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Graduating from medical school and starting your internship is one of the biggest transitions you will make in your professional life. We understand how challenging it is to start your first post as a new doctor, so we've pulled together this list of practical tips and real life advice to help you prepare for your intern year.

We recommend you read some of the AMA and partner publications designed to keep you as a medical professional ethical and safe. They are listed below.

The AMA has a zero-tolerance for bullying and harassment and you can read here what the AMA has publicly stated on this matter.  If you are experiencing bullying or harassing behaviour in your workplace please contact your State/Territory AMA for advice and support.

Read the AMA policy on entry requirements for vocational training

 NOTE: For most States and Territory intern applications for 2018 should be available in the next few months.   

 

What to expect as an intern

Hopefully your transition from medical student to intern will be informed by your clinical experiences and exposure to medical and allied health professionals.  However, if you are applying for an internship interstate, you may need some additional resources to assist you make the transition.

Some States and Territory AMAs produce resource guides for new graduates so contact your State AMA here for further information. 

State and Territory AMAs generally meet with interns during Orientation week activities and these meetings will provide you with a good overview of what your AMA can do for you.  If you have missed these sessions, contact your AMA State or Territory office for further information.  Remember that your honorary student membership of the AMA expires upon graduation and you will need to join as a qualified medical practitioner.  If you have not yet become a member, you can do it on line from here

If you are unsure about your pay or entitlements in your new job, as a member of the AMA, your State AMA has industrial officers who can ensure any issues or errors are sorted out at no additional cost to you.

Employment for doctors in training in Australia will vary, sometimes significantly, between States and Territories.  So the AMA has developed a guide to assist junior doctors to be able to understand the individual state systems and be armed with questions and direction as to where to obtain further information.

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Prevocational Training – Intern

On completing your medical degree, you receive provisional registration and enter the workforce as an intern or postgraduate year 1 (PGY1) doctor.  This part of your training lasts for 12 months (47 weeks full time), and is usually undertaken in a public hospital - although interns will increasingly spend part of their training in general practice, community-based settings and private hospitals in the future.

As an Intern, you will undertake a series of work rotations designed to expose you to a range of clinical situations and environments.  This stage will help inform career choices for many graduates by providing experience in different medical specialties including general practice and provides grounding for subsequent specialist training.

Your 12 month internship will incorporate the following:

  • 8wks – emergency medical care
    Providing assessment and management of patients with acute undifferentiated illnesses – including acutely ill patients.  Can be undertaken in emergency or in some general practice settings that provide equivalent experiences.
  • 10wks – medicine
    Caring for patients with a broad range of medical conditions.  Participating in assessment and admission of patients with acute medical problems. Managing in-patents with a range of general medical conditions.
    Discharge planning (including preparation of discharge summaries and other components of handover) to the patient's GP and sub-acute/long-term care facility or ambulance care.
  • 10wks – surgery
    Caring for patients with broad range of acute and elective surgical conditions and/or who exhibit the common features of surgical illness including metabolic response to trauma, infection, shock and tumours (neoplasia).
  • 19wks − a range of other approved positions in areas such as aged care, anaesthesia, general practice, palliative medicine, psychiatry, rehab medicine or surgery. 

When you successfully complete your internship you receive general medical registration through the Medical Board of Australia (MBA).

 

Support for non-vocational trainees prior to entering a vocational training program

 The AMA recently released this position statement on support for non-vocational trainees prior to entering a vocational training program.

There are significant numbers of doctors in training working in hospitals who have completed their internship but who are yet to enrol in a specialist vocational training program. This position statement articulates the training, professional development and welfare needs of non-vocational trainees working in public teaching hospitals in Australia.

For the purposes of this position statement, non-vocational trainees are defined as pre-vocational doctors employed in a salaried position in a public teaching hospital who are not enrolled in an accredited vocational training program, but are working to gain entry into a training program. It does not apply to doctors who have made a conscious decision not to enter a specialist training program, or complete specialist training.

 AMA Position Statement on Support for non-vocational trainees prior to entering a vocational training program – 2016

See also

AMA Position Statement on Entry requirements for vocational training – 2014

AMA Position Statement on Medical workforce and training – 201

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After the intern year – what’s next?

Take charge of your career

As the competition for medical training positions heats up, proactively managing, planning and reviewing your career is now more than ever, a critical component of helping you secure that much coveted job.  

The first impression you make upon applying for a new job is through your cover letter, resume (curriculum vitae) and interview.  These tools require attention to detail ensuring they deliver the message to your employer in a clear and concise manner whilst still conveying the right information.  For assistance contact AMA Career Adviser, Christine Brill by emailing: careers@ama.com.au

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What support is available?

To assist you in feeling better prepared and therefore more confident to engage in your interview process, AMA Career Advice and the State AMA Careers Advisers/Consultants offer a range of support services for doctors and medical students.  These include: resume templates, resume development and review sessions, cover letter reviews, career assessments, mock interview sessions and tips and tricks.

AMA Career Advice aims to support you in navigating and proactively managing the professional challenges and opportunities that present throughout your career lifecycle.  Whether you are interested in career planning or making a change, we understand that this can be a very anxious and challenging time for you, and we are here to help. 

The AMA’s Career Advice service and Resource Hub are here to assist and can offer you the support you need to make the right decision.  Contact the AMA Career Adviser (Christine) on careers@ama.com.au or contact the State or Territory AMA advisers listed below for details on their one-to-one career advisory services 

Member StateContact 

Northern Territory

Australian Capital Territory

South Australia

Tasmania

Western Australia

Christine Brill - AMA Federal
E: careers@ama.com.au
P: (02) 6270 5483

Christine has over 30 years experience working for the AMA and with the medical profession - from medical student through all the life stages of a medical practitioner.  Christine's knowledge of and engagement with the profession, together with her Masters in Human Resource Management and Graduate Diploma in Employment Relations means that she is well-placed to assist the profession in providing career advice.

Queensland

Holly Bretherton - AMA QLD
P: (07) 3872 2248
E: h.bretherton@amaq.com.au
W: http://amaqcdt.com

Holly joined AMA Queensland in 2012 and since then Holly has help increase student and doctor in training membership and the suite of member services available to them.  Holly has a Bachelor of Business and works with the AMAQ Council of Doctors in Training and is an experience professional in membership recruitment and retention.  Holly has worked with the health community for many years and understands well the environment our doctors work in and their needs as medical professionals.

New South Wales

Anita Fletcher - AMA NSW
P: (02) 9439 8822
E:anita.fletcher@amansw.com.au

Anita is an HR professional with extensive experience in operational and management roles in the private and NFP sectors. Anita knows what does and doesn’t appeal to recruiters and selection panels and is the point of contact for the AMA (NSW) Careers Advisory Service, working closely with doctors to help them achieve their career goals. Anita can assist members with planning and preparing for the next steps in their career and improve communication skills so that doctors can approach critical interviews with confidence. 

Victoria

Mardi O'Keefe - AMA VIC
P: (03) 9280 8722
E: careersadvisor@amavic.com.au
W: http://amavic.com.au/page/Member_Services/Careers/

Mardi is a career management and organisational development professional with 20 years of experience in the corporate, government and health sectors.  Mardi's expertise is in supporting individuals to navigate and manage the professional challenges that surface throughout their careers.  Mardi has a BSc (Psych) and a MAppSci (organisation dynamics) and is accredited to use a number of psychometric tools. 

IMPORTANT: Please note that when accessing these services, 3-5 working days’ notice is required, prior to application due dates and interview dates to allow sufficient time to complete the service and provide you with the best opportunity for that competitive edge.

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Prevocational training – Resident

Most junior doctors spend at least one more year after their internship working in the public hospital system to gain more clinical experience in a range of settings with greater levels of responsibility.  This stage helps equip you with the prerequisite experience and procedural skills for entry into specialist training programs.

While some specialist medical colleges accept entrants after successful completion of postgraduate year 1 (PGY1), most prefer applicants to have completed a second or even third year of training (PGY2 and PGY3).  Doctors during this period of prevocational on-the-job training are known as Resident Medical Officers (RMO) or “Resident”, Hospital Medical Officer (HMO) in Victoria or Trainee Medical Officer (TMO) in South Australia.

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Vocational training – Registrar

After completing your internship and one or more additional years as a Resident, you can apply for admission to a recognised medical specialty training program.  This is the necessary training to obtain fellowship of one of the recognised specialist medical colleges, and allows you to practise medicine independently.

Most specialist colleges have clinical, practical and exit exams, in conjunction with other assessments to assess the full range of skills and behaviours required as a doctor, such as communication and team work.

Specialist training programs and examinations are administered by the individual colleges and vary between three and seven full time years to complete, depending upon the specialty you choose.

Vocational training for most medical specialties is undertaken in a public hospital, however it increasingly includes rotations in private hospitals, regional, rural and community health settings. The exception is general practice, where doctors undertake most of their training in designated private general practices in a community setting.

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Qualifying for independent practice – Fellow

Upon successful completion of a recognised medical specialty training program you will be awarded a fellowship of the college and can undertake additional sub-specialty training.  For example, anaesthetists may undertake additional training in intensive care.

You are now also entitled to an unrestricted Medicare provider number, which enables you to practise medicine independently in your chosen field, anywhere in Australia.

Up to this point you would have almost exclusively undertaken your training as an employee of the public health system, except for GPs who undertake their training in private practice.  Upon completing your specialist training, the options open to you will broaden to include:

  • Private medical practice
  • A combination of private medical practice with a visiting medical officer engagement at one or more public hospitals
  • Employment as a staff specialist in a public hospital or health facility

Not all doctors choose to undertake specialist training.  Some will leave the medical workforce, others pursue a research career, and some choose to work as locums or continue to work in hospitals as non-vocational doctors, typically known as Career Medical Officers (CMOs).

Check with your specialist college of choice for information about completing your specialist training part time in order to accommodate family needs, study or research obligations, for example.  Your State AMA can advise on the industrial terms and conditions around part time employment too.

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Specialty Training Pathway Guide

Not sure what kind of doctor you want to be?  

With over 64 different medical specialties to choose from in Australia, making the decision to specialise in one, can seem daunting.  

That's why the AMA has developed this national, specialty training pathways guide.  As an AMA member you can access this full guide to research particular specialties or compare the key attributes of all 64 specialties, such as entry requirements, cost, and positions available.

Let the AMA’s specialty training pathways guide help inform your career decisions.  Please note  information within the guide was accurate at time of publishing, but intending trainees should clarifyany queries  with the relevant College. 

Take me to the guide now!

 

Our Tips and Tricks for your intern and early postgraduate years

 #1 Observe and prepare.  Talk to and observe people already in specialities to get an idea of what you should expect and what will be expected of you.  A good place to start is talking to your fellow junior doctors who are already on rotations in that department.  Think about what skills and knowledge would help you deal with typical challenges you might face in that speciality, so you start your rotation well prepared. 

#2 Take charge of your development.  Be proactive and identify what you need to work on most and actively arrange your own learning.  You have many opportunities to be involved in how your intern training program operates.  Taking an active interest in your education and training will benefit both you and your fellow interns. Talk to your Director of Clinical Training to find out how to be involved.

#3 Seek regular feedback.  Don’t wait for formal feedback from supervisors and assessors.  Seek feedback regularly from everyone you work with.  Getting more feedback will help you identify key areas to focus on in your learning and development. 

#4 Ask for help.  If you don’t know something, ask.  Chances are your registrar has had a similar experience and can help guide you through it.

#5 Be Honest.  You’re not expected to know everything as an intern, so if you don’t know the answer, don’t lie.  You won’t get in trouble for not doing something, but you will get in trouble for lying about it.   

#6 Keep a portfolio.  Use your portfolio as a tool to help you continuously record and evaluate your progress and to help you plan your own learning and development. 

#7 Make time for you.  Adapting to chronic sleep deprivation, long hours, dealing with sick and dying patients and the many other demands placed on you as a new doctor can lead to burnout.  Realistically, you may have little spare time as an intern, but try to take even 20 minutes out of your day wherever you can to do something - go for a run or walk, read for pleasure or take up a new hobby.  You are NOT your job, so try to have a life outside the hospital.  It will keep you feeling balanced.

#8 Have a good support network.  It’s imperative you have a good support network of people you can talk to and share your experiences with.  Yes, your family and friends might be confronted by your experiences with bodily fluids, and you can’t mention specifics because of confidentiality – but you can talk about your own emotional response to what you’re seeing.  If you keep all your experiences to yourself – your frustration, your excitement, your sadness and your relief – you can easily feel isolated and depressed.  Talking to your friends, family and colleagues regularly about your experiences will help keep you grounded.

#9 Have a GP you relate to. As a doctor you will know the importance of having a GP to advise you on your health, fitness and wellbeing.  Having “corridor consultations” does not qualify as a private and confidential conversation with your own GP, so don’t be tempted to seek the advice of other new graduates.  The AMA in most States will help you find a GP if you do not have one, although it is likely your Medical School has a list of “student friendly” GPs too.

#10 Get involved with your AMA.  The AMA is your partner through your medical career and can offer many benefits and services to you.  Check out the AMA and State AMA websites and see what opportunities exist for engagement; ie, representative fora, discussion groups, etc. 

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Real life advice

Please keep visiting this site as re life experiences of medical colleagues will be added progressively over the coming months.  Featured soon will be an O&G specialist, older persons psychiatrist, orthopaedic surgeon, general practitioner and a haematologist.  Other specialties will be featured progressively.

In the meantime why not read the stories of some of our doctors which fall into the category “life after med school”

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Other useful resources

AMA Council of Doctors in Training

The AMA Council of Doctors-in-Training is the Council responsible for representing Doctors-in-Training and advocating on issues important to you. Consisting of representatives of each State and Territory, the Council meets to discuss and formulate policy, develop useful guides and resources and organises national leadership events.

The Council of Doctors-in-Training collaborates with the Council of General Practice on issues specifically affecting General Practice Registrars. 

Learn more about the Council of Doctors in Training from its home page on this website or click through from here.

Learn more about the Council of General Practice from its homepage on this website or click through from here.

For any questions about AMA Career Advice or suggestions for inclusions on the resource Hub, please email careers@ama.com.au

AMA-AMSA “Social media and the medical profession

AMA-AMSA “A guide to working abroad for Australian medical students and junior doctors

AMA-MIIAA “Clinical images and the use of personal mobile devices – a Guide for medical students and doctors

AMA “Community residency program for JMOs – a plan to train the next generation of family doctors

AMA “Safe Hours Audit – 2011

AMA “Safe handover: safe patients – guidance on clinical handover for clinicians and managers

AMA Junior Doctor Guide

AMA link to specialist training pathways

The AMA “List of Medical Services and Fees” assists medical practitioners in determining their fees and provides an important reference for those in medical practice

Find out about the reduced cost subscription to “Up to Date” for AMA members. 

The Medical Journal of Australia is provided to AMA members as a benefit of membership.  Have a look at the MJA on line edition too at www.mja.com.au 

Not a member – join now!

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AMA support for doctors in training

AMA calls for more support for specialist training

The AMA has called for a significant expansion of the Commonwealth Government’s Specialist Training Program (STP), which provides funding to support specialist training posts in non-traditional settings such as the private sector.

In a submission responding to a Department of Health Discussion Paper, the AMA made a strong case that the STP is making a valuable contribution to supporting the quality of specialist training, and there is scope to do more.

Former AMA President, Professor Brian Owler, said at the time that highly-regarded medical workforce modelling undertaken by the former Health Workforce Australia (HWA) showed that Australia now has enough medical school places, but the challenge is how best to distribute the medical workforce.

“We should now be trying to improve the distribution of the medical workforce and encouraging future medical graduates to train in the specialties where they will be needed to meet future community need for healthcare services,” Professor Owler said.

“The HWA modelling predicted that large numbers of doctors in training will not be able to get the training posts they need to enter specialist training.

“HWA predicted a shortfall of 569 first-year advanced specialist training places by 2018, rising to 689 places in 2024, and rising further to 1,011 places in 2030.

“This training bottleneck will cause problems right down the training pipeline because growing numbers of doctors in training will be stuck in prevocational training and competing for the limited number of available pre-vocational training places.

“The AMA recommends that the Government should expand the number of STP places from 900 to 1,400 places by 2018, and to 1,900 places by 2030.”

The AMA submission emphasises the need to continue to ensure that a strong educational focus is put on STP placements, and recognises that the STP can play a positive role in addressing workforce shortages in particular specialties and geographic areas.

The AMA recommends that priority is given to funding posts in those areas of the medical workforce that need boosting, in particular:

  • rural training
  • generalist skills, and
  • specialities that are under-supplied.

In relation to rural training, the STP has generally only supported one-year placements for doctors in training. In this regard, the AMA highlights that the structure of the program needs to be altered so that it can support coordinated long-term pathways for trainees interested in pursuing rural careers.

The AMA submission recommends using STP funding to help establish regional training networks, particularly where they can be linked to existing infrastructure such as rural clinical schools.

Background

Medical training in expanded settings is an increasingly important adjunct to the public teaching hospital model that has served Australia well over many years.

The Specialist Training Program (STP) is a Commonwealth Government program that gives junior doctors who are undertaking specialist training the opportunity to train in settings outside traditional metropolitan teaching hospitals.

From these settings, trainees can acquire the skills and knowledge from learning experiences that are not generally available in conventional training environments to help meet the standards required to become a Fellow of a recognised specialist medical college.

The Minister for Health is consulting with stakeholders on potential reforms to the STP. As part of the consultation process, the Department of Health has released a Discussion Paper on the current design of the program. The AMA was one of the stakeholders invited to make a submission.

The AMA submission is at https://ama.com.au/submission/submission-review-specialist-training-program

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Post graduate medical education and training

With recent increases in the number of graduates of Australian medical schools and pressures on clinical training capacity, the AMA is committed to ensuring that you have access to high-quality, appropriately supported, undergraduate, prevocational and vocational education and training. 

We know how challenging your time as a junior doctor can be, with significant personal, training and service demands.  After the transition from medical student to intern, the next significant step is deciding upon and applying for specialty training. 

Once you've begun vocational training, navigating your College's training requirements can be daunting.  It's important to ensure you have the support you need to progress through your training and become a well-rounded consultant in your specialty - whatever that may be!

The AMA has created this page of resources, practical tips and real life advice for pre-vocational trainees to help get you through these important stages of your career.

Of particular interest will be our specialty training pathways guide available here. 

Investigate a range of specialties

Investigate a wide range of different specialties – not just the ones you are exposed to through rotations.  This demonstrates you are taking your chosen specialty seriously through self-directed reading, observation and discussion with trainees and consultants in that field.  Exploring a wide variety of specialties will also identify similarities and differences which will help equip you for effective multi-disciplinary practice. 

After you have read the AMAs guide to specialist training pathways you will want to explore further.  Entry requirements for each training program vary and are frequently updated.  Visit the education and training pages of the colleges below to find out more about training in each specialty.

Tips and Tricks for career advancement

  • Identify your preferences. Think about what is going to be important to you in your future medical career.  Ideally you should choose a specialty that matches your personality, values, interest and skills.  Think about the practice settings you prefer, the medical conditions that interest you, and even the activities and tasks that are part of a certain specialty. 
  • Most importantly, discuss your career aspirations widely and attempt to identify role models in specialties in which you identify an interest.
  • Know the facts about the future medical workforce.  Medical workforce modelling is difficult and relies on accurate data and a number of important assumptions.  State and Federal government agencies and the Colleges have all produced reports modelling Australia's future medical workforce, which may be helpful and useful to consider as Government and other stakeholders adapt the best available medical workforce modelling data to assist with important career-making decisions.
  • Explore the support available.  Explore the support available from your hospital Medical Education Officer, director of Clinical Training and Term Supervisor for each term, as part of their role is to assist you in thinking about your career options.  They may also be very useful in putting you in touch with representatives from various specialties.
  • In addition, some Colleges and hospitals may organise local information sessions on the application process for specialty programs, and one-on-one appointments with career consultants may be available through your hospital or AMA State office.      
  • Get mock interview experience. AMA Career Advice has a number of tips and tricks for interviewing well.  Email careers@ama.com.au for the “interview skills tips and tricks” document.  Get mock interview experience from consultants and other colleagues.  Some State AMAs offer mock interviews as part of their interview skills training. Check the State and Territory AMAs for further information.
  • Keep your portfolio updated.  Some speciality application processes require applicants to demonstrate accomplishment of various clinical and professional skills.  Trainees often benefit from having recorded these skills in a career portfolio.  Start good habits early and use your portfolio as a tool to help you continuously record and evaluate your progress, and to help you plan your own learning and development.  Your portfolio should include at least all completed term assessments, skill certifications, courses and conferences.
  • Many trainees also keep details of operation and procedures in which they are involved.  Ensure that any patient related information contained in your portfolio is used and stored according to your professional and legal obligations and any relevant policies of your health service. 
  • Coming soon is the AMA e-portfolio.  Watch this space for further information and/or email careers@ama.com.au if you want to be notified when it is available.

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State Resources to explore

State and Territory AMA’s also offer a range of publications, events, educational and networking opportunities for junior doctors and links to the State and Territory AMAs are here. 

Visit your State AMA website to find out more.

Insurance

The AMA recommends all doctors (from graduation through to retirement and beyond) maintain their own professional medical indemnity insurance, whether in salaried or private practice).

 Feedback sought: We are contemplating webinars on general career options, speciality training, interview skills etc.  Before progressing this, we’d welcome your feedback on whether you think this would be of value to you.  Email careers@ama.com.au with your views.

Other useful resources

Want to hear what specialist practitioners say about their chosen specialty? Coming soon are interviews with an O&G specialist, specialist haematologists, psychiatrist, orthopaedic surgeon, intensive care specialist and GP say about their chosen career. 

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DISCLAIMER: 

This material is generic in nature and is made available on the understanding that the AMA is not engaged in rendering professional advice. Before relying on the material provided, users should carefully evaluate its accuracy, currency, completeness and relevance for their purposes, and should obtain professional advice relevant to their particular circumstances where necessary.Whilst every effort has been made to ensure the accuracy of the information on this Resource Hub, the AMA or its employees cannot be held responsible for any loss or damage arising to any person as a result of using this site.