- Implementation of an expansion of specialist training settings should be phased in gradually to coincide with the increased number of medical school graduates and subsequent specialist trainees.
- The priority and focus of the expansion of specialist training settings should be to meet the educational requirements of specialist training programs unable to be met adequately in current training settings.
- Training opportunities and any constraints need to be identified by jurisdiction, speciality and setting; specific programs should be implemented flexibly and responsively. In most cases, changes to training settings should be implemented incrementally.
- Implementation should be undertaken on the basis of agreed national principles that are developed from the overarching and operational principles identified by the Reference Group, with flexibility to be able to respond to speciality, setting and jurisdictional variation and requirements.
- The system of training rotations should reflect that public teaching hospitals will continue to be the central point of training for most specialties, and that trainees should experience training in a range of settings as needed to meet educational requirements.
- The Medical Specialist Training Steering Committee should consider the options of a council or advisory committee for governance and administration of a program to expand specialist training settings. The arrangements should be developed with recognition of the contributors of funding, quantum of funds, and the chosen governance option.
- The governance structure should be established as a transitional body in the first instance, reviewed after 2 full years of operation.
- Membership of any governance structure should reflect the key stakeholder groups including jurisdictions, colleges, trainees and consumers.
- Mechanisms should be established to monitor the effectiveness of the system and the uptake of training opportunities in the expanded range of settings by number, jurisdiction, (sub)specialty and setting.
- A review of the transitional governance arrangements should consider the effectiveness and appropriateness of the structure in light of more significant implementation with the increase in medical specialist trainee numbers from 2010.
- The responsibilities of the chosen governance structure will be to administer an expansion of medical specialist training settings; it will not extend to administration of existing training arrangements.
- The Reference Group notes the increased number of graduating medical students who will be entering vocational training in the coming years and commends the expansion of training settings as one important mechanism to address this issue.