00
3. TOTAL TAXABLE EARNINGS This Pay Year to Date 6. SUPERANNUATION This Pay Year to Date
3,460.62 3,460.62 Super Contributions Amount
NEW GESB SUPER WS6 328.76 328.76
7. NET PAY 2,590.62 2,590.62
GENERAL INFORMATION: LEAVE Balance Calculated Leave Type
DISBURSEMENTS (BANKED) ANNUAL LEAVE 0.15 W
Bank Account Amount LONG SERVICE LEAVE 0.00 W
CBA Smith, Joe 2,590.62 MED PRACT AL ADDIT LVE 3.00 H
PROF DEV LV ACCRUING 0.15 H
Are your leave balances
PROF DEV LV NON-ACCRUE 80.00 H
accruing each fortnight?
SICK LEAVE – FULL PAY 3.06 H
Are any deductions in leave correct?
TOIL PUBLIC HOLIDAY 0.00 H
Leave Balanced displayed are subject to audit
COMMENTS
* Tax on earnings is dependant on a number of variables.
THE LEGEND BELOW EXPLAINS THE MOST COMMONLY USED CODES YOU MAY FIND ON YOUR PAYSLIP.
BASE HOURS PENS 25% O/T 2.0
Base hours – as a full-time employee this ought to be Penalty of 25% for hours worked 12 midnight and 8am Overtime for hours worked in excess of 120 per
80 hours per fortnight (including any observed/worked PENS 50% fortnight paid at 200%
public holidays) Penalty of 50% for hours worked on a Saturday ON CALL ALLCE – DIT
PROF DEV ALL PENS 75% On call allowance
Professional development allowance Penalty of 75% for hours worked between midnight P/HOL OBSERV
PENS 20% Saturday and 8am Monday Public holiday (observed) when rostered off duty on
Penalty of 20% for working between 6pm and O/T 1.5 public holiday, paid as if the day was an ordinary
12 midnight on any weekday Overtime for hours worked in excess of 80 hours per working day
fornight paid at 150%INTERNSHIP 101 – WHAT YOU NEED TO KNOW 19
NORTH METRO AREA HEALTH SERVICE
Employee Name ABN No: 123456789101
Smith, Joe Payroll Date Period
10/01/2019 522
Date From Date To Description Units Rate Amount
PRIOR PERIOD TAXED EARNINGS
TOTAL 0.00
CURRENT PERIOD TAXED EARNINGS Check that your
28/12/2018 BASE HOURS hours for each shift 8 37.60 300.80
are correct.
28/12/2018 PENALTIES AT 20% 4 7.52 30.08
29/12/2018 BASE HOURS 8 37.60 300.80
29/12/2018 PENALTIES AT 50% 8 18.80 150.40
30/12/2018 BASE HOURS 8 37.60 300.80
30/12/2018 PENALTIES AT 75% 8 28.21 225.68
01/01/2019 P/HOL OBSERV 8 37.60 300.80
02/01/2019 BASE HOURS 8 37.60 300.80
02/01/2019 ON CALL ALLCE-DIT 10 11.68 116.80
04/01/2019 BASE HOURS 10 37.60 376.00
07/01/2019 BASE HOURS 10 37.60 376.00
08/01/2019 BASE HOURS 10 37.60 376.00
09/01/2019 BASE HOURS 10 37.60 376.00
09/01/2019 PENALTIES AT 25% 2 9.40 18.80
Did you receive all
10/01/2019 OVERTIME @1.5 overtime owing to you? 4 18.80 75.20
28/12/2018 10/01/2019 PROFESSIONAL DEVT ALLOW $220.14
28/12/2018 10/01/2019 SMART SALARY SP FIXED -$384.48
TOTAL $3,460.62
TOTAL TAXABLE EARNINGS (SECTION 1) $3,460.62
PRIOR PERIOD UNTAXED EARNINGS
TOTAL 0.00
CURRENT PERIOD UNTAXED EARNINGS
TOTAL 0.00
TOTAL UNTAXED EARNINGS (SECTION 2) 0.00
As an AMA (WA) member service, our Industrial Team can provide advice and advocacy relating to identified
salary and entitlement errors (including underpayment and overpayment).
If you are experiencing problems in rectifying pay errors, you can have the issues dealt with by following
these steps:
• Having established that there is an error, approach your hospital rostering team (Medical Administration/
Workforce) to verify the error and seek their assistance in correcting the error. In most cases, the error
can be fixed by updating the roster information.
• After having verified the error with the hospital rostering team, ensure they follow up with HSS. Your
employer is responsible for ensuring you receive your correct pay. Hospital Health Service (HSS) is the
centralised payroll service for the Department of Health.
• Keep records of all contacts made or attempted with your employer.
If you are not able to make any progress after having followed this process,
please contact the AMA (WA) Industrial Team on 9273 3000 or email mail@amawa.com.au20 INTERNSHIP 101 – WHAT YOU NEED TO KNOW
Prescribing 101
N
ot much changes between
your last day as a medical
student and your first day as
an intern – apart from the title! There
is no profound change in knowledge
base or skill set.
Your most important accessory,
however, is your pen. Black or blue
is best. Avoid other colours unless
you want to battle it out with a
pharmacist.
• The back sheet – LMWH other drugs in that class affect
Now you prescribe because you recommendations for dosing, the patient?
have to, so here are some quick tips Warfarin recommendations for • Admission – Why have they
to help get you scribbling safely. dosing AND reversal. been admitted? If they have
been admitted with syncope
The Medication Chart A Legal Order from postural hypotension then
• Front page – single dose For a medication to be given safely withholding their antihypertensive
medications (e.g. resus drugs) in a hospital it must have a legal may be necessary.
• Front page – telephone orders. order – if done correctly this will • Bloods – Do they have any
Utilise this on your ward cover also save you precious time. renal or liver dysfunction? Is it
shift when you can’t get to a A legal order consists of: iatrogenic? E.g. Flucloxacillin
patient straight away. Don’t causing liver dysfunction and
PATIENT – Check the label (and
forget to ask about allergies worsening renal function due
if you start a new chart, place a
before prescribing. to Vancomycin. So you need to
sticker on it).
• Inside of medication chart adjust the dose due to impaired
ROUTE – IV/PO/inh. This will renal function.
– Variable dose medications
depend on whether the drug is
(most commonly gentamicin) • Check Obs – This may prompt
bioavailable for the given route.
• The patient’s regular medications you to withhold or commence
For example, naloxone is not new medication.
• Back page – PRN medications. bioavailable via oral route. Some
Do your colleagues a favour and • DVT – Do they need prophylaxis
drugs come in multiple oral
put some pain relief, anti–emetics or do they need anti–coagulants
formulations i.e. Oxycodone TABS
and aperients for all your patients withheld? Most surgeons have
vs CAPS (S8 prescriptions need to
on admission. When prescribing their own preferred anti–coagulant
be very specific!). regime – ask the registrar.
PRN medications, you should
DRUG – Use generic names • Drug Boffins – When stuck or
also include an indication in the
(it helps everyone out). unsure, ask the pharmacist. They
space provided.
DOSE – With correct unit of are very approachable and know
The Anticoagulation measure. If you use (ii) then you more about medications than the
Chart must write the strength of the tablet doctors (unless pharmacy was
• DVT prophylaxis should next to the name. your undergrad – if so everyone
be considered in every TIME/FREQUENCY – Date with will ask you instead).
hospitalised patient. 24 hour times. You must write the • Extra Tests – Some drugs will
• Common reasons NOT to give times in the boxes provided. require that the patient have a
prophylaxis include; YOUR SIGNATURE AND PRINTED drug level or blood test following
– Bleeding SURNAME – The prescriber must administration. E.g. gentamicin
be identifiable for an order to and warfarin. Don’t forget to
– Anticoagulation for
be valid. submit the path forms in advance.
another cause
IMPORTANT TIP – All prescriptions • Oxygen charts are here to
• The front of chart – single
should be written in a legible stay and need to be renewed
dose drugs, prophylaxis
manner. regularly. If your patient has
orders and therapeutic
COPD, do NOT give unrestricted
anticoagulation orders.
• The middle sheets – heparin
Prescribing Checklist oxygen and aim for sats 88–92.
infusion including dosing • Allergies – What are they?
strategies for VTE and ACS. Could it be a side effect? WillYou can also read
