Does working less hours in early-career impact development of clinical skills?

GPs are divided over whether young doctors can get enough expertise doing part-time hours, a Healthed survey has found.

Great divide or demographic dissonance?

While GPs were split 48:52, certain influences were clear.

Unsurprisingly, answers varied by hours worked. Sixty-three per cent of respondents practising fewer than 12 hours per week agreed part-time junior doctors will acquire adequate expertise, compared to just 35% of those working more than 40 hours per week.

Many respondents noted it will simply take longer to accumulate experience, while some said it comes down to each trainee. “Depends on the motivation and interest that the junior doctor has in patient care,” wrote one.

“They can only do so if they ensure that they make the most of their time when they are working to learn,” according to another.

One respondent pointed to quality versus quantity of experience: “Depends on their exposure to various patient cases rather than time,” they wrote.

“Depends on mentoring and teaching approach,” agreed another.

Others argued part-time work was detrimental to professional development. “General practice is patient contact. Part-time often gives no continuity,” one respondent said. Another said part-time trainees were “Missing opportunities in learning and exposure.”

Age old problem?

The tendency to look favourably on part-time work for junior doctors declined with increasing respondent age.

This trend mirrors recent survey findings from Deloitte Access Economics, which found Gen Zs and millennials often look for flexibility in their workplaces. “The pandemic prompted many to re-evaluate the role work plays in their lives and to seek more balance,” they wrote.

One Healthed survey respondent put it this way: “A life outside medicine is good for the doctor and the patient, makes the doctor stronger and with more to offer the patients.”

“Part-time work can mean a happier doctor and a doctor who is more reflective,” wrote another.

There was also a trend down gender lines, with 57% of female GPs and only 38% of male GPs saying part-time junior doctors could gain adequate experience.

This may be because Australian women are much more likely to work part-time than men, often because they shoulder the bulk of caring responsibilities.

“I’ve worked part-time since the birth of my kids (which gave added experience in itself),” one respondent wrote. “It is much more sustainable for my mental health.”

What your colleagues are saying:

“It will take longer. I recall being on call from Friday am until Monday evening one weekend in three back in the day. Awful, but I learned a lot.”

“Full time exposure is necessary for diagnostic diversity exposure.”

“Part time work really should be for older doctors who must ensure their own health. Younger doctors generally have to develop stamina for the work required and starting off part time does not do this.”

“You will unfortunately never get the breadth and length of general practice – it’s time spent in practice that makes the experience and expertise.”

“Part time is fine given the flow of a busy GP.”

“It will be harder to gain appropriate expertise and more effort will need to be made to stay up to date and follow up patients; but definitely still possible.”

“Obviously takes time. A healthy life/work balance will make the person a better GP and have better mental health in the long term.”

“I firmly believe you are best to work full time and hard for at least 5 years post internship to consolidate your knowledge and gain experience.”

“Skill comes with practice. Less practice, less skill. Tiger Woods would not have been a great golfer if he had the same attitude.”

“As long as they make up the same total number of hours as a full-time registrar. Also depends on patient load: a full-time GP with empty books will obviously gain less experience than a GP registrar with full books.”