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13 Feb 2018


It’s the start of a new clinical year, and for newly graduated doctors starting internship, the beginning of their medical career. It’s a nerve-wracking and exciting time, and prompts reflection on past experiences and what was learnt. Lots of excellent advice has been shared, notably on twitter under hashtags like #tipfornewdocs and #tipsfornewinterns. However, something that is not taught or even well acknowledged as an important part of the doctor in training’s (DIT) repertoire of skills is the important role as an advocate that doctors can perform.

Advocacy takes many forms, and scales from an individual patient advocate within the system and within the hospital to public health advocacy on important issues affecting the community. For our patients, DITs regularly perform whatever kind of odd job that doesn’t fall within the capacity of anyone else in the healthcare team, or can be called upon to advocate within the hospital, within the healthcare system or within a patient’s family or social dynamic. The impact of this on patient care in hospitals, as well as in community roles, is significant. It often gets the patient the right treatment or the right access at that right time. The gratitude of patients when a DIT goes the extra mile is one of those things that keeps morale up when the tough days and tough weeks add up. Being grateful for these opportunities and the satisfaction brought by solving these problems is an important perspective to maintain.

In the current climate, where overtime, overwork, hours and health and wellbeing of doctors in training is frequent topic of conversation, DITs often find themselves advocating for our colleagues and juniors. To know that our colleagues and our seniors have our backs, and will support us, is what makes it possible to do the hard and difficult things when they arise. It’s an empowering experience to have someone show up and advocate for you, and it’s been the lifeblood of delivering health care for a long time. Isolated, fearful people have poor mental health, and perform at far less than their best. It’s a significant part of the challenge of our expanding medical training and non-specialist workforce, and an under-appreciated burden on senior staff in the public hospital system most notably.

I’d encourage anyone not currently doing so to get involved with something bigger than themselves as well. There’s a great number of opportunities to become involved in professional organisations, advocacy organisations and other volunteer organisations doing good work for the profession and for specific communities. Being involved expands your perspective, your understanding of what your colleagues actually do, and invites you to share the vision of our healthcare leaders about what health care delivery could look like.  Advocacy skills and teaching are well within the grasp of any DIT with an issue they feel passionately about. There’s a lot of evidence out there demonstrating the value of medical professionals in administrative roles, and there’s a corollary with clinician involvement in policy making as well. The most powerful advocates are clinicians at the coalface – where injustice or inequality is seen, clinicians are obliged to take up that role.



Published: 13 Feb 2018