The Hospitalist Pilot Project was implemented at the beginning of 2007 in NSW public hospitals. Hospitalists have been defined by NSW Health as:-

"A newly created role for medical practitioners within the NSW Health system. The Hospitalist focuses on coordinating clinical care for patients in a hospital or community setting to ensure their patient journey is smooth, effective and safe."

The Hospitalist positions are not standard and vary on the basis of the need of the individual institution. In NSW, Hospitalists are not dissimilar to the current category of hospital doctor employees known as Career Medical Officers (CMOs). CMO positions are not offered by all States and Territories.

The AMA supports the creation of in-hospital positions that provide ongoing training and education to offer a career pathway and professional development for doctors not wishing to complete specialty training. Such positions must be subject to clinical governance with clear lines of responsibility and accountability for clinical and other agreed outcomes. The existing model of generalist prevocational training followed by specialty training to produce a highly trained workforce for the provision of health care in public hospitals must be maintained.

With regard to Hospitalist positions in public hospitals:

1. The role of these positions must be well described prior to their establishment, including the way in which they provide complementary services to the existing specialty medical and allied health teams.
2. Consultation with representative organisations with whom Hospitalists will be working, including specialists and doctors-in-training, must be undertaken before the introduction of new positions and at regular intervals following their implementation.
3. These positions must not be used as a cost-saving alternative to the provision of adequate specialist services.
4. Creation of these positions must consider the impact on provision of training for junior doctors and must not undermine the teaching quality or accessibility of specialist training experience for junior doctors.
5. These positions must not be used to replace general physicians.
6. These positions must not be used to replace registrars.
7. These doctors must not be required nor encouraged to perform duties for which they do not have appropriate expertise or that would usually require specialist training, and are not considered for appointment to specialist positions.
8. These positions must be supported by way of supervision, accreditation, pathways for career development and structured training.