AMA Victoria Council Forum
The Future of Medical Training
Dr Sam Merriel
President, AMA Victoria Doctors-in-Training Subdivision
Surgical Resident, Southern Health
The approaching storm
• Increasing intern & resident numbers
• Retiring senior clinicians
• Changing medical workforce
demographics
4
The facts
Increasing medical graduates
• 81% increase in domestic graduate
numbers from 2005 to 2012 nationally
• Domestic Vic graduates
2005 = 441
2012 = 714
‘Riding the wave: current and emerging trends in graduates from
Australian university medical schools’ MJA 2007; 186 (6): 309-312
6
Retiring senior clinicians
• ‘For every 110 health professionals that
retire, there will only be 84 qualified
people to replace them by 2025’
September quarter Clarius Skills Index, analysed by KPMG (published
08/11/11)
7
Changing medical workforce
• Gender balance
• Post-graduate medicine
• Work-life balance
8
2010 AMA CDT Specialist
Trainees Survey
2010 AMA CDT STS
• 538 respondents from 18 specialty
disciplines
• Positives
– Selection processes
– Aligning clinical experience with learning
objectives
– Access to supervision
10
2010 AMA CDT STS
• Negatives
– Appeals processes
– Recognition of prior learning
– Cost
‘The 2010 Specialist Trainees Survey’ MJA 2011; 195 (7): 382
11
The future
Future vocational training
•
•
•
•
•
Choice
Maintain quality
Recognition of costs
Flexible
Responsive to trainees needs
13
Professor Peter R Ebeling
Chair, Department of Medicine, The University of Melbourne,
Western Hospital, Footscray.
Head, Department of Endocrinology, Western Health, Footscray.
Chair, Department of Medicine (RMH/WH) at Western Hospital.
Medical Honorary Associate, Department of Diabetes and
Endocrinology, Royal Melbourne Hospital, Parkville.
Chairman of the Victorian State Committee of the Royal
Australasian College of Physicians.
About PREP Training
• Physician Readiness for Expert Practice (PREP)
• Aim
To develop a Physician or Paediatrician competent to provide at
consultant level, unsupervised comprehensive medical care in one
or more of the sub specialties of internal medicine or paediatrics
RACP Training Pathways
Principles of PREP Training
• Supportive learning environment
• Learner-centred approach
• Reflective practice
PREP Framework
PREP Basic Training: Divisions
PREP Advanced Training
Riding the wave: current and emerging trends in graduates from
Australian university medical schools
Abstract
• The number of domestic graduates from Australian medical schools
is set to increase by 81% in 7 years, from 1348 in 2005 to 2442 by
2012.
• Including international students, medical school graduates will total
almost 3000 by 2012.
• Planning must begin now to ensure that the significant flow-on
effects of these increases are managed effectively.
• Most urgently, postgraduate medical training will require a
substantial injection of resources to expand opportunities for clinical
training, without compromising quality.
• Patterns of career choice by medical graduates and workforce
supply levels must be monitored to ensure responsiveness to the
effects of substantially larger, and more diverse, graduate cohorts.
Catherine M Joyce, Johannes U Stoelwinder, John J McNeil and Leon Piterman MJA 2007; 186 (6): 309-312
Australian Trainees by Specialty (2010)
Source: MTRP 14th Report
(31% of all trainees in “physician specialities”)
Australian university medical school graduates
Domestic and international by state/territory:
State
Australian Capital Territory
2005
2012
(actual)
(projected)
Change(%)
0
93
New South Wales
504
965
91.5%
Queensland
284
575
102.5%
South Australia
209
224
7.2%
Tasmania
57
107
87.7%
Victoria
441
714
61.9%
Western Australia
113
237
109.7%
1608
2916
81.3%
Total
WEBSITE
www.racp.edu.au
www.racp.edu.nz
PHONE
+61 (02) 9256 5444 (Aus)
+64 (04) 472 6713 (NZ)
EMAIL
racp@racp.edu.au
racp@racp.org.nz
Mr Erich Janssen
Chief Executive Officer
General Practice Education and Training Ltd