title: The work environment of junior doctors: their perspectives and coping strategies.
abstract: OBJECTIVE
  This study explores the associations between psychological distress in junior doctors and their work environment and how they cope with work stressors.
  
  
  METHODS
  A cross-sectional survey designed by Health Education and Training Institute was delivered in 2014 to over 1900 junior doctors across 15 hospital networks through Australian Capital Territory and New South Wales. Psychological distress was evaluated using the Kessler Psychological Distress Scale-10 (K10). Numerous variables were assessed for associations with psychological distress to identify the strongest relationships and the coping strategies used. Potential associations between work demands, coping strategies and psychological distress were explored.
  
  
  RESULTS
  540 responses were analysed. 414 (81%) thought their workload was reasonable, 376 (75%) were enjoying their current job and 446 (82.6%) were content with their work life. However, 85 (15.7%) reported that they would not study medicine if given their time again, and 146 (27%) reported workplace bullying. The mean K10 score was 17.2 (σ=6.3) and the prevalence of elevated psychological distress was between 63% and 80% higher than the general community. Variables most strongly associated with distress were: being discontented with workload, lack of enjoyment from current job, taking time off work and having experienced workplace bullying. There was a preference to use social activities as a method of coping but at higher levels of psychological distress there is a greater proportion who took time off work.
  
  
  CONCLUSIONS
  Psychologically distressed junior doctors need recognition, support and treatment. Future interventions should focus on improving work environment, job satisfaction, provision of supports, use of healthy coping strategies and improving work-related relationships. This could potentially reduce levels of psychological distress in junior doctors, optimise delivery of healthcare to patients and maximise workforce potential.
authors.affiliation: Medical School, Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: Tzong-Yang
authors.initials: TY
authors.lastname: Pan
authors.affiliation: St George and Sutherland Clinical School, University of New South Wales, Sydney, Australian Capital Territory, Australia.|Department of Surgery, The Sutherland Hospital, Sydney, New South Wales, Australia.
authors.forename: Howard S
authors.initials: HS
authors.lastname: Fan
authors.affiliation: Medical School, Australian National University, Canberra, Australian Capital Territory, Australia.
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Owen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D011569:Psychiatric Status Rating Scales; D013315:Stress, Psychological / Q000453:epidemiology*; D016526:Workload / Q000523:psychology*; D017132:Workplace / Q000523:psychology*
keywords: Junior doctors; coping strategies; psychological distress; work environment