AMA Victoria Council Forum The Future of Medical Training

Dr Sam Merriel President, AMA Victoria Doctors-in-Training Subdivision Surgical Resident, Southern Health

The approaching storm Increasing intern & resident numbers Retiring senior clinicians Changing medical workforce demographics 4

The facts

Increasing medical graduates 81% increase in domestic graduate numbers from 2005 to 2012 nationally Domestic Vic graduates 2005 = = 714 ‘Riding the wave: current and emerging trends in graduates from Australian university medical schools’ MJA 2007; 186 (6):

Retiring senior clinicians ‘For every 110 health professionals that retire, there will only be 84 qualified people to replace them by 2025’ September quarter Clarius Skills Index, analysed by KPMG (published 08/11/11) 7

Changing medical workforce Gender balance Post-graduate medicine Work-life balance 8

2010 AMA CDT Specialist Trainees Survey

2010 AMA CDT STS 538 respondents from 18 specialty disciplines Positives –Selection processes –Aligning clinical experience with learning objectives –Access to supervision 10

2010 AMA CDT STS Negatives –Appeals processes –Recognition of prior learning –Cost ‘The 2010 Specialist Trainees Survey’ MJA 2011; 195 (7):

The future

Future vocational training Choice Maintain quality Recognition of costs Flexible Responsive to trainees needs 13

Professor Peter R Ebeling Chair, Department of Medicine, The University of Melbourne, Western Hospital, Footscray. Head, Department of Endocrinology, Western Health, Footscray. Chair, Department of Medicine (RMH/WH) at Western Hospital. Medical Honorary Associate, Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville. Chairman of the Victorian State Committee of the Royal Australasian College of Physicians.

About PREP Training Physician Readiness for Expert Practice (PREP) Aim To develop a Physician or Paediatrician competent to provide at consultant level, unsupervised comprehensive medical care in one or more of the sub specialties of internal medicine or paediatrics

RACP Training Pathways

Principles of PREP Training Supportive learning environment Learner-centred approach Reflective practice

PREP Framework

PREP Basic Training: Divisions

PREP Advanced Training

Riding the wave: current and emerging trends in graduates from Australian university medical schools Abstract The number of domestic graduates from Australian medical schools is set to increase by 81% in 7 years, from 1348 in 2005 to 2442 by Including international students, medical school graduates will total almost 3000 by Planning must begin now to ensure that the significant flow-on effects of these increases are managed effectively. Most urgently, postgraduate medical training will require a substantial injection of resources to expand opportunities for clinical training, without compromising quality. Patterns of career choice by medical graduates and workforce supply levels must be monitored to ensure responsiveness to the effects of substantially larger, and more diverse, graduate cohorts. Catherine M Joyce, Johannes U Stoelwinder, John J McNeil and Leon Piterman MJA 2007; 186 (6):

Australian Trainees by Specialty (2010) (31% of all trainees in “ physician specialities ” ) Source: MTRP 14th Report

Australian university medical school graduates Australian Capital Territory093 New South Wales % Queensland % South Australia % Tasmania % Victoria % Western Australia % Total % Domestic and international by state/territory: State Change(%) (actual)(projected)

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Mr Erich Janssen Chief Executive Officer General Practice Education and Training Ltd