May Erlinger will know she's made it when she does the coffee run.
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In the hierarchical world of medicine, the most senior doctor is responsible for caffeination.
"If someone's offering to buy your coffee, say yes," the junior doctor said.
"There's just this unspoken thing. One day you will be the one that's buying coffee for everyone."
Dr Erlinger spoke to The Canberra Times in late 2023, before starting at Canberra Health Services as a junior doctor.
The aspiring neurosurgeon and Australian National University graduate is one of many determined to turn around medicine's toxic culture.
'Eat their young'
Another is second-year medical student and nurse Caitlin Walsh. She trained and worked as a nurse in Brisbane before moving to Canberra.
"There was always this phrase [when] we went through nursing, [that] nurses eat their young," Ms Walsh said.
"It was just something you had to go through, the older nurses would just always pick on the younger nurses."
Besides hazing-type attitudes in hospitals, Ms Walsh said the high status of medicine can make doctors, in particular, feel untouchable.
"These people have been told, 'You're so special and you're so smart, and you're so much better than everyone else'," she said.
"Nurses do a lot of the same things as well, but they just do not get the hype."
She said nurses were underutilised in the healthcare system.
It is partly why she is studying medicine.
"It was a challenging decision [going into medicine] because I've got so much pride at being a nurse," Ms Walsh said.
Dr Erlinger pursued medicine after a career as a research assistant, where she worked in a Sydney hospital.
"Bullying, harassment, sexual harassment, it's an awful culture of medicine," she said.
"That's representative of maybe the type of people that will sometimes enter medicine as opposed to specific facilities.
"You can absolutely perpetuate that behaviour, and I think previously at Canberra Health Services, it's maybe gone a bit unchecked, which is why there was a bit of a reckoning [in 2022]."
Good news after suspensions
In 2022, some senior cardiology staff at Canberra Hospital were suspended over long-term bullying allegations.
Dr Erlinger's first student placement was in the cardiology department.
"Clearly people weren't getting along, and so it made it a very uncomfortable environment a lot of the time," she said.
"I was like, 'Oh, no, is this what the rest of my life is going to look like'?"
Since then, the culture has "gotten a lot better", Dr Erlinger said.
"Not just in cardiology, but everywhere in the hospital. I couldn't have a bad thing to say about a single rotation I've had this year," she said in 2023.
"There have been some brilliant vascular surgeons this year that are just absolute allies and game-changers and people who are trying to change the culture of medicine.
"There's still issues with culture at every hospital, but you see the individuals coming through and trying to lead that change. And that's really what is starting to make the difference."
'Uplifting space'
Ms Walsh, a Queenslander, did not want to leave the sun and sand of Brisbane for Canberra's cold.
"[But being admitted to the ANU] was the best thing that could have happened to me. That was a sign from the universe that this is what I was supposed to do," she said.
"It's been a very uplifting space to be in."
She supports the post-graduate degree program as students have more life experience.
Students are interviewed before being admitted.
"[What's] really setting apart the new generation of doctors is that they've got these personal attributes, whereas beforehand, you just needed to be incredibly academically intelligent," Ms Walsh said.
Interviewees want to know how the students think and approach problems, head of the ANU's school of medicine and psychology, Professor Paul Fitzgerald, said.
The school does not just want to "select the right people but also educate them in an environment that encourages and develops [their] value system and their personality", he said.
Reform agenda
There will be an in-depth review into the Doctor of Medicine and Surgery this year.
"I'm hoping that we will produce are really innovative new medical program that will be nation-leading," Dr Fitzgerald said.
Already, grades are rated as a pass or fail, and students work together to solve problems in small groups for assessments.
This is to prevent unhealthy competition and promote collaboration.
Many medicine students graduate from ANU's health science degree, Dr Fitzgerald said.
There will be changes to that program in the next year because it "created an environment that was too competitive".
He also wants to better support students with mental health struggles, and prepare them for a changing industry.
About one-in-three medical students are depressed, according to a 2018 University of Melbourne study.
"We need to be ensuring that we're not exacerbating that problem with our education programs," Dr Fitzgerald said.
"We [need to] design our training in a way that helps build resilience and flexibility."