2. Reports commissioned by the Department of Health and Ageing

10th Report Medical Training Review Panel

Medical Training Review Panel 2006

The then Minister established the Medical Training Review Panel for Health and Family Services in 1997 to oversee the take-up of training places by Hospital Medical Officers (HMOs) who came within the new proficiency standards created by the Health Insurance Amendment Act (No.2) 1996. Membership of the Panel is subject to approval by the Minister for Health and Ageing and includes representation from a broad range of stakeholder groups and state and territory health departments. A senior executive of the Department chairs the Panel.

Each year, the MTRP produces a report that provides an annual overview of vocational training placements, outcomes of medical college examinations and an overview of new college fellows. The 10th and most recent report of the Panel now includes data on the numbers of medical students undertaking university studies and the number of applications received for positions in advanced training courses. The 11th MTRP, expected to be released soon, will include for the first time data on overseas trained doctors entering specialist programs.

Community and Rural Terms for Junior Doctors in Australia: A National Review 2002

Postgraduate Medical Council of NSW

The lack of uniform data that describes the number and types of community and rural terms included in postgraduate medical officer training led to the Department of Health and Aged Care commissioning a study designed to:

'…collect relevant data, review and analyse issues and report on the findings, and to make recommendations for the future measures to support community and rural term experiences for junior medical officers.'
The outcomes of the review indicated the lack of consistency in a model of rotation with the exception of the rural remote area placement program which follows a core set of criteria. Financial and workforce constraints were seen to be the greatest barriers to the development of new rural terms and this was reflected in the recommendations.

The review recommended the continuation of support for rural and community terms with suggested enhancements to include:

• mandatory rotations during the first two postgraduate years
• articulation of supervision and education requirements
• provision of appropriate facilities including information technology and
• evaluation processes. Top of page

The Registration and Training Status of Overseas Trained Doctors in Australia

Hawthorne L, Hawthorne G, Crotty B. 2007

This report was commissioned by the Department of Health and Ageing in 2006 to:

• assess the experience of Overseas Trained Doctors (OTDs) entering the Australian medical workforce via the Australian Medical Council (AMC) examination pathways noting the number, characteristics and length of time taken to reach full registration
• define examination and medical employment outcomes from a cross-section of AMC candidates and explore variations in accreditation and employment patterns
• identify the potential number of clinical training places required for OTDs and
• provide empirically-based advice concerning the most appropriate future means of securing comprehensive national data concerning Australia's OTD population.

In reaching their findings, researchers undertook detailed analysis of statistics derived from the following data sources:

• data on OTDs from the Department of Immigration and Multicultural Affairs (DIMA), the Australian Bureau of Statistics (ABS) 2001 Census, and other key data sources
• the AMC database (all cases 1978 – August 2005)
• a mail out survey to 3,000 OTDs engaged in the AMC examination pathway in the past 5 years yielding a 42% response rate (1,144 completed cases)
• OTD data files held by three state Medical Boards (New South Wales, Victoria and Western Australia)
• three commissioned state-specific OTD case studies and
• interviews conducted with 29 state and Commonwealth key informants.

Three recommendations were made based on the findings:

Recommendation 1: Data collected on each international medical graduate applying to work in Australia should be centralised and standardised so that the same information is collected by all jurisdictions.

Recommendation 2: All OTDs should undergo a standardised assessment process before commencing work in Australia.

Recommendation 3: After assessment, all OTDs should be offered a training program to remediate any identified areas of weakness and then to assist them to attain full registration

The researchers were unable to adequately predict the proportion of OTDs likely to require supervised clinical training places.Top of page

Career Decision Making by Postgraduate Doctors, Key Findings

Australian Medical Workforce Advisory Committee 2005

This document presents the key findings from two surveys undertaken by the AMWAC in 2004 on behalf of the Department of Health and Ageing. It is the second report to provide results from a longitudinal study on factors influencing the career choice and workforce participation decisions of postgraduate doctors.

The Department commissioned the study so that it could gain a better understanding of factors that might influence career choice and workforce participation and that might subsequently inform national workforce planning including:

• choice of discipline
• workforce attrition/retention
• hours of work
• type of medical practice and
• location of practice (state/territory and geographic).

The report concludes that there are a number of intrinsic and extrinsic factors that influence choice of discipline. Intrinsic factors include the intellectual stimulus of the specialty, assessment of one's own ability and interest in helping others. Influencing extrinsic factors relate to working conditions and culture.

Female practitioners give greater consideration to the impact of culture and working conditions on work life balance than their male counterparts. Time to complete training and flexible working arrangements are more important to doctors choosing general practice as their specialty area of practice and some specialties have more effective recruitment strategies than others.

The findings of the surveys also supported current thinking on the role of rural based education and training, initiatives to increase the number of rural entrants to medical schools and rural scholarships and cadetships.Top of page

Evaluation of the regionalisation of general practice vocational training

ACIL Tasman 2005

To understand whether general practice (GP) training was being delivered appropriately after the implementation of the findings of the Ministerial Review of General Practice Training in 1998, the Department of Health and Ageing engaged ACIL Tasman to evaluate the regionalisation of GP training by General Practice Education and Training (GPET).

Acknowledging that the regionalised training program was still in its infancy, the findings indicated that a number of issues associated with the rural pathway might affect the recruitment of junior doctors into general practice training. In order to attract more rural trainees ACIL Tasman recommended a greater level of flexibility into, and more targeted incentives for, registrars training on the rural pathway.Top of page

Our Duty of Care

National Review of Nursing Education 2002

The Australian Government Department of Health and Ageing and the Australian Government Department of Education, Science and Training established this review to examine:

• the effectiveness of current arrangements for the education and training of nurses encompassing enrolled, registered and specialist nurses
• factors in the labour market that affect the employment of nurses and the choice of nursing as an occupation
• the key factors governing the demand for, and supply of, nursing education and training and
• examine the future nursing educational needs of the health, community and aged care system and to advise on appropriate education policy and funding frameworks.

The recommendations from Our Duty of Care encompassed a diverse range of issues such as the skill mix and work organisation, augmentation and retention of the nursing workforce, training of care assistants, funding of clinical training and nursing education standards.

Health Ministers prioritised the recommendations and allocated responsibility for action.

Most recommendations were referred to the National Nursing and Nursing Education Taskforce that was established in 2004 following the review. Remaining recommendations were allocated to state and territory health departments, the Department of Health and Ageing, the Department of Education, Science and Training and subcommittees of the Australian Health Ministers' Advisory Council.Top of page

'Getting em n keeping em'

Indigenous Nursing Education Working Group 2002

In 2000, the Office for Aboriginal and Torres Strait Islander Health within the Department of Health and Ageing established the Indigenous Nursing Education Working Group to provide advice on ways to increase the number of registered Indigenous nurses and improve the competency of the nursing workforce generally to deliver appropriate care to Indigenous people.

The Report presents a national framework with 32 recommendations that seek to:

• increase the recruitment, retention and graduation of Indigenous students of nursing
• promote the integration of Indigenous health issues into core nursing curricula
• improve nurses' health service delivery to Indigenous Australians and at the same time
• monitoring outcomes and revising strategies in response to evaluations.Top of page

National Allied Health Professional Workforce

National Rural and Remote Allied Health Advisory Service 2004

The Department contracted the National Rural and Remote Allied Health Advisory Service (NRRAHAS) to analyse and provide a 'snap shot' view of allied health professions currently providing services to rural and remote regions across Australia. The report comments on the complexity of describing the allied health workforce and the need for a comprehensive national approach to collecting and analysing data on the allied health workforce. NRRAHAS defines the health professions it includes under the term 'allied health' to be:

Audiology
Dietetics
Hospital pharmacy
Radiography
Occupational therapy
Orthoptics
Orthotics/Prosthetics
Physiotherapist
Podiatry
Psychology
Social work
Speech Pathology

Acknowledging that the reliance on census data is problematic and potentially inaccurate, particularly where numbers are small, it presents a range of workforce demographics by state and territory for the 12 identified occupational groups including: headcount; gender; age; place of residence; indigenous status; qualifications; employment sector; participation in education and training; and hours worked.