Australian Medical Association

The AMA this week brought together trainee doctors from across Australia for a Forum on training pathways for the future, with a strong emphasis on improving access to a well-trained medical workforce for all Australians, no matter where they live.

Forum delegates represented major medical trainee organisations across most specialties including general practice, surgery, medicine, emergency medicine, psychiatry, pathology, radiology, and obstetrics.

A summary of the results of the 2010 AMA Specialist Trainees Survey is published in the latest edition of the Medical Journal of Australia.

In a perspective prepared by the current Chair of the AMA Council of Doctors in Training (AMACDT), Dr Michael Bonning, Deputy Chair Dr Rob Mitchell, past AMACDT Chairs, Dr Alex Markwell and Dr Andrew Perry, and Dr Rick Fielke (SA) and Dr Dror Maor (WA), trainee opinion on key aspects of vocational education is canvassed.

Dr Bonning said today that medical colleges have a proud tradition and are fundamental to the delivery of high quality medical training in Australia.

The AMA today released its Position Statement on Prevocational Medical Education and Training – 2011.

AMA President, Dr Steve Hambleton, said that the significant increase in medical student numbers in Australia puts additional pressures on the health system to provide clinical training for students and junior doctors.

“The AMA has called for an overarching medical workforce plan that ensures there is an appropriate number of adequately funded undergraduate, prevocational and vocational training places,” Dr Hambleton said.

The AMA will today launch A Guide to Working Abroad for Australian Medical Students and Junior Doctors, a practical resource to assist medical students and young doctors maximise the learning experience of working in medicine in other countries.

Deputy Chair of the AMA Council of Doctors in Training (AMACDT) and co-author of the guide, Dr Rob Mitchell, said the guide is essential reading for any medical student or junior doctor planning to work overseas.

“Students and young doctors who are keen to make a contribution to global health now have easy access to comprehensive information that will help make their overseas placement a success,” Dr Mitchell said.

MJA media - Pilot flexible training positions should be introduced to help junior doctors balance work and family commitments, according to an article in the Medical Journal of Australia.

More women than men are graduating as doctors, and more doctors are raising children in their training years, but permanent flexible training positions across the medical subspecialties are lacking, says Dr Suzanne Mahady, an advanced trainee at Westmead Hospital, Sydney.

AMA Position Statement on the Role of the Doctor

The AMA today released a new Position Statement on the Role of the Doctor. AMA President, Dr Andrew Pesce, said that at a time of significant health reform that involves moves towards team-based approaches to health care, it is important to set out the unique qualities that make doctors the pivotal players in Australia’s health system.

AMA Position Statement on the Health and Wellbeing of Doctors and Medical Students

The AMA today released a revised Position Statement on the Health and Wellbeing of Doctors and Medical Students.

MJA media release: The Undergraduate Medicine and Health Sciences Admission Test (UMAT) does not reliably predict academic performance at university, according to a study published in the Medical Journal of Australia.

In 2009, 14 universities in Australia and New Zealand used the UMAT as part of their selection processes for accepting students into medical degree programs.

AMA President, Dr Andrew Pesce, said today that the AMA welcomes the acknowledgement by Health Ministers that there are significant administrative problems with the new Australian Health Practitioners Registration Agency (AHPRA) that must be urgently fixed.

Dr Pesce said the AHPRA problems have had a significant impact on doctors and their patients.

“Some doctors have had to stop working until their registration has been reinstated, and patients have been unable to claim Medicare rebates because their doctors were suddenly unregistered due to AHPRA processes,” Dr Pesce said.

MJA release: Australian medical schools need to improve their conflict-of-interest policies to ensure quality medical student education, medical research and patient care, according to a study in the latest Medical Journal of Australia.

Dr Paul Mason, Intern at the Royal Melbourne Hospital, and co-author Prof Martin Tattersall, Professor of Cancer Medicine from the Central Clinical School at the University of Sydney and Royal Prince Alfred Hospital, Sydney, examined the adequacy of policies at Australian medical schools for managing and declaring potential conflicts-of-interest with the pharmaceutical industry.

MJA release - Despite strong advocacy for academic health science centres (AHSCs) to be introduced in Australia, they have been ignored, according to an article in the Medical Journal of Australia.

An AHSC is a partnership between a tertiary health care provider and a university. Together they drive a care continuum from innovation, to bedside, to the community, aiming to deliver the latest advances and highest standards to patients.

MJA release: Most doctors in Australia are moderately or very satisfied with their jobs, according to an NHMRC-funded study published in the Medical Journal of Australia.

Dr Catherine Joyce, Senior Lecturer for the Department of Epidemiology and Preventative Medicine at Monash University, Melbourne, and co-authors from Monash and the University of Melbourne investigated whether levels of job satisfaction and determinants of satisfaction differ between Australian GPs, specialists, specialists-in-training and hospital non-specialists.

MJA media release: Australian medical schools do not have consistent fitness-to-practise policies (FTPPs) for addressing unprofessional conduct by medical students, according to a study in the Medical Journal of Australia.

Assoc. Prof. Paul McGurgan at the University of Western Australia, and co-authors described current use and possible effects of Australian medical school FTPPs, and aimed to define and benchmark FTPP best practice.

The survey included 15 of the 19 medical schools in Australia. Of these, 12 schools reported using an FTPP. The most common reason for exclusion of medical students was persistent inappropriate attitude or behaviour, including poor attendance, and most exclusions occurred by the third year of study.

MJA media release: Dissection anatomy should be an integral component of medical education, according to a study published in the Medical Journal of Australia.

Prof George Ramsey-Stewart, Professor of Surgical Anatomy at the University of Sydney, and co-authors evaluated the 2010 “Anatomy by whole body dissection” elective course offered to senior medical students at the University of Sydney.

The AMA today released an online professionalism guide to assist doctors and medical students to maintain professional standards when using online social media.

The guide – Social Media and the Medical Profession – was developed by the AMA Council of Doctors-in-Training (AMACDT), the New Zealand Medical Association Doctors-in-Training Council, the New Zealand Medical Students’ Association, and the Australian Medical Students’ Association.

AMACDT Chair, Dr Michael Bonning, said today that evidence is emerging that the use of online social media can pose risks for medical professionals.

MJA media release - The lack of adequate training subsidies for undergraduate medical student training is costing general practices, according to an article in the Medical Journal of Australia.

Dr Caroline Laurence, Research and Development Manager of Adelaide to Outback GP Training Program, and co-authors conducted a study to identify the financial costs and benefits associated with teaching in private general practice.

The AMA welcomes the Medical Board of Australia’s review of assessment processes for international medical graduates (IMGs) working in Australia.

The Board has announced it will work with the Australian Medical Council to determine the terms of a review of the assessment pathways for IMGs, which came into effect on 1 July 2008.

Videos and audio of the speakers at the AMA Medical Training Summit, 29 September 2010.

AMA President, Dr Andrew Pesce, said that the AMA welcomes additional funding for medical student training announced by the Government today.

Dr Pesce said the funding would only deliver the desired future medical workforce results if it were complemented with comprehensive workforce planning arrangements and extra training places for medical graduates once they have finished their university courses.

AMA President, Dr Andrew Pesce, said today that discussion at the AMA Medical Training Summit was strongly supportive of immediate action to fix medical training in Australia.

Dr Pesce said that the AMA believes that Australia needs a national medical training framework with appropriate funding to deliver the right number of highly trained medical practitioners in the disciplines and in the regions where they are needed across the country, urban and rural.

Australians have access to a world-class health care system that is the envy of many other countries. According to the Australian Institute of Health and Welfare, life expectancy in Australia is amongst the highest of all OECD countries.

Event:      AMA Medical Training Summit
Date:       Wednesday 29 September 2010
Time:       10.00am - 4.00pm
Venue:    Conference Room, 3rd Floor, AMA House, 42 Macquarie Street, Barton ACT

The AMA Medical Training Summit today will be attended by more than 80 key stakeholders - including medical students, doctors in training, supervisors, and representatives of medical schools, colleges, postgraduate medical education councils, hospitals, general practice and key health organisations.

AMA President, Dr Andrew Pesce, said that the AMA is hosting the Summit to discuss and develop practical solutions to the current problems in medical training in Australia.

“Ideally, the Summit will reach a consensus position on the extent of the problem, the numbers and types of training places needed in the future, options on where and how these places might be created, and timelines for funding and implementation,” Dr Pesce said.

Event: AMA Medical Intern Crisis Summit

Date: Wednesday 29 September 2010

Time: 10.00am - 4.00pm

Venue: Conference Room, 3rd Floor, AMA House, 42 Macquarie Street, Barton ACT

Media welcome to attend.  Media wishing to attend should contact:

Geraldine Kurukchi
Phone:  02 6270 5467
Mobile:  0427 209 753
gkurukchi@ama.com.au

 The AMA will next month host a summit of key medical training stakeholders to discuss and develop solutions to the crisis around the shortage of prevocational and vocational training positions for medical school graduates.

AMA President, Dr Andrew Pesce, said today that Australia faces the loss of hundreds of locally produced, highly trained medical graduates to other countries or other professions.

The AMA shares the concerns of Australia’s biggest medical schools that the national shortage of medical internships has severe implications for the future medical workforce and its ability to meet the health care needs of a growing and ageing population, with more people suffering chronic and complex conditions.

Dr Pesce said the internship shortage has reached crisis point and all Australian governments, including the next Commonwealth Government, must work together to find solutions.

Supporting the medical workforce

The topic of the Conference – ‘10 Years From Now’ – is very appropriate given the era of health reform in which we are all operating at the moment.

We do need to plan for the future.

This session is titled ‘Medical Practitioner Registration and Training – issues for CHA facilities in 2010 and beyond’.

An important part of the future of our health system is the medical workforce.

The AMA welcomes today’s announcement that the Federal Government has increased funding for GP supervisors who are teaching and training the next generation of GPs.

AMA Vice President, Dr Steve Hambleton, said the 20 per cent increase in the supervision allowance acknowledges the dedication of GP supervisors to preserve and promote the vital role of general practice in the Australian health system.

“We have to support our family doctors – this generation and the next,” Dr Hambleton said.

“GP supervisors make an enormous contribution to health care in Australia by training future GPs to serve the community.

AMA Position Statement on Medical Professionalism 2010

The AMA today released a Position Statement on medical professionalism that identifies the major values of the medical profession, including doctors’ commitment to put patients first.

The AMA Position Statement on Medical Professionalism 2010 draws on the AMA Code of Ethics and the AMA-endorsed World Medical Association Declaration of Geneva and the Declaration of Seoul on Professional Autonomy and Clinical Independence.

AMA President, Dr Andrew Pesce, said there is global professional and community interest in the concept of medical professionalism and what it means to be a medical professional in today’s dynamic health care environment and broader social environment.

“The Position Statement serves to identify the major values of the profession and highlights the profession’s commitment, and indeed responsibility, to put patients first, regardless of the challenges posed by a rapidly changing health care environment,” Dr Pesce said.

AMA President, Dr Andrew Pesce, said today that the AMA welcomes the Government’s significant investment in medical training with the announcement of big increases in the number of medical training places across the board.

The Government has announced there will be 1200 general practice training places by 2014, 975 Pre-vocational General Practice Placements Program (PGPPP) places by 2013, and 900 specialist training positions in private, community and rural settings by 2014.

Dr Pesce said the Government has recognised the important role of general practice with a sharp increase in GP training positions and more than doubling the number of PGPPP places.

AMA President, Dr Andrew Pesce, said today that the AMA welcomes the Government's decision to accept the major recommendations arising from the Review of the Medical Training Review Panel (MTRP).

Dr Pesce said the medical profession is pleased that the MTRP will have an ongoing expanded role in medical education and training, and that it will work closely with Health Workforce Australia.

“This is great news for medical students and doctors in training,” Dr Pesce said.

The MTRP is the only body that brings together all relevant stakeholders in medical education - including the AMA, medical schools, prevocational medical education councils, medical colleges and health departments.  The MTRP was established in 1997 to monitor and report on the number of medical specialist training places in Australia.

The Australian Medical Education Study report – What makes for success in medical education? – endorses calls by the AMA for greater investment in medical education and training to produce a medical workforce capable of meeting the future health needs of a growing and ageing population.

The study undertook research between 2005 and 2007 involving all the major stakeholders, and included surveys of medical students, junior doctors, educators and employers.

AMA President, Dr Andrew Pesce, said today that the report highlights the high international rating of an Australian medical education but advises that more needs to be done to properly fund and resource medical training in Australia.

The AMA has written to Health Minister Nicola Roxon urging greater support for international medical graduates (IMGs) working in Australia, highlighting the problems they face in accessing basic community services such as Medicare and public education.

AMA President, Dr Andrew Pesce, said the AMA has always been a strong supporter of the role played by IMGs in providing health services in the Australian community and wants them to continue as respected and valued members of the Australian medical workforce.

“Along with better access to health and education services for IMGs, we would like the Government to abandon the current 10-year moratorium, which effectively forces many IMGs to work exclusively in rural and remote areas for 10 years or more,” Dr Pesce said.

The AMA welcomes today’s announcement that funding to support clinical training, which was agreed at the November 2008 COAG meeting, will now start to flow.

AMA President, Dr Andrew Pesce, said this initial round of funding is urgently needed and is a good start to addressing the training needs of Australia’s future medical workforce.

Medical student numbers are growing rapidly.  In 2007, there were 1,544 domestic medical graduates, an increase of 22 per cent from 2003.  This is projected to increase to 2,920 graduates by 2012.

Dr Pesce said Australia currently doesn't have the teaching resources in place to cope with the increase in student numbers.

AMA President Dr Andrew Pesce today urged Indigenous medical students to apply for the 2010 AMA Indigenous Peoples’ Medical Scholarship.

The scholarship was established in 1995 to help increase the number of Indigenous doctors in Australia.

“The AMA believes that an essential part of closing the gap in Indigenous health is to build an adequate workforce for Indigenous health. This importantly includes doctors and health professionals who are Indigenous,” Dr Pesce said.

“There is evidence that there is a greater chance of improved health outcomes when Indigenous people are treated by Indigenous doctors and health workers.

An AMA national survey of junior doctors has exposed insufficient medical training resources and infrastructure in our public hospitals.

The AMA Junior Doctor Training, Education and Supervision Survey has collated the views of more than 900 junior doctors from across Australia on the quality of their medical training and the support they are receiving to become independent practitioners.

AMA President, Dr Andrew Pesce, said today that medical training in public hospitals is being held together by dedicated senior doctors who are giving their time and skills to junior doctors without the support of State Governments.

“This is another poor report card on the performance of our public hospitals,” Dr Pesce said.

AMA President, Dr Andrew Pesce, today said an extra 1400 medical intern places would be needed by 2013 to help ensure the looming surge of medical school graduates can become fully-trained doctors.

Dr Pesce said there would be around 3500 medical school graduates in 2012, compared to 2200 graduates at the end of 2008.

“Since 2004, the Federal Government has dramatically increased medical school places to help address workforce shortages,” Dr Pesce said.

“While there is no doubt Australia has a shortage of doctors and it was a good idea to fund extra medical school places, medical training does not stop when students graduate from university. There are currently only 2030 intern places for medical graduates available across the country and, beyond the intern year, a looming shortage of training positions right through to specialist training.

Some glaring anomalies fixed, but more to do – AMA

The Health Insurance Amendment (New Zealand Overseas Trained Doctors) Bill 2009 was introduced to Parliament this morning.  The Bill will amend the Health Insurance Act 1973.

AMA President, Dr Andrew Pesce, said today that the new Bill would fix some of the glaring anomalies in a scheme that is being increasingly questioned by the medical profession and the community.

Dr Pesce said the AMA had written to Health Minister, Nicola Roxon, last month in support of proposed changes to the Health Insurance Act, especially around the so-called ’10-year moratorium’, whereby International Medical Graduates (IMGs) must work in a district of workforce shortage for a minimum period of 10 years.

MJA Media Release - Junior Doctors stressed, overworked

Many junior doctors meet criteria for burnout and fear that their workload could compromise patient safety, according to the results of two surveys published in the Medical Journal of Australia (MJA).

Dr Alex Markwell and Dr Zoe Wainer, of the AMA Council of Doctors in Training, report in the MJA on a confidential survey of 914 junior doctors in Australia and New Zealand.

“We were pleased to discover that 77 per cent of respondents enjoyed working as a doctor and 73 per cent were looking forward to working that year,” Dr Markwell said.

AMA President, Dr Andrew Pesce, today said the results of a survey published in the Medical Journal of Australia (MJA) provide an important snapshot of the health and wellbeing of junior doctors and how they are balancing their personal and professional lives.

The October 19 2009 issue of the MJA includes details of the AMA Council of Doctors in Training 2008 Survey of the Health and Wellbeing of Junior Doctors.  The AMA first publicly released the results of the survey last year.

Dr Pesce said the AMA undertook the survey because it continues to be concerned about the pressures that junior doctors are facing in the early stages of their career, especially the challenges of working in the public hospital system.

“The survey found that junior doctors have a rewarding and satisfying career in medicine, with more than three-quarters of respondents reporting that they had enjoyed working as a doctor over the previous year and were looking forward to their work in the coming year,” Dr Pesce said.

AMA President, Dr Andrew Pesce, said today that the increase in doctor numbers reported by the Australian Institute of Health and Welfare (AIHW) is good news for the Australian community, but concerns remain about the ageing of the medical workforce, slower growth in GP numbers, and continuing doctor shortages in rural Australia.

The AIHW Medical labour force 2007 report shows there were an estimated 67,208 doctors practising medicine across Australia in 2007, which is an increase of 20.5 per cent from 2003.  However, GP numbers grew by only 10 per cent over the same period and, unlike the overall medical workforce, the average age of GPs is rising.

Dr Pesce said that Australia is facing greater health challenges with an ageing population and more people with complex and chronic conditions, and a quality medical workforce in sufficient numbers is needed to face these challenges.

AMA President, Dr Andrew Pesce, said today that the AMA is encouraged by comments from Health Minister, Nicola Roxon, that the Government is keen to expand intern training places, including in general practice.

In a speech yesterday, the Minister said: “We hope to work with States through this agency [Health Workforce Australia] to expand intern training places, including into community settings like general practice.”

Dr Pesce said the AMA would work with the Government in any process to increase intern training places but there must be immediate action to meet impending strong demand for places.

MJA Media Release -  Trainee doctors need better supervision

New systems should be put in place to ensure medical trainees in teaching hospitals are adequately supervised, according to two articles published in the Medical Journal of Australia.

Dr Craig Hore, an intensive care specialist from Port Macquarie Base Hospital in NSW, and his co-authors write that the least experienced doctors in hospitals can be the first called upon to review sick patients after hours.

Dr Hore said inadequate clinical supervision might be a contributing factor to increased death rates of seriously ill patients at weekends.

“There is evidence that supervision has a positive effect on patient outcomes, and that lack of supervision is harmful for patients. Hence, inadequate training and supervision can be contributing factors to serious adverse events,” he said.

MJA Media Release -  Doctors struggle to find teaching time

Due to workforce shortages, doctors are struggling to maintain their involvement in teaching and in research activities, according to an article published in the Medical Journal of Australia. Further, the demands for doctors to teach medical students and doctors-in-training are increasing, with even more medical students now enrolled.

New strategies are needed to encourage general practitioners to teach medical students in their practices, according to a letter published in this year’s General Practice edition of the Medical Journal of Australia.

Dr Mary-Louise Dick, Senior Lecturer in the School of Medicine at the University of Queensland, and her co-authors interviewed 55 Brisbane-based GPs who teach third-year University of Queensland medical students.