Working at Cantonal Hospital took away my self-confidence - says junior doctor

Two former junior doctors at the Cantonal Hospital in Baar have revealed how they were subjected to harassment at work, one of them wishing he had never applied to work there in the first place. The names used in this article have been changed for obvious reasons.

The motto heading the Cantonal Hospital’s website states “Humanity and professionalism are at the core of our everyday work,” though this is not what two former junior doctors found. It was pointed out in this article that the experiences of the two doctors were not just a problem encountered in Zug, but in other hospitals across the country, too. What appears to be common to all those who experience harassment in the course of their work is that problems were not openly discussed, so great is the fear that the complainants fear they will be regarded lazy or unmotivated.

One junior doctor, Lisa, gave the impression of being greatly relieved when given the opportunity to talk about her problems. She explained how there was always so much to do in the internal medicine department where she worked, nevertheless she felt she was good at coping with it all. However, she began to notice other doctors did not appear to be put under as much stress as she was, the senior doctor deciding what she was capable of, and what not. She felt junior doctors were divided into those who were the “super heroes” and those who were the “black sheep”, whose mistakes were always noticed, unlike the others.

In order to progress higher up the ladder, she took to studying her medical textbooks even on her days off, and for up to five hours at a time. She noticed that it was she who actually supported to supposed “super heroes” when they wanted advice, too, and also found it strange that even they were frightened of the senior doctor, even if they did not admit it.

After three months Lisa changed to the casualty department, but things did not improve. “Senior doctors were very much under stress, not least in having to guide junior doctors in this area,” she said. In the hospital where she now works, junior assist in casualty after six months’ work experience in other areas.

Marco was another junior doctor at the Cantonal Hospital. He prefers not to mention in which area he worked as he fears it could be disadvantageous to his future career. He mentioned how he was put under considerable pressure, having had to take charge of sixteen patients after only two days on the ward, whereas junior doctors in other hospitals are given such duties after longer periods of initial experience.

What particularly annoyed him was the way in which mistakes were dealt with, senior doctors talking about them among themselves but not to the junior doctors concerned. “Any feedback was very informal, over lunch, say, or discussed on in general with all other junior doctors, but weeks later,” he claimed. Fortunately, things are better at the hospital where he now works. “Here we all sit down together to see what can be done better next time,” he said. “Very rarely was there any positive feedback in Zug,” he maintained.

A huge matter for junior doctors, of course, is the number of hours they are expected to work. “Very often we used to work two periods of five days with only one day off between,” said Lisa. “You even had to discuss private evenings out with friends with the secretary to the senior doctor,” she said. She often did shifts which were not convenient to her and, when she complained, the senior doctor showed no understanding whatsoever.

In Marco’s case, for months (in Baar) he used to start a shift at 7 am but not leave until after 10 pm. In fact he worked out he put in as many as 65 hours per week in the first few months at the Cantonal Hospital (50 being regarded as normal). And it was much the same for Lisa, even though working such long hours is not allowed by law. “It was like being on a hamster’s wheel,” she said. One hardly had time to go to the loo.”

As to how such problems could be solved, both think more staff are needed, Lisa also adding how work times worked much better for care staff. She felt doctors should delegate more, something which she felt hardly ever happened at the Cantonal Hospital. She also felt it important that only those who really needed urgent care were treated at the casualty department. Much time was wasted on non-urgent matters there. Summing up she felt very much exploited and she was given little guidance, or subjected to remarks like, “surely you learned that at medical school”. “I was made to feel stupid,” she said, “and this in a training hospital, too.”

Because he felt overworked during his time at the Cantonal Hospital, Marco began to look for another job and is now much happier in his new role at a hospital elsewhere. “Had I known what was coming to me, I would never have applied to the Cantonal Hospital in Baar in the first place,” he confessed. Lisa, too, has found another position where she is much happier, unlike in Baar where she lost her self-confidence.

When the hospital was asked for its reaction to all this by a journalist of the Zuger Zeitung, the senior doctor in the internal medicine department rejected totally the accusations of harassment. “Such demeaning comments in a medical or personal capacity are just not tolerated here,” he said. “And if it is a matter of an appraisal, this is treated in a purely factual way,” he insisted. “Anything else would be unprofessional.”

When hospital director Matthias Winistörfer was asked to comment, he said that any doctor who felt he or she was being harassed in any way could speak with him in confidence about it.

For their part, two representatives of junior doctors at the hospital, Stefan Malesevic and Flavio Gössi, said they held meetings with junior doctors every three months, without senior doctors being present, the aim being for them to pass on any concerns junior doctors may have. “So far we have not heard of any cases of harassment. Overall there is a very good working climate here and this is borne out by annual anonymous feedback about junior doctor training here,” they said, adding that, in a points system, 6 being the maximum, the hospital achieved a 5.4 rating.

“We have a very open policy when it comes to medical mistakes,” added Winistörfer, “They are rectified as soon as possible. If junior doctors are not present at the time, they are duly informed later.”

As to the quality of care in the casualty department, Winistörfer considered this “good”, with junior doctors assisted and trained by more senior ones there. “There is always a senior doctor on duty, even at night-time,” he concluded.