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Background/Aims To determine the prevalence of psychological distress in Australian junior medical officers ( JMO) and investigate the determinants associated with psychological distress over a 3-year (2014-2016) period. Methods JMO were surveyed using the 2014-2016 JMO Census ( n = 220, 399 and 466 each year; response rate approximately 15%). Levels of psychological distress were assessed using the Kessler Psychological Distress Scale ( K10). A K10 ≥ 25 was chosen to indicate high psychological distress, and this determinant was compared to various demographic and work-related factors. Results Australian JMO experience a high level of psychological distress (mean: 18.1, median 16.0). There were no differences in demographical variables, such as age, gender, marital status, dependants and between postgraduate years 1 and 2. Increasing hours worked per week was associated with a higher K10, with every hour worked increasing odds by 3%. Attitudinal items, including feeling unwilling to study medicine again, feeling poorly trained and experiences of bullying, were related to high psychological distress. Coping strategies like exercise and spending time with friends correlated positively with lower distress, while time off work, frequent alcohol use, smoking and drug use were associated with increased distress levels. Of those with a high K10, 54.5% indicated that they did not use any form of professional support; 17.83% expressed that given their time again, they would not choose to study medicine. Conclusion A focused approach to JMO support and education regarding significant risk factors identified is likely to assist health policies that aim to improve the mental well-being of Australian JMO. [ABSTRACT FROM AUTHOR]