In addition, to enhancing the education and training opportunities available to specialist trainees, another benefit driving an expansion of specialist training settings is ensuring access to appropriate supervision. Availability of supervisors for trainees was identified as an issue by the Medical Specialist Training Taskforce and Reference Group 3 of the Medical Specialist Training Steering Committee.
The Australian Medical Workforce Advisory Committee publication The Public Hospital Medical Workforce in Australia (2004) reported that many newer trainees and resident medical staff are less willing to work the long hours of their predecessors and to accept unpaid overtime. The ageing of the current specialist workforce means that they too are not willing to work the longer hours that they may previously have been willing to do.6
The ageing and participation rate of current specialists, coupled with the increased number of graduates expected to enter specialist training, will place considerable pressure on the capacity of existing supervisors.
There is a need to expand the pool of available specialist willing to supervise trainees. A benefit of expanding specialist training into other settings is that it will open new avenues for specialists to take on teaching and supervisory roles.
It has been suggested that supervision responsibilities should be more explicitly recognised and rewarded, to encourage more specialists to become involved in the training of registrars. It is noted that in general practice training, supervisors in private settings are provided with a training, accreditation, and supervision 'fee' as a subsidy to compensate for possible loss of income while training / supervising.
However, the Reference Group notes that there is not consistent support (even amongst the medical profession) for explicit remuneration for supervisory responsibilities over and above that already included in salaries to staff specialists and payments to visiting medical officers.
It is further noted that explicit funding for supervision would have cost implications for implementation of an expansion of specialist training settings and potentially to health system costs more widely. The potential costs of expanding settings for specialist training, including costs associated with supervision, have been examined in detail by Reference Group 1.
6 Australian Medical Workforce Advisory Committee, The Public Hospital Medical Workforce in Australia (2004)