Urethral catheterisation is a fundamental skill for junior doctors, critical for patient safety and care. Despite its clinical importance, many junior doctors report insufficient training and confidence, resulting in procedural complications. This study evaluates the experience, confidence, and complication rates among first-year junior doctors across multiple Australian hospitals, highlighting areas for curricular improvement.

An electronic survey was distributed to 87 first-year junior doctors from three major Australian hospitals at the conclusion of their initial training year. Participants provided data on catheterisation frequency, self-rated confidence levels (average-difficulty, above-average difficulty, and suprapubic catheter changes), and incidence of catheter-related complications.

Of the 87 invited junior doctors, 74 (85.1%) completed the survey. Competency was formally recognised in 89.2% for male catheterisation and 92.4% for female catheterisation. Despite competency sign-off, 72.9% had performed fewer than five catheterisations, 17.6% completed between 5–10 procedures, and only 9.5% performed more than 10 procedures during the year. Concerning self-confidence, just 29.7% reported being "very confident" performing average-difficulty catheterisations, while confidence sharply declined to 5.4% for above-average difficulty cases. Merely 6.8% expressed high confidence in managing suprapubic catheter changes. Alarmingly, 21.6% of respondents reported direct involvement in procedural complications, predominantly false passages and traumatic urethral injuries.

The results highlight a concerning discrepancy between formal competency assessments and actual procedural experience and confidence among junior doctors. High rates of catheter-related morbidity indicate an urgent need for improved training methods and greater procedural exposure in medical curricula. We strongly advocate for mandatory, simulation-based catheterisation training early in internship, alongside structured practical experience, to enhance both confidence and competence, ultimately safeguarding patient safety.