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15 Aug 2019

BY DR TESSA KENNEDY, CHAIR, AMA COUNCIL OF DOCTORS IN TRAINING

It’s that time of year again. Selection into training, selection into jobs, selection of the place you’re going to call home for the next 6-24 months until we do it all over again.

Compared to the recruitment and selection processes in other countries, where a one-time ‘match’ might be all that is required between medical school and completion of specialty training, medical training pathways in Australia can be a convoluted bureaucratic adventure. To say the least.

We’ve discussed previously many of the advantages of our formative generalist years, and perhaps the need to actually increase flexibility to move laterally between training programs. But this annual-ish cycle of the whole workforce re-application for employment (that you’re so likely to find again that a bank will usually wager you a mortgage) does mean a whole lot of CV updating, selection criteria writing, closing-date server crashing, post-nights interviewing, stress-inducing madness. For everyone involved! We mustn’t forget that the burden of the process falls equally on the shoulders of senior clinicians administering it.

Sometimes the process even threatens to fold back in on itself. I’ve certainly applied in August for a registrar job identical to that to which I’d been promoted in July, been appointed 12 months ahead of a start date, and faced re-applying for a job I hadn’t even started due to intervening maternity leave. Thankfully in my experience the common-sense contract extension has been a thing, but not everyone is as lucky.

It’s unsurprising really for everyone, employees and employers alike, to get a little bit over it.

It’s difficult to create recruitment processes that discriminate (as they should) between candidates to identify those who are most suitable for the position being offered, while avoiding unconscious bias leading to unfair discrimination according to irrelevant characteristics (gender, ethnic background, fashion sense, level of extraversion, or more commonly and insidiously – just the person you know) all in a 10-minute interview slot.

Enter the pre-interview. Forbidden by most jurisdictional policies, these shady but totally mainstream meet-and-greets continue to occur, particularly among physician training circles. Like most things, its persistence is as much about inertia as anything. Happily some sites are taking the lead by creating group informational sessions, in an attempt to showcase their training program while at once trying to reduce the likelihood of a candidate being asked something “we can’t ask in the interview” – because it’s likely irrelevant and opens the door to conscious or unconscious discrimination of the bad kind. So maybe just don’t ask at all?

Other training programs, possibly out of fear of anti-competitive behaviour (ahem), seem to have swung the pendulum far in the other direction. In attempts to provide transparent, objective and defensible criteria against which to rank and choose candidates, we are seeing a burdensome list of points for a CV that is not so facetiously described as a needing to be bought. By attending approved courses, acquiring approved postgraduate degrees, attaining success in examinations of a specialty in which you haven’t even technically started to train.

All this, seemingly ever more divorced from what should surely matter most – your clinical experience, acumen, and professional qualities.

All this, to have a series of temporary contracts that offer little in the way of job security or at least certainty of where you’ll call home, little opportunity for longitudinal supervision for trainees, little sense of return on investment for supervisors, and a lot in the way of paperwork, mandatory training modules, and attempts to time leases and conception to fit in with term changeover.

Not to mention anyone with a significant life event actually falling on term changeover is destined never to celebrate it, as you’re either packing up and moving, or rostered on to cover those who are.

All this, however, can change in time. Looking for a place to start? 

  • Please remember not to ask or answer irrelevant, inappropriate personal questions that have the potential to convert bias into discrimination (“I’m sorry, could you repeat that? It sounded like you were asking a question that did not relate to the selection criteria” is the best retort I’ve heard!).
  • Ensure your selection panels are as diverse as the candidates you want selected.
  • Seek to ask “why not” rather than “why” when considering requests for flexible work and longer contracts.
  • When a trainee is not successful, feedback is essential for them to either do better or try elsewhere next time.

Published: 15 Aug 2019