r/ausjdocs

There's so much conspiracy and mistrust for these specific medicines. Even pts with established CVD reluctant to take them. It's like anti vax level paranoia for some reason despite them being some of the most studied and effective medications we have. I get irrationally annoyed by it.

Also posted on /r/Psychiatry but thought I'd get an Australian opinion.

Some patients with BPD make conditional threats that they will commit suicide if you do not admit them (or extend their admission). I send a lot of these people home.

Some of them do try to commit suicide and end up on a medical or surgical ward. The direction I tend to give is that they should be stabilised and sent home rather than to the psych ward, especially if the act was because a previous admission wasn't extended. IMO this makes it abundantly clear admission is not benefiting them if they are continuing to present like this despite a recent stay, my feeling is there is probably some iatrogenic harm there as there would not have been an extinction burst at the point of discharge if there had never been an admission, and I certainly do not want to reinforce behaviour that high-lethality suicide attempts are tickets to previously-declined admissions.

However, what do we do if a patient attempts to leave while being medically stabilised, and demonstrates capacity to do this? They are aware they are being stabilised, that they are unwell, and that the risks of leaving include death.

I've seen two schools of thought from consultants.

One is that we should not allow people to commit suicide, and that having BPD impacts capacity. However, I would argue that many people are allowed to deny lifesaving treatment in ways which essentially amount to suicide, and that there are clearly disordered personality-driven processes contributing to these in some people, e.g. I am going to leave before being treated for my MI because I am annoyed that someone else was seen before me. We still allow them to leave.

I find myself aligning more with the second school of thought which is that leaving is a stupid decision, but it is their stupid decision and they are free to make it - thus this should be handled along the DAMA pathway, they should not be detained, and they should be allowed to leave with thorough safety netting and return instructions (and a signature on the DAMA paperwork). If we detain them, often I see that they are detained until stabilisation, are sent home, and then promptly end up in hospital again with another suicide attempt. Conversely when it becomes clear you will not detain them they tend to stop threatening to leave (or come back if they have already left).

What are your thoughts on this? Keen for some discussion.

An interesting look behind the scenes of hospital car parks.
The Northern Beaches Hospital car park. 1389 spots.
It’s on the market with an annual income of $3.55million. This would imply a price of $50million with a 7% cap rate.

Offered by both for rotational positions and was wondering if anyone can offer insight about the resident experience and career opportunities at either hospital.

Particularly interested in opportunities to get more exposure to radiology, ICU, or anaesthetics.

Are there any standout departments at either location? Any departments to be avoided?

Any lifestyle pros to either you won’t find talking to workforce?

I'm trying to get evidence of how many paediatric patients i saw in ED back in 2024 for a GP application. The hospital said they cannot provide this from their EDIS system. Had anyone else had any success with the IT department pulling this data from medical notes?

F doctor, 30s, returning to work as gen med registrar next year. Advice on where to get good pieces to build a work capsule from?

I’m currently having the best time ! Have such a fantastic group of registrars who mostly rotated through us as interns or students and now are completing GP training . But there are more applications for next year than I can handle alone and they are all such fantastic dr’s I would be devastated to disappoint them and how fantastic is it that they want to stay in the town and with us ! Is there anyone out there who could consider helping out ! Anyone who wants something new , someone who loves teaching . We could approach the uni for possibly a role with the medical students We could even do fly in fly out 3-4 days a week
from Adelaide . Please message/contact me if interested or to have a chat

Hey guys, I’m an active med student in aus originally from China. I wanted to get your thoughts on a pretty tragic story that’s been going viral in the Chinese medical community recently. It’s been weighing on my mind a lot, and honestly, the contrast in medical culture between back home and Australia is wild.

The story involves a 36-year-old associate chief physician and cancer researcher working at a top-tier hospital in China. He’d given his entire adult life to medicine, starting med school at 18 and going through 13 straight years of university—5 years undergrad, 4 years master's, and 4 years PhD. He was incredibly accomplished on paper, holding a doctorate and even receiving a special State Council allowance for his research.

However, his day-to-day reality was heartbreaking. Ever since his training days, he routinely paid out of his own pocket for impoverished patients who couldn't afford treatment, eventually accumulating nearly 400k RMB (about 85k AUD) in personal expenditure, with most patients never paying him back. And patients in China kept his persona mobile number and WeChat . Totally out of boundary. Bombarding messages and consultation to him . On top of that, because he strictly refused to overprescribe costly medications or order unnecessary tests to hit department financial targets, his colleagues isolated him. His department head frequently chewed him out and retaliated by dumping all the night shifts on him.

Things took a terrible turn when he was diagnosed with Stage III cancer. After two rounds of chemoradiotherapy, he suffered severe side effects, including awful mouth ulcers and respiratory tract damage. Despite this, he pushed through a massive 9-hour surgery for a complex patient transferred from Shanghai Ruijin Hospital while actively coughing and vomiting blood himself. In a recent live stream with a public figure named Da Bing, he confessed that he wasn't afraid of dying, but was terrified of dying in unbearable agony. What broke him the most was the sheer lack of empathy from some patients, who even told him, "You treat cancer and got cancer yourself, it just shows your medical skills are terrible."

Coming into the Australian system, reading this was a massive shock. Back home, this kind of fatal self-sacrifice is often romanticized, to an extend it led to severe moral injury and total burnout. I wanted to ask the JDOs and seniors here: how does Australia prevent junior doctors from falling into this kind of martyr complex? Between AHPRA fitness-to-practice rules, boundary enforcement, and hospital culture, how do you guys handle personal limits when systemic pressure piles up? Overloading shifts? Mean colleague .

Would love to hear your perspectives.

I’m currently working in a very busy and understaffed department.

One of my colleagues has taken stress leave this rotation and another has switched rotations. We are all exhausted and work at least 2-3 hours overtime daily plus weekends. We have made mistakes due to fatigue. Feedback from other doctors is that this department is notoriously bad and unsupported.

Personally, I feel stressed out all the time, my appetite is bad, I can’t sleep at night out of fear of going to work, I once called my parents crying after a particularly bad day at work.

To add to my stress my seniors have not signed off my assessment forms. I haven’t received any feedback that my performance was bad. So I’m not sure why the stalling.

I have now been asked to make a presentation for our monthly grand rounds. It’s making me feel even more stressed. I haven’t even been able to attend grand rounds because I’ve been so busy. No one gave a crap that I can’t go to teaching. Now I need to make a presentation which feels very unfair.

It’s all starting to be a little bit too much.

Currently having a pretty massive career dilemma and honestly have no idea what to do.
I’m a PGY2 and been offered a spot in a good BPT network. I genuinely like medicine. I’ve really enjoyed gen med (done regional) and a couple of medical subspecialties (metro) and I can absolutely see myself being happy as a physician (though am currently unsure exactly what I want to do). I like the intellectual side, complex patients, MDTs, teaching etc. So this isn’t a case of me hating medicine and wanting to escape.
BUT I’ve also spent a lot of this year exploring ophthalmology and I genuinely really like it. I’ve done an ophthal term, eye work in ED, research/education stuff, an overseas observership etc. I also have a lot of rural points and have started a masters. I applied for ophthal jobs this year and got an interview for one of the more competitive metro jobs but didn’t get it.
I then came to terms with my bpt role and have been getting rlly excited for the job and to move back to metro and doing study etc to prep.. (have been regional last 5 years and ready for the city). 
Now I’ve very randomly got an offer/opportunity for an ophthalmology job in a regional area next year which has thrown me. 
And this is where I’m losing my mind lol.
The job itself sounds pretty good. I’d get proper ophthalmology experience, there are supportive people there, there’s time for research etc. However, I rlly don’t want to stay regional for another year. It would also set me up for a regional training pathway, which could be an advantage if I wanted to pursue that route. The downside is that I don’t want to spend my whole training journey regional and getting the job doesn’t mean I’m guaranteed ophthalmology training anyway.
If I take it, I’d have to turn down my physician training offer and move away from my partner in metro (also a doc).
The annoying thing is I KNOW I want ophthalmology to some extent.
If I was offered an ophthalmology job at one of my ideal tertiary hospitals in the city, I think I would take it without much hesitation. And if my partner was working in the same regional area, I’d also be MUCH more tempted by this regional job.
But I don’t know if that means I genuinely want ophthalmology enough to take this opportunity, or whether I just really like the idea of ophthalmology when the circumstances are favourable. I do worry some of my motivations for ophthal are that it’s got great QOL as a consultant and procedural work which I enjoy and makes good $$ so maybe I’m just being greedy and want ophthal because it’s so scarce and pays well (but also is that bad??). I also worry abt the fact it’s a more independent specialty and I think I like to work in teams but who knows ..
On the other hand, if I take physician training now, I think I’ll be very happy. I already know I like medicine and I have a fairly clear training pathway. I’ll finish my RACP and be able to chose from a number of really interesting specialties (some which even have a procedural element) - there’s so much less uncertainty and as someone that enjoys a large number of different areas of medicine I’m almost guaranteed to be happy whatever specialty I pick. I think I’ll most likely be rlly happy in bpt but I’m scared I’ll spend the rest of my life wondering if I should have just given ophthalmology a proper shot. 
I can probably reapply for physician training (as not as competitive ) if I take the ophthal year, but obviously it would be harder than just taking the position I already have. This feels like my last golden ticket to ophthal and much harder to reapply in future. If it take the job I would probably enjoy and I could end up spending 2–3+ years trying to get onto training and at that point would definitely fall to the sunk cost mindset and keep trying just another year. If that doesn't work and I eventually go back to physicians, I'd be starting much later than I otherwise would and would be much harder to get a good network too as unsure what referees I would even use after a few years in eyes (and I won’t lie this would make me a little resentful). On the flip side hey maybe I get on PGY4 and go damn so glad I took that opportunity. 
Some people think I should take physicians because I genuinely like medicine and the risk of delaying everything for an uncertain ophthalmology pathway is huge (especially when I’m not sure I even want it more). 
Some others think I'm crazy for not taking the ophthalmology job because they think it's a rare opportunity and I can always go back to BPT.
And I genuinely don't know who is right.
The thing that has really fucked with my head is that when I recently got told “okay, you're taking the ophthalmology job”, my first reaction was actually feeling sad about giving up bpt and I feel I keep asking around and wanting people to tell me that taking bpt is ok.
But then when I imagine ophthalmology completely disappearing as an option, I also feel sad and think “fuck, what if I could have been an ophthalmologist?”
So yeah. Both feel like real careers I could be happy in. My gut is saying just do bpt but I also don’t know if that’s because I’m rlly burnt out from job apps and rejections that I don’t feel up to the ophthal grind atm. Equally I’m also feeling a little silly for running around telling everybody I’m ophthal keen all year and now just turning down a job? 
Please make my decision for me !?

Hi everyone,

I’ll be moving from QLD Health to a Victorian public hospital soon and wanted to get some advice from anyone who has made a similar interstate move.

Apart from accommodation and the physical move, what are the important things I should sort out or be aware of when changing from QLD Health to the Victorian public health system?

Things I’m particularly wondering about:
• Superannuation/QSuper – What happens to my existing QSuper when I leave QLD Health? Can I continue using it in Victoria, or do I need to join another fund and later consolidate/roll over my QSuper?

• Salary packaging – Do I need to close/finalise my current QLD salary packaging account and set up a completely new one in Victoria?

• Leave balances – Annual leave, personal leave and long service leave – does anything transfer interstate, or should I make sure certain balances are paid out/finalised before leaving?

• Payroll & tax – Anything that needs to be changed or organised when moving between state health services?
• Professional indemnity/insurance – Anything that needs updating when changing employer/state?

• Employee benefits/allowances – Any QLD Health benefits or allowances that stop when leaving, or Victorian benefits that I should specifically apply for when starting?

• Other If anyone has done QLD Health → Victoria, I’d really appreciate any tips or things you wish you had organised before leaving Queensland.

Thank you!