Distressed doctors: a hospital-based support program for poorly performing and "at-risk" junior medical staff.

Despite "safe-hours" campaigns and doctors health programs, "at-risk" behaviour and suicides still occur in junior doctors. A recent national survey found that 46% of junior doctors believed that their hospital administration was not supportive. The Royal Melbourne Hospital has developed a comprehensive program for preventing and identifying at-risk behaviour and supporting junior doctors, tailored to the individual's needs. Patient and individual doctor safety is paramount, and confidential collaboration between medical workforce and medical education structures, clinical supervisors and the Victorian Doctors Health Program is required. The boundaries of the hospital's "duty of care" for those who do not want assistance is unclear, and balancing increased supervision within a limited workforce is challenging.