Twelve tips for performing well in vivas.

The viva examination is a common method of assessment in medical education. It is, in essence a performance given by candidates to examiners, and as such, candidates would be well advised to optimize their performance. Knowledge and skills are essential to passing the viva, but they alone are not sufficient. The process of the performance is also important, but it is not often made explicit in feedback during viva practice. Moreover, there are many aspects to the performance process that can be worked on to improve candidates' chances of passing. Here we present 12 tips focused on performance processes, for use by supervisors and their trainees.

Optimising rostering patterns for Australian junior doctors.

Optimising junior doctor rosters is a common subject of debate both in Australia and overseas. While total work hours are recognised to increase the risk of fatigue-related complications for both junior doctors and their patients, patterns of work are less commonly described. Multiple low quality evidence recommendations exist to guide rostering practices to reduce predominantly the risk of fatigue-associated error and burnout, but also to avoid disruptions to continuity of care and provide adequate training opportunities. Given available evidence is poor, further centre and specialty-specific studies are required to delineate optimal rostering patterns for Australian junior doctors.

Exploring newly qualified doctors' workplace stressors: an interview study from Australia.

PURPOSE: Postgraduate year 1 (PGY1) doctors suffer from high levels of psychological distress, yet the contributory factors are poorly understood. This study used an existing model of workplace stress to explore the elements most pertinent to PGY1 doctors. In turn, the data were used to amend and refine the conceptual model to better reflect the unique experiences of PGY1 doctors. METHOD: Focus groups were undertaken with PGY1 doctors working at four different health services in Victoria, Australia. Transcripts were coded using Michie's model of workplace stress as the initial coding template. Remaining text was coded inductively and the supplementary codes were used to modify and amplify Michie's framework. RESULTS: There were 37 participants in total. Key themes included stressors intrinsic to the job, such as work overload and long hours, as well as those related to the context of work such as lack of role clarity and relationships with colleagues. The main modification to Michie's framework was the addition of the theme of uncertainty. This concept related to most of the pre-existing themes in complex ways, culminating in an overall sense of anxiety. CONCLUSIONS: Michie's model of workplace stress can be effectively used to explore the stressors experienced by PGY1 doctors. Pervasive uncertainty may help to explain the high levels of psychological morbidity in this group. While some uncertainty will always remain, the medical education community must seek ways to improve role clarity and promote mutual respect.