Message from the Chair

For some, this will be an exciting time as they progress to the next level of their career. For others, the news they receive may shatter plans for their future and career as they find out they haven't been accepted into the training program they have devoted their working lives towards. 

I can certainly relate to the stress and exhaustion that job insecurity, working long hours, and the daily pressure to perform perfectly in a difficult job can bring, having been an unaccredited O&G registrar for three years prior to being accepted into training. These experiences are shared by many as the number of doctors working in unaccredited registrar positions continues to rise as hospitals struggle to meet service delivery demands, whilst not being able to offer enough formal training positions, as these training opportunities are limited. 

Unaccredited registrars are uniquely Australian, and in an overstretched public health system it seems that more and more often they are being used to plug holes rather than being offered meaningful training opportunities for career progression. As the training bottleneck grows, DiTs are languishing in the unaccredited space and becoming disenfranchised and disengaged from their work as doctors. This is one of the most important issues currently facing DiTs and the medical workforce as a whole. The current system is unsustainable and needs reforming so that all doctors can have the opportunity for fulfilling careers and patients can receive high quality care.   

Medical Training Survey data show that unaccredited registrars have poorer working experiences than accredited trainees. They are more likely to experience unacceptable workplace behaviours, have heavy workloads, and feel under-appreciated or concerned about securing employment. They are also more likely to consider a career outside of medicine. These are doctors that the health system cannot afford to lose. 

CDT’s Operational Plan focuses on improving conditions for prevocational and unaccredited trainees as one of our three key advocacy priorities. The two areas of focus are - accreditation of all medical positions and improving selection processes for vocational training. The CDT Prevocational Special Interest Group advises CDT on issues related to prevocational training and has allowed for increased advocacy work to be done in this space. 

CDT also have representatives to the Service Registrar Working Group as part of the National Medical Workforce Strategy. The work of this group encompasses registrars not yet on a training program, and hospitalists or career medical officers. These are two groups of doctors with very different supervision and training requirements, but both are vulnerable to lack of support and security. We need to ensure that there is some sort of definition and accreditation of these roles so that they can be part of a training trajectory that is beneficial to DiTs and patients, or a fulfilling job that is a legitimate career option.  

CDT’s Policy Advisory Committee have also been hard at work creating and renewing policy pertaining to prevocational doctors. They have produced the Entry Requirements for Vocational Training position statement. The position statement was approved by CDT at a recent meeting and was informed by a CDT Trainee Forum themed around entry requirements for selection into training in held October 2021. Through this position statement, the AMA CDT calls for  

• sufficient numbers of high-quality vocational training places to support community need for a skilled medical workforce, 

• published explicit pre-requisites for vocational training that are achievable during routine prevocational training,  

• a focus on diversity when selecting trainees 

• evidence based entry requirements that are merit based, equitable and transparent 

• appropriate communication from the colleges to prospective trainees regarding processes, changes to entry requirements and feedback for unsuccessful candidates, and 

• reasonable and justifiable costs relating to the selection process. 

The complete position statement will be available on the AMA website following the upcoming October Federal Council meeting. This policy will be used by CDT to advocate to the colleges for improved selection into vocational training.