Medical Training Review Panel: Seventeenth Report

Trends in Advanced Vocational Training

Page last updated: 09 April 2014

The total number of advanced training positions/trainees increased by just over 40% between 2009 and 2013 (Table 4.28). The proportion of female advanced trainees increased very slightly across the five years to its highest level of 52.1% in 2013. The number and proportion of part-time advanced trainees, however, fluctuated from year to year, decreasing after the highest level in 2011 (15.4%) to 12.5% in 2012 and then increasing to 13.3% in 2013.

Table 4.28: Vocational training positions/trainees: Total, advanced, female advanced and part-time advanced trainees, 2009–2013
Total college trainees
Advanced training positions/
trainees
Female advanced trainees
Proportion female
(%)
Part-time advanced trainees
Proportion part-time (%)

(a) Female advanced trainees for RANZCO include 5th year trainees.

Source: Medical colleges and GPET
2009
12,958
8,249
3,967
48.1
1,052
12.8
2010
14,679
9,432
4,494
47.6
971
10.3
2011
15,478
10,214
5,116
50.1
1,577
15.4
2012
16,740
10,996
5,536
50.3
1,379
12.5
2013
17,888
11,832
(a)6,160
52.1
1,576
13.3
Increase
2009-2013 (%)
38.0
43.4
55.3
8.3
49.8
4.1

Over the five years from 2009 to 2013, a number of medical colleges increased training numbers (Table 4.29). It is important to note that the total figures in Table 4.29 differ from the sum of state/territory totals in some years because it includes trainees in overseas placements (Table 4.30).

Occupational and environmental medicine showed the largest increase between 2009 and 2013, with growth of 85.5%. This was followed by general practice and emergency medicine, showing increases of 70.3% and 65.1% respectively. Surgery showed the smallest increase at 9.1%, while intensive care decreased by about one-quarter over the five-year period.

Table 4.29: Advanced training positions/trainees by medical specialty, 2009–2013
Medical specialty
2009
2010
2011
2012
2013
Change
2009-2013
(%)

(a) Emergency medicine and paediatrics data account for trainees undertaking paediatric emergency medicine.
(b) International medical graduates were included in trainee numbers from 2009.
(c) Includes registrars on the Independent Pathway only.
(d) RACS does not differentiate between basic and advanced surgical trainees as the surgical program is an integrated program (SET).
(e) Includes trainees based overseas.
(f) Includes advanced Australian trainees who are undertaking FRANZCOG training only and not overseas trained specialists who are also undertaking RANZCOG advanced training as a requirement to obtain college fellowship.
(g) Includes 3 and 4th years only, not 5th year.
(h) Includes 6 trainees who are completing their final year of training overseas.
(i) Total number of surgical trainees in 2011 was 1,167, including 966 Australian, 180 New Zealand and 21 overseas.
(j) Total number in 2012 was 3,325 (includes double counting of some registrars).
(k) Excludes 4 living overseas in 2012. The definition of Advanced Training changed in 2012, hence the significant change in the number of posts.
(l) Includes 11 trainees who were completing their final year overseas.
(m) Includes 229 fellows in subspecialty training.
(n) Based on Dec 2011 data. This total excludes 183 New Zealand, 7 overseas accredited training posts and 7 New Zealand and 2 overseas SET trainees on approved extended leave.
(o) Total number is 3,974 (includes double counting of some registrars).
(p) Excludes the New Zealand and Hong Kong advanced trainees.
(q) Includes 15 trainees who are currently completing their final year overseas.
(r) Includes fellows completing advanced training certificates.
(s) Excludes 9 trainees based overseas.

Source: Medical colleges and GPET
Addiction medicine
..
11
13
18
24
..
Adult medicine
(e)1,157
(e)1,406
1,469
1,468
1,513
30.8
Anaesthesia
485
612
566
609
657
35.5
Anaesthesia - pain medicine
53
51
58
59
65
22.6
Dermatology
39
45
54
57
49
25.6
Emergency medicine(a)(b)
811
881
1,057
1,204
1,339
65.1
General practice - GPET
2,309
2,572
2,948
(j)3,289
(o)3,932
70.3
General practice - ACRRM(c)
..
70
6
(k)156
155
..
Intensive care
375
332
312
302
281
-25.1
Medical administration
92
105
86
98
(p)107
16.3
Obstetrics and gynaecology
(f)131
(f)123
143
(f)133
(f)159
21.4
Occupational and environmental medicine
55
87
80
84
102
85.5
Ophthalmology
77
(g)49
(h)86
(l)80
(q)90
16.9
Paediatrics(a)
453
583
640
593
556
22.7
Palliative medicine
..
58
71
24
80
..
Pathology
224
301
314
314
301
34.4
Pathology and RACP (jointly)
137
131
173
208
213
55.5
Psychiatry
322
350
368
(m)417
(r)418
29.8
Public health medicine
61
60
72
61
81
32.8
Radiation oncology
101
110
137
141
122
20.8
Radiodiagnosis
328
333
366
372
364
11.0
Rehabilitation medicine
138
143
162
177
191
38.4
Sexual health medicine
..
19
7
10
20
..
Sport and exercise medicine
..
..
27
28
(s)30
..
Surgery(d)
901
1,000
(i)966
(n)1,094
983
9.1
Total
9,150
9,432
10,214
10,996
11,832
29.3

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Advanced vocational training activity increased markedly in all states from 2009 to 2013 (Table 4.30).

However, the Australian Capital Territory had the smallest increases and showed considerable fluctuations across the five years. It should be noted that the true picture of increases in training in the Australian Capital Territory provided by this data is distorted by the fact data for some specialties were previously reported with New South Wales data and general practice numbers continue to be reported together.

Table 4.30: Advanced training positions/trainees by state/territory, 2009–2013
NSWVicQldSAWATasNTACTAust(a)

(a) Australian total differs from the sum of state/territory totals in some years because it includes trainees in overseas placements.

Source: Medical colleges and GPET
2009
2,727
2,190
1,486
623
722
156
130
122
8,249
2010
3,033
2,448
1,780
740
700
170
176
252
9,277
2011
3,314
2,596
2,042
852
912
207
151
139
10,194
2012
3,580
2,769
2,244
888
983
239
178
151
10,996
2013
3,859
2,916
2,476
914
1,052
250
208
143
11,832
Increase
2009–2013 (%)
41.5
33.2
66.6
46.7
45.7
60.3
60.0
17.2
43.4

Overall, the proportion of advanced vocational trainees who are female has shown small increases over the five years from 2009 to 2013, reaching just over half of all advanced vocational trainees (Table 4.31).

The proportion of female advanced trainees has fluctuated over the years in most specialties, particularly those with smaller numbers of trainees. In spite of this variation, there are a number of specialties that have had consistently lower proportions of female trainees, such as surgery, sport and exercise medicine, intensive care medicine and occupational and environmental medicine. In contrast, sexual health medicine, dermatology, rehabilitation medicine, public health medicine, paediatrics, obstetrics and gynaecology, general practice and palliative medicine have maintained higher proportions (around three-fifths each year) of female advanced trainees.

Table 4.31: Proportion of female advanced vocational trainees by medical specialty, 2009–2013
Medical specialty
2009
2010
2011
2012
2013
Change 2009-2013 (%)
Proportion female (%)

(a) In 2010 the proportion was calculated for pathology medical specialty only. The percentage for both pathology and pathology and RACP (jointly) was 53.4.
(b) Proportion of Australian surgical trainees. The total proportion of female surgical trainees including Australian, New Zealand and overseas trainees was 24.4%.
(c) The decline in female trainees in the pathology medical specialty only is matched by an exact increase in the number of female joint RCPA/RACP trainees.

Source: Medical colleges and GPET
Addiction medicine
..
36.4
30.8
44.4
46.0
..
Adult medicine
40.2
42.3
43.0
45.6
48.0
19.4
Anaesthesia
50.7
39.9
43.1
44.0
44.9
-11.5
Anaesthesia - pain medicine
35.8
29.4
27.6
38.9
52.3
46.1
Dermatology
59.0
55.6
61.1
73.7
63.3
7.3
Emergency medicine
41.9
38.6
41.1
40.9
41.4
-1.2
General practice
63.8
64.9
..
..
..
..
- GPET
..
..
65.8
64.9
64.9
..
- ACRRM
..
..
33.3
27.5
25.0
..
Intensive care
24.3
27.1
26.9
30.5
32.7
34.8
Medical administration
14.1
27.6
41.9
39.8
40.2
184.4
Obstetrics and gynaecology
67.9
65.0
60.1
65.4
69.2
1.9
Occupational and environmental medicine
25.5
14.9
21.3
20.2
24.5
-3.7
Ophthalmology
31.2
38.8
38.4
23.8
40.0
28.3
Paediatrics
58.7
61.4
65.9
65.3
67.0
14.1
Palliative medicine
..
53.4
63.8
60.0
67.5
..
Pathology
64.5
(a)80.1
59.2
64.3
58.8
(c)-8.9
Pathology and RACP (jointly)
..
..
47.4
35.7
56.3
..
Psychiatry
53.1
55.1
63.0
55.6
55.0
3.6
Public health medicine
59.0
61.7
52.8
67.0
65.0
10.1
Radiation oncology
57.4
58.2
51.8
56.7
53.2
-7.4
Radiodiagnosis
34.8
31.8
31.4
46.5
34.0
-2.2
Rehabilitation medicine
61.6
61.5
64.8
68.9
69.0
12.0
Sexual health medicine
..
52.6
28.6
80.0
70.0
..
Sport and exercise medicine
..
..
22.2
25.0
20.5
..
Surgery
23.1
22.8
(b)23.8
25.5
28.1
21.7
Total (%)
48.1
47.6
49.9
50.4
52.0
8.3
Total female trainees
3,967
4,494
5,116
5,536
6,160
55.3

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Overall the proportion of female advanced trainees remains fairly constant across states, approximately in the range of 40% to 60% each year. However, the Northern Territory has consistently had the highest proportion of female trainees each year (fluctuating between a low of 52.3% in 2010 and peaking at 61.6% in 2011). In most cases, the proportion of female trainees was considerably lower in the Australian Capital Territory (Table 4.32).

Table 4.32: Proportion of female advanced trainees by state/territory, 2009–2013
NSW
Vic
Qld
SA
WA
Tas
NT
ACT
Aust
Proportion female (%)

Source: Medical colleges and GPET
2009
39.2
49.4
46.2
47.2
45.2
48.7
60.0
42.6
48.1
2010
50.0
48.8
46.1
46.4
48.9
57.6
52.3
40.1
47.6
2011
53.8
49.9
47.3
48.2
47.3
51.2
61.6
34.5
50.2
2012
52.7
50.8
46.8
50.2
50.9
52.7
60.1
35.8
50.3
2013
53.4
52.5
48.8
52.2
54.2
53.6
57.7
39.9
52.1

The number of part-time advanced trainees increased by 14.3% between 2012 and 2013. (Table 4.33). Considerable variability in reported numbers of part-time advanced trainees from year to year makes it difficult to distinguish any discernible trends in part-time training. Considerable fluctuations are also seen within specialties between 2009 and 2013.

Table 4.33: Advanced trainees undertaking part-time training by medical specialty, 2009–2013
Medical specialty
2009
2010
2011
2012
2013

(a) Includes trainees within the joint RACP and RCPA program and trainees based overseas.
(b) Emergency medicine and paediatrics data account for trainees undertaking paediatric emergency medicine.
(c) Numbers reflects trainees who have undertaken part-time training at any time during the first half of the year. This does not mean they have been in part-time training for the whole year.
(d) Includes registrars on the Independent Pathway only.
(e) RACS does not differentiate between basic and advanced surgical trainees as the surgical program is an integrated program (SET).
(f) Totals for 2009-2010 have been changed to include numbers of trainees from sport and exercise medicine.
(g) 2010 data are year to date of posts credentialed.
(h) This report uses different methodology for calculating part-time trainees than the 16th MTRP submission, hence the total of part-time trainees for 2012 is changed to 715.
(i) Excludes the New Zealand and Hong Kong advanced trainees.

Source: Medical colleges and GPET
Addiction medicine
6
5
3
4
5
Adult medicine(a)
51
59
63
55
48
Anaesthesia
21
24
25
45
24
Anaesthesia - pain medicine
7
6
6
8
10
Dermatology
1
5
2
7
6
Emergency medicine(b)(c)
na
(g)23
36
105
193
General practice
743
631
..
..
..
- GPET
..
..
991
(h)715
1,020
- ACRRM(d)
..
..
0
0
0
Intensive care
2
1
3
5
4
Medical administration
1
1
5
4
(i)9
Obstetrics and gynaecology
25
3
7
6
8
Occupational and environmental medicine
0
0
0
0
0
Ophthalmology
2
1
0
3
4
Paediatrics(a)(b)
70
76
154
74
75
Palliative medicine
16
6
2
4
11
Pathology
1
11
18
28
15
Pathology and RACP (jointly)
1
5
9
Psychiatry
60
64
29
82
78
Public health medicine
17
11
17
16
7
Radiation oncology
1
4
2
5
5
Radiodiagnosis
5
7
13
8
11
Rehabilitation medicine
17
26
24
31
25
Sexual health medicine
7
11
4
5
7
Sport and exercise medicine
1
1
0
3
2
Surgery(e)
0
1
3
2
0
Total(f)
1,054
977
1,416
1,379
1,576