8. Expected Outcomes

Becoming more efficient
Becoming more effective
Becoming more responsive
8.1 More trainees - better training
8.2 Achievability

Through the establishment of expanded networks it is anticipated that the most visible outcomes will be in the development of a more efficient, effective and responsive medical specialist training system, which will be able to supply more doctors and provide a better training experience.

Becoming more efficient:

• The relationship between service provision and training will be more clearly defined across the range of settings
• More trainees can be brought into the training programs without creating additional pressure on existing posts
• Colleges working together will ensure more efficient and better training, especially in the non-technical competencies
• There is potential for achieving efficiencies in training through focusing on competences as the measure of proficiency
  1. Generic competencies will provide the basis for shared training and assessment across specialties
  2. Criteria of explicitly stated levels of competence, rather than time in training, can also enable good trainees to complete their training more quickly
• The movement of trainees across settings will be better coordinated whilst providing greater flexibility

Becoming more effective:

• Training will be more targeted to align competencies, outcomes and settings
• Expanded network training will ensure that trainees have the widest possible experience and are therefore better prepared to take on all of the requirements of a beginning independent practitioner in their specialty
• Training will be more closely aligned to the changing health needs of the community
• Expanded training, especially into rural and community environments will enhance equity between primary/tertiary care and metropolitan/rural
• Colleges will be actively involved with the expanded networks to ensure that training standards are maintained
• Supervisors will be better equipped to fulfil their role
• Improved communication and collaboration between settings will lead to improved horizontal and vertical integration of training
• Trainees will be more willing to move across settings with confidence that their employment conditions are assured

Becoming more responsive:

• Specialist curriculum and training outcomes will be expanded to encompass the wider needs of community health care
• Graduating trainees will be better prepared to work in multidisciplinary teams and work across a wider range of settings, as well as to cater for the needs of chronic as well as acute care patients

8.1 More trainees - better training

All of these improvements are being argued as both necessary, and as the most effective way to achieve one goal which is to produce the best possible medical specialist graduates to meed the needs of the Australian community in the next decade and beyond.

The expanded networks will ensure that training standards, and the contribution of the traditional public training hospitals, are maintained whilst providing training opportunities in a wider range of settings. This model will both improve training and accommodate the need for more trainees. For a variety of reasons colleges are already seeking opportunities to extend their training beyond traditional training environments. The proposed model will ensure that movement of trainees from one environment to another will be better coordinated, and the various sites for training will be better prepared to support training, and better resourced.

The current high standards of specialist medical training in Australia will be enhanced both through stronger collaboration between all of the stakeholders, the expansion of training settings, and the addition of competencies. As the colleges (and other stakeholders) work together to enhance the training of the generic competencies they will ensure that those competencies are appropriately addressed across all of the specialties, and demonstrate the effectiveness of multidiscipline teamwork and collaboration.

Training across the diverse range of settings will ensure that future trainees will be better prepared to work in those settings, as well as address the needs of the wider array of patients and medical problems that are presented in those settings. Training will be improved through the recognition of supervisors who will receive better preparation for their roles and responsibilities and will be more appropriately rewarded.

8.2 Achievability

All of the proposed changes to the curriculum, training infrastructure, diversification of sites, as well as the changes of culture, are achievable. The clearest indication of that prospect is the numerous examples which have been outlined in this report.