Up to 1,200 doctors are deeply distressed by the Royal Australian College of Physicians “appalling” handling of an IT meltdown that wiped out a crucial, high-stakes examination on Monday.
Senior physicians have raised serious concerns for the mental health and wellbeing of the registrars now forced to resit the test after months of gruelling study regimen, hospital workloads and personal sacrifice.
A technical fault abruptly shut down the basic training exam. The test cost each candidate $1,800 to sit and is a requirement for doctors aspiring to specialise as physicians or paediatricians.
The college is facing mounting criticism from its membership, with calls for the President and others responsible for the incident to resign.
Several doctors who sat the botched exam spoke to Fairfax Media on condition of anonymity over concerns that speaking publicly could impact on their future careers.
As crowds of confused registrars poured out of exam centres across the country, many were crying inconsolably, visibly distressed and angry.
“It was just awful … complete chaos” one registrar said.
“There were a number of candidates sitting on kerbs crying ... no one [was] advising of what happens next.”
Several registrars described chaotic scenes long before the technical meltdown.
Candidates were not permitted to bring bottles of water into the five-hour exams to protect the computers from damage. Some rooms had no supervisors present, candidates were invariably allowed mobile phones and at least one centre cancelled a break between sessions.
One Sydney registrar said a fellow candidate was not allowed to leave the exam room to use a breast pump.
“That lady was in excessive amount of pain for a long time and there was no sympathy or empathy to help her through that progress,” the registrar said.
RACP president Dr Catherine Yelland apologised for the stress and disruption caused by the exam’s cancellation. The college announced on Tuesday afternoon that a replacement paper test would be held on March 2.
But candidates and their supervisors warned there would be long-term ramifications for the registrars, their families, colleagues and hospitals.
“It’s such a high-stakes exam with profound consequences for doctor health and wellbeing and patient wellbeing, the function of hospitals,” one registrar said.
Doctors can spend up to two years preparing for the once-yearly exam. They work up to 12-hour hospital shifts, including night shifts, attend lectures, and study for several hours a day for the exams.
Burnt out doctors warned their distress could affect patient care.
“I’m in no fit state to do a good job for my patients,” a male registrar said.
They spoke of the burden on their families and colleagues, and the now-empty promises of their lives improving post-exam.
A female registrar said she had cared for her two babies as she juggled study and shift work.
“We’re required to sacrifice personally and financially and at the expense of my family.
“Many of our physician training doctors have families including the responsibility to care for very young children," she said.
Professor Ian Kerridge, haematologist and bone marrow transplant physician at Royal North Shore Hospital said he has received about 30 calls from “incredibly distressed” trainees after the aborted exam.
“It’s a terrible, terrible episode and it’s hard to imagine something more appalling than this act of incompetence," Professor Kerridge said.
“For all the college bleating about being worried about trainees killing themselves and then they do this? It’s unbelievable."
The senior physician said the College's principal role was to educate doctors.
"If they fail to do that and care for the registrars under their care then we have a serious problem."
RACP’s president-elect of adult medicine Professor Paul Komesaroff said the botched exam may prove the single most damaging event in the College’s history as medical organisations address doctor suicide and psychological distress.
Professors Kerridge and Komesaroff, an outspoken critic of the College, were among several senior physicians calling for Dr Yelland and other senior officer holders to resign or be stood down over the incident.
They demanded the college offer registrars a compassionate response, that could include reimbursing exam fees and compensation for flow on financial hardships.
“Simply saying ‘don’t worry, we’ll set the exam in a fortnight’, is a slap in the face,” Professor Kerridge said.
Professor Komesaroff said the “entire anachronistic sudden-death exam system” should be overhauled and urged the college to allow all candidates through to the next stage of training.
Dr Yelland said the college took responsibility for the failure and rejected the suggestion she should resign.
“Walking away won’t help anyone … somebody needs to actually deal with the issues, which is what we’re doing."
She said the RACP was considering how to handle the financial burden the disruption had caused some registrars and would charge them to resit the exam.
Dr Yelland said the RACP had given the test's contracted administrators Pearson VUE 48 hours to report on how the error occurred.
The college was also conducting an internal review of the entire exam process, she said.