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Trainee doctors face uncertain future

24 Feb 2015

There is significant uncertainty among specialist medical trainees about their job prospects as new Fellows face increasingly fierce competition for a limited number of employment opportunities.

In a further sign that the health and medical training systems are struggling to cope with recent rapid growth in the number of graduates, an AMA survey of specialist trainees found little more than a third were confident about finding employment as a Fellow after completing their training.

The AMA said that managing “exit block” from training was an emerging issue, with graduating Fellows in several specialties finding it increasingly difficult to secure positions in either the public or private systems.

It said this could have knock-on effects that could derail the training of many aspiring doctors.

“Failure to ensure there are sufficient employment opportunities for new Fellows will effectively shift the bottleneck in the medical training pipeline from the beginning to its end,” the AMA warned in its 2014 Specialist Trainee Survey report. “Newly graduated Fellows who are forced to occupy senior registrar positions because of a lack of employment opportunities will block the training pipeline, and the capacity for vocational training within the health system will be compromised.”

The AMA said urgent work was needed to find out why many new Fellows were finding it difficult to find employment opportunities, and recommended more be done to help medical students and junior doctors identify specialties with better employment prospects.

While many trainees are worried about they will be able to find a job, most felt well prepared for work, as long as they could find it.

The survey, which involved responses from 583 out of 13,801 hospital-based trainees (a 4.2 per cent response rate), found a high level of satisfaction with the quality of their training and their career choice.

Overall, 78 per cent said they were satisfied with their training program, 84 per cent were happy with the amount of supervision they received and 79 per cent felt they received sufficient clinical experience to meet the objectives of their training.

Encouragingly, almost 80 per cent reported that the demands of their training were compatible with safe working hours, a significant improvement from the 69 per cent who responded similarly in 2010, adding to evidence of success in the past decade in clamping down on excessive hours and reducing fatigue risk.

AMA President Associate Professor Brian Owler said the results showed that the medical colleges were performing well in most areas of vocational training, which was gratifying given recent rapid growth in the number of trainees coming through the system.

But A/Professor Owler said the survey showed “significant areas where colleges have fallen short of their trainees’ expectations”, including in the way they handled complaints about bullying and harassment, providing feedback for trainees, and their appeals and remediation processes.

The AMA President said colleges and health departments should draw on the survey’s results to help improve the quality of vocational training, and called for the establishment of a regular National Training Survey to monitor the training experience and inform improvements.

“A National Training Survey, similar to the successful United Kingdom model, would dramatically improve workforce planning, including important downstream planning to guarantee employment for doctors when they have finished their specialist training,” A/Professor Owler said.

Adrian Rollins

Published: 24 Feb 2015