Issues about the medical workforce generally and medical training in particular - both postgraduate and undergraduate - have been the subject of a range of reviews and program development activity in the medical and university sectors.
Medical education study
In February 2005 the former Minister for Education, Science and Training, the Hon Dr Brendan Nelson MP commissioned the Department of Education, Science and Training (DEST) to conduct a study into undergraduate medical education. According to DEST, some concerns had been raised within the medical profession and by some students about issues such as teaching pedagogy, the appropriate balance in content across different subject areas within medical degrees, and the appropriate level of access to clinical education to ensure that graduates are able to follow a variety of career paths in the medical profession.4DEST have been guided in their study by a steering committee and round table of medical education stakeholders. The results of the study '…will inform further analysis of those elements of medical training, such as content and delivery of medical education, which contribute to successful learning outcomes and career pathways for students.'5
Prevocational general practice placement program
Under this Commonwealth-funded project, junior doctors in PGY 1 and 2 are able to undertake a rotation in a general practice. This is the only context in which trainees can gain experience outside a public hospital accredited by a postgraduate medical council during prevocational training.Under this arrangement, an agreement is reached between an accredited public hospital and a general practice which is accredited for GP training. The trainee spends 10 or 12 weeks in the general practice, functioning in a similar way to a junior GP trainee.
The scheme has been operating to a limited extent in a number of states - so far, most successfully in South Australia. All funding, including backfilling of trainee positions, is provided by the Commonwealth.
COAG health workforce reforms
In July 2006, the Council of Australian Governments (COAG) announced a range of measures aimed at ensuring the health workforce is able to respond to the evolving care needs of the Australian community, while still maintaining safety and quality. Some of these measures include the following.6- To help ensure that specialist trainees have appropriate skills and experience, COAG agreed that the Commonwealth and the states and territories will establish, by January 2008, a system for these trainees to undertake rotations through an expanded range of settings beyond traditional public teaching hospitals. This could include a range of public settings (including regional, rural and ambulatory settings), the private sector (hospitals and practices), community settings and non-clinical environments such as simulated learning.
- COAG noted the importance of ensuring that health education and training is better aligned with workforce needs. To assist with this, the Commonwealth and the states and territories signed a memorandum of understanding for better consultation on health-related university places. COAG also agreed to establish a taskforce on the national health workforce to undertake project-based work and advise on workforce innovation and reform.
- To facilitate workforce mobility, improve safety and quality and reduce red tape, COAG agreed to establish by July 2008 a single national registration scheme for health professionals – beginning with the nine professions currently registered in all jurisdictions. They also agreed to establish by July 2008 a single national accreditation scheme for health education and training, to simplify and improve the consistency of current arrangements.
4 Department of Education, Science and Training, Medical Education Study: Information Paper, June 2006.
5 Ibid.
6 Health Workforce page, COAG Communiqué July 2006, accessed at www.coag.gov.au at 10:45 am 25 August 2006.