Stress, personal and educational problems in vocational training. A prospective cohort study.

Introduction: Australian general practitioners suffer from high levels of stress, but the incidence among GP registrars during vocational training is less well described.

Methods: All 400 new Australian GP registrars in 1999 were invited to participate in the study. Consenting registrars completed an annual questionnaire and initial psychometric scales. Medical educators also provided information annually about known registrar problems.

Results: Participating numbers were 213 (year 1), 226 (year 2), 203 (year 3), and 98 (year 4). More than half reported at least one problem in years 2, 3 and 4. Those reporting problems scored significantly higher on initial psychometric scales, and reported lower enthusiasm for training (p < 0.01). Problems reported included unsatisfactory work conditions, administrative concerns and issues with rural terms. These problems were often not detected by their training providers. Recommendations are presented to minimise the frequency and impact of training problems.

Conclusion: Registrars in vocational training for Australian general practice commonly experience problems. Structural changes in the provision of general practice training provide an opportune time to consider ways to ameliorate some of these problems.