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Doctor training bottleneck symptom of bigger problem

It is with great enthusiasm and a touch of trepidation that I introduce myself as the new Chair of AMA’s Council of Doctors in Training. It is with honour that I look forward to representing the interests and aspirations of both prevocational and vocational Doctors in Training (DiTs) nationally, carrying on the hard work of the previous Chairs. Coming from a leadership role within a College trainee committee, I hope to bring a fresh perspective to this position.

17 Jun 2012

It is with great enthusiasm and a touch of trepidation that I introduce myself as the new Chair of AMA’s Council of Doctors in Training. It is with honour that I look forward to representing the interests and aspirations of both prevocational and vocational Doctors in Training (DiTs) nationally, carrying on the hard work of the previous Chairs. Coming from a leadership role within a College trainee committee, I hope to bring a fresh perspective to this position.

The next twelve to eighteen months promises to be a turbulent time for both current and future DiTs.  I look to build upon the strong legacy left by previous chairs and consolidate the Council’s position as the peak advocacy body for DiTs. The Council’s priorities have recently been articulated in its strategic plan for 2012-13, which I urge you to read. It is available on the AMA website at ama.com.au/dit. 

Three key goals for the Council for the next twelve months are:

  • to optimise the AMA’s working relationship with Health Workforce Australia to ensure that DiTs have a place at the table when it comes to determining policy solutions to the inevitable bottleneck in the training pipeline, as predicted by the Health Workforce 2025 report;
  • to continue the Council’s role as one of the policy powerhouses of the AMA and encourage ideas, innovation and thought among doctors in training, both within and outside the organisation; and 
  • to renew our contact with grassroots doctors in training members, reaffirming the benefits of DiT membership and developing a number of exciting membership tools.

Core to the business of the Council is training. The timely evolution of interns into independent medical practitioners is crucial for the ongoing delivery of healthcare to all Australians. While the Health Workforce 2025 report examined the training pipeline, this remains but one piece of the larger puzzle, and this bigger picture should not be forgotten.

The cornerstone of the ‘training house’ is funding. That no one can quantify how big this house is, how many occupy it, the dollars it consumes or can measure how well it works speaks volumes about the difficulty of this problem.

Many of the issues on the Council’s agenda emanate from the central issue of funding.  The origins of the shift to Doctor of Medicine programs can be found here (ably demonstrated by the Higher Education Base Funding Review), as can the looming shortages of clinical supervisors and clinical academics.

Significant research needs to be undertaken to produce meaningful funding models to encompass the spectrum of medical training, from student through to Fellow. Steps are being taken but they remain small and tentative. Promising moves toward the early development of key performance indicators for teaching and training are occurring, but the gestation looks to be lengthy. We fear that until substantial progress is made the funding of medical training will remain in its current vacuum.     

It will be a time of significant change. There will be enormous opportunity to improve upon the strengths inherent in the current system. The Council hopes to ensure that the changes that will occur build positively upon the already high quality of training within the Australian setting, at both a prevocational and vocational level. 

With those thoughts, I will leave you with this:

“Better is possible. It does not take genius. It takes diligence. It takes moral clarity. It takes ingenuity. And above all, it takes a willingness to try.” - Atul Gawande, Better: A surgeon’s notes on performance


Published: 17 Jun 2012