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Three years ago, I stepped into a dedicated medical wellbeing role with enthusiasm and a quiet sense of optimism. Like many doctors, I believed that if we provided the right supports and encouraged seeking help early, wellbeing would improve. Three years later, my thinking is far more grounded.
By the end of most days in our current healthcare environment, the question is no longer “how was work?” but “how tired are you?” I hear it in passing conversations, during meetings and in free-text survey responses. Doctors talk about enjoying their work, liking their teams and valuing their training, yet still feeling persistently stretched. While not always burnt out in a dramatic sense, it is more a sentiment of being worn down by the accumulation of small, ordinary pressures that rarely trigger a formal concern, yet steadily shape how sustainable the job feels.
This pattern has become impossible to ignore. It highlights that doctor wellbeing is not primarily about individual coping but rather, how work is designed. What I have learnt is that wellbeing does not fail because doctors do not care about it. It fails when it is treated as separate from how healthcare is organised and delivered.
Across Australia, doctors are reporting high levels of burnout, fatigue and moral distress. National data consistently show that doctors in training are particularly affected, with workload, long hours and limited control over work featuring prominently. It is estimated around one in three doctors experience high levels of psychological distress, with higher rates since the COVID-19 pandemic. These findings are echoed in the Medical Training Survey, where burnout, fatigue and workload continue to be reported as major concerns.
Despite growing awareness, many doctors remain understandably sceptical of wellbeing initiatives. Too often, wellbeing is positioned as something extra, another obligation amidst an already overstretched system. My experience has been that wellbeing work only gains traction when it is clearly connected to the realities of clinical work.
Moving from individual support to system insight
Early in the role, my focus was largely on individual-level interventions. Education sessions, wellbeing resources and reducing barriers to seeking support seemed like the logical place to start. These remain important, but are not sufficient.
Over time, it became clear that the strongest drivers of wellbeing sit upstream. A strong body of international literature shows that workload, job control, organisational culture and values alignment are far more predictive of burnout than individual resilience factors. Doctors do not burn out because they lack insight or coping skills. They struggle when rosters are unsafe, supervision is inadequate and service demands overwhelm training.
This premise was central to the direction of my work. Rather than asking how we help doctors cope better, I began asking what in the system is making coping necessary in the first place.
Listening is not passive, it is active work
One of the most impactful tools I have used has been structured listening. Workforce wellbeing surveys, focus groups, exit interviews and Schwartz Rounds all create structured ways for doctors to speak honestly about their experience.
The value of this approach is well described in the literature. Psychological safety and perceived organisational support are strongly associated with clinician engagement and retention. In practice, doctors consistently report feeling more engaged when their experiences are sought, acknowledged and fed back to leadership. What surprised me was not what doctors said, but how much it mattered that someone was asking.
However, there is an important caveat. Collecting data without acting on it quashes credibility. Evidence suggests that collecting staff feedback without visible follow-up can increase disengagement and cynicism. Wellbeing measurement only works when organisations are prepared to respond, even if the response is incremental or imperfect.
Culture is built through everyday decisions
The notion of workplace culture is central to wellbeing, but I am cautious about wellbeing strategies built mainly on aspirational language. Culture is not created by slogans or mission statements, it is created by everyday decisions.
Doctors notice who gets their leave approved. They notice whether training time is protected when the ward is busy. They notice how concerns are handled when they are raised. Some of the most effective wellbeing improvements I have facilitated have been small but practical; predictable rosters, transparent leave processes, protected training time, consistent supervision and regular pastoral care check-ins. These interventions rarely carry a wellbeing label, yet they strongly influence professional fulfilment and workforce retention.
This aligns with evidence showing that organisational interventions, rather than individual-focused programs, produce the most sustained reductions in burnout.
The close link between education and wellbeing
Working across both medical education and wellbeing has reinforced how closely the two are linked. Doctors in training are particularly sensitive to system pressures because they are still developing confidence, competence and their professional identity.
Poorly structure training environments are associated with higher burnout and lower learning engagement. Conversely, flexibility in training, supportive supervision and protected learning time improve both wellbeing and patient safety. Embedding wellbeing into education, rather than treating it as an optional extra, has been one of the most effective strategies I have seen. Moreover, framing wellbeing as a core part of being a safe and effective doctor gives it legitimacy in clinical environments.
Why leadership ownership matters
Perhaps the most important lesson from working in a dedicated role is that wellbeing work cannot be sustained by one person or one portfolio. Dedicated roles can catalyse change, but long term impact depends on leadership ownership.
The initiatives that endure are those embedded into routine governance, workforce planning and education structures. This approach aligns closely with the Every Doctor Every Setting framework, which emphasises shared responsibility across systems rather than reliance on individual resilience.
Doctors can tell when wellbeing is treated as core business. They can also tell when it is not.
What comes next
Three years in a medical wellbeing role has shifted my thinking from programs to systems, from individual resilience to organisational responsibility and from short-term fixes to sustainable initiatives.
If we want doctors to thrive, we need to design workplaces that allow them to provide quality patient care, learn effectively, feel valued and remain human. Wellbeing follows from this.
Sharing these reflections through InSight+, in partnership with Drs4Drs, is an opportunity to move the conversation forward and towards better systems that support doctors in every setting.
Dr Emma Hodge has been the Medical Education & Wellbeing Registrar at Bundaberg Hospital for the last 3 years and the Clinical Lead for the Queensland Health Medical Wellbeing Project. She is currently a final year Medical Administration Registrar at Gold Coast University Hospital and the Chair of the AMAQ Committee of Doctors in Training.
The Every Doctor, Every Setting (EDES) Framework and Action Plan are Australia’s national approach to strengthening the health, wellbeing, and psychosocial safety of doctors and medical students across all career stages and work settings.
Led by the National Doctors Health and Wellbeing Leadership Alliance (NLA), EDES provides both a shared framework and a practical action plan to drive change at individual, organisational, and system levels. Since 2023, EDES has been supporting the medical sector to move from commitment to implementation though leadership, practical tools and real work examples.
The EDES Insight+ Series highlights initiatives that align with the EDES showcasing how organisations and individuals are translating EDES priorities into meaningful, on the ground action across diverse medical settings.
To learn more about the EDES Framework and Action Plan, or to explore how your work aligns with EDES, visit www.everydoctoreverysetting.org.au.
This program is funded by the Australian Government Department of Health, Disability and Ageing.
