The need to increase the opportunities for medical specialist training beyond the traditional metropolitan public hospital setting has gained recognition and acceptance over the last few years. The Phelan report in 2002 and the Medical Specialist Training Taskforce report in 2004 have increased awareness of these issues.
Major metropolitan public hospitals are, and for the foreseeable future will remain, the key location for the provision of specialist training. However, with the changing role and capacity of public teaching hospitals, they are becoming less able to fully accommodate all aspects of vocational training - and requirements in some disciplines are not being optimally met. There is therefore an educational imperative to expand into other settings.
The current shortfall in training opportunities will be only further exacerbated by the dramatic increase in graduates entering specialist training in coming years. Increasing the capacity of the system will require an expansion of the settings in which training is undertaken to better match it with current and future patterns in service delivery.
Arrangements need to be made to start to build the capacity of the health system to absorb the increasing number of medical graduates and maintain training standards. This will ensure the system is ready for full scale implementation from around 2011 when the increased number of medical school graduates will begin to enter vocational training.