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Medical Training Review Panel—Eighteenth Report, May 2015


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May 2015 Medical Training Review Panel

Eighteenth Report

Medical Training Review Panel 18th Report

Print ISBN: 978-1-76007-162-2 Online ISBN: 978-1-76007-163-9

Publications approval number: 11027

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This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Communication Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or via e-mail to copyright@health.gov.au.

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MTRP 18th Report

Medical Training Review Panel

GPO Box 9848, Canberra ACT 2601

Telephone: (02) 6289 9175 MTRP@health.gov.au

The Hon Sussan Ley MP Minister for Health Minister for Sport Parliament House Canberra ACT 2600

Dear Minister

In accordance with the requirements of subsection 3GC(4) of the Health Insurance Act 1973, I am pleased to submit to you the eighteenth report of the Medical Training Review Panel (MTRP).

The report covers the three levels of medical training in Australia, providing data on all trainees in undergraduate, postgraduate and vocational training programs in 2014. It also provides information on graduates and college fellows for 2013. Details of overseas trained medical practitioners and their education levels, and their migration patterns to work in Australia have also been documented to provide a more complete picture of the supply of medical practitioners.

Data were provided by the Medical Deans Australia and New Zealand Inc., state and territory health departments through their postgraduate medical councils, specialist medical colleges, General Practice Education and Training Limited and the Australian Medical Council. Selected administrative data from the Australian Government Department of Health and the Australian Government Department of Immigration and Border Protection are also included in the report.

In 2014, there were 16,837 medical students studying in Australian universities. Over three-quarters of all places were Commonwealth-supported.

Of the total medical students, 3,737 were in the first year of their medical studies and 3,185 or 85.2% of these were domestic students. Domestic students with a rural background comprised just over a quarter of all commencing domestic students.

Overall international students occupied 2,453 or 14.6% of places. These students were studying onshore in Australia as private or sponsored students and were not Australian citizens, permanent residents or New Zealand citizens.

In 2013, a total of 3,441 students graduated from Australian medical schools. Of these, 2,944 or 85.6% were domestic students.

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There were also 3,287 trainees commencing their postgraduate year 1 training in 2014. This was an increase of 169 (5.4%) from 2013.

The number of vocational medical trainees (19,158) in 2014 was over two and a half times the number reported in 2000.

There were 2,954 new college fellows in 2013, of these over two-fifths were females.

In 2013, a total of 50,704 medical practitioners were fellows of medical colleges, over one-third of all fellows were females.

In 2013-14, there were 2,650 visas granted to medical practitioners across the two main subclasses - 457 and 442/402. Almost half of visas under the main classes were granted to applicants from the United Kingdom and Republic of Ireland.

The data within the report highlight the continued increase in medical education and training that has occurred during the last ten years.

The production of the MTRP annual report is managed with involvement of representatives from the key stakeholders in medical workforce training. These representatives bring different insights into the way medical education and training can deal with the challenges of increasing student and trainee numbers, and produce a workforce with the skills that match the future needs of the Australian community.

Yours sincerely

Penny Shakespeare Chair Medical Training Review Panel

15 April 2015

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Contents

LIST OF TABLES ................................................................................................................. X

LIST OF FIGURES ............................................................................................................. XVI

ACRONYMS .....................................................................................................................XVII

EXECUTIVE SUMMARY ........................................................................................................ 1

University Medical Training .............................................................................................. 1

Prevocational Medical Training ........................................................................................ 5

Vocational Medical Training ............................................................................................. 6

Fellowship ...................................................................................................................... 8

Female Medical Training ............................................................................................... 10

International Supply of Medical Practitioners ..................................................................11

CHAPTER 1: INTRODUCTION ..............................................................................................13

Medical Training Review Panel Structure and Responsibilities ...........................................13

Report Structure........................................................................................................... 14

University Medical Education ................................................................................... 14

Prevocational Medical Training ................................................................................. 14

Vocational Medical Training ..................................................................................... 14

International Supply ................................................................................................ 14

Special Purpose Training Programs ......................................................................... 14

Appendices ............................................................................................................ 15

Notes on the Data and its Preparation ............................................................................ 15

Data Sources .......................................................................................................... 15

Data Quality Issues ................................................................................................. 16

Reporting Periods ................................................................................................... 16

Examination of Trends ............................................................................................. 16

Medical College Acronyms and Specialties ................................................................17

CHAPTER 2: UNIVERSITY MEDICAL EDUCATION AND TRAINING ......................................... 18

Medical Students ......................................................................................................... 18

Current Data........................................................................................................... 19

Types of Student Places .......................................................................................... 22

Scholarships ........................................................................................................... 26

Student Characteristics ........................................................................................... 26

Aboriginal and/or Torres Strait Islander Students ....................................................... 31

Rural Exposure ....................................................................................................... 32

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Attrition Rates ........................................................................................................ 34

Trends ................................................................................................................... 40

Medical Graduates ....................................................................................................... 42

Current Data........................................................................................................... 42

Trends ................................................................................................................... 42

Projected Numbers of Graduates ............................................................................. 46

CHAPTER 3: PREVOCATIONAL MEDICAL TRAINING ............................................................ 50

Background ................................................................................................................. 50

Postgraduate Year 1 ..................................................................................................... 51

Current Data........................................................................................................... 51

Internship in Rural Location ..................................................................................... 53

Trends ................................................................................................................... 54

Postgraduate Year 2 ..................................................................................................... 55

Current Data .......................................................................................................... 55

Trends ................................................................................................................... 57

CHAPTER 4: VOCATIONAL MEDICAL TRAINING .................................................................. 58

Vocational Medical Training in Australia.......................................................................... 58

General Practice Training ......................................................................................... 59

Changes to College Training in Australia ................................................................... 60

Accredited Training ....................................................................................................... 61

Vocational Training Data ................................................................................................ 63

Basic Training ........................................................................................................ 65

Trends in Basic Training .......................................................................................... 67

Advanced Training .................................................................................................. 71

Subspecialty Training .............................................................................................. 78

Trends in Advanced Training .................................................................................... 85

General Practice .................................................................................................... 90

Medical College Examinations ....................................................................................... 92

Current Data........................................................................................................... 92

Trends ................................................................................................................... 96

New College Fellows ..................................................................................................... 99

Current Data........................................................................................................... 99

Trends ................................................................................................................ 103

New Fellows by Subspecialty - Selected Colleges .................................................. 106

College Fellows ..........................................................................................................110

Fellows by Subspecialty - Selected Colleges ..........................................................114

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CHAPTER 5: INTERNATIONAL SUPPLY .............................................................................118

Australian Government Department of Immigration and Border Protection Entry Processes ..118 Temporary Work (Skilled) visa (subclass 457) .........................................................118

Medical Practitioner (Temporary) visa (subclass 422) ..............................................119

Occupational Trainee visa (subclass 442) .............................................................. 120

Training and Research visa (subclass 402) ............................................................ 120

Current Data .........................................................................................................121

Requirements for Practicing Medicine in Australia ........................................................ 123

Common Assessment Requirements ......................................................................124

Competent Authority Pathway ................................................................................124

Standard Pathway ................................................................................................ 126

Assessment of Overseas Trained Specialists .......................................................... 129

Standard Specialist Assessment ........................................................................... 130

Medicare Provider Number Restrictions ...................................................................... 133

Restrictions of Practice ........................................................................................ 133

Current Distribution of Overseas Trained Doctors ................................................... 134

CHAPTER 6: SPECIAL PURPOSE TRAINING PROGRAMS ...................................................137

Background ...............................................................................................................137

3GA Programs Providers ............................................................................................ 138

Section 3GA Programs .............................................................................................. 140

Approved Medical Deputising Services Program .................................................... 140

Approved Private Emergency Department Program ................................................ 140

Approved Placements for Sports Physicians Program ............................................. 140

Sports Physician Trainees ..................................................................................... 140

Australian General Practice Training .......................................................................141

Prevocational General Practice Placements Program ...............................................141

Queensland Country Relieving Doctors Program .....................................................142

Rural Locum Relief Program ..................................................................................142

Special Approved Placements Program ..................................................................142

Temporary Resident Other Medical Practitioners Program ...................................... 143

Remote Vocational Training Scheme ...................................................................... 143

APPENDICES .................................................................................................................. 144

Appendix A: MEDICAL TRAINING REVIEW PANEL ROLE AND MEMBERSHIP ................ 145

Appendix B: MEDICAL COLLEGE TRAINING REQUIREMENTS ...................................... 148

Appendix C: GLOSSARY OF TERMS .......................................................................... 203

Appendix D: EXTENDED DATA TREND TABLES ........................................................... 207

Appendix E: DATA SPECIFICATIONS ........................................................................... 251

Appendix F: TRAINING PROGRAM TERMINOLOGY ....................................................... 261

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List of Tables

TABLE DESCRIPTION PAGE

CHAPTER 1: INTRODUCTION

Table 1.1: Medical colleges: Acronyms, names and specialties ........................................... 17

CHAPTER 2: UNIVERSITY MEDICAL EDUCATION AND TRAINING

Table 2.1: Medical students in Australian universities, 2014 ................................................ 19

Table 2.2: Domestic medical students in Australian universities, 2014 .................................20 Table 2.3: International medical students in Australian universities, 2014 .............................21 Table 2.4: International students studying in Australian offshore programs, 2014 .................22 Table 2.5: Medical students by type of student place and university, 2014 ...........................23 Table 2.6: Commencing medical students by type of student place

and university, 2014 ..........................................................................................24

Table 2.7: Medical students by type of student place: Number and proportion of places, 2010-2014 ....................................................25

Table 2.8: Commencing medical students source of scholarships, 2013 ..............................26 Table 2.9: Commencing medical students by sex and age, 2013 .........................................26

Table 2.10: Commencing medical students discipline of highest tertiary qualification completed, 2013 ............................................................................27

Table 2.11: Commencing medical students level of highest prior tertiary qualification by medical degree entry program, 2013 ..........................................27

Table 2.12: Preferred type of medical practice in final year of medical degree by gender, 2013 .......................................................................................28

Table 2.13: Preferred type of medical practice in postgraduate year 1 by gender, 2013 ..........29 Table 2.14: International commencing medical students holding temporary or ‘other’ entry permits by place of birth, 2013 ...................................................31

Table 2.15: Commencing medical students by Aboriginal and/or Torres Strait Islander status, 2008-2013 ............................................................................................31

Table 2.16: Aboriginal and/or Torres Strait Islander medical students studying in Australian universities, 2006-2014 ....................................................................32

Table 2.17: Commencing domestic students with a rural background by state/territory, 2014 ......................................................................................33

Table 2.18: Commencing domestic medical students: Attrition rates, 2013 ............................35 Table 2.19: Commencing international medical students: Attrition rates, 2013 .......................36 Table 2.20: Commencing medical students: Attrition rates, 2008-2013 .................................37 Table 2.21: Continuing domestic medical students: Attrition rates, 2013 ................................38 Table 2.22: Continuing international medical students: Attrition rates, 2013 ............................39 Table 2.23: Continuing medical students: Attrition rates, 2008-2013 .....................................40 Table 2.24: Commencing medical students: Domestic, international and

proportion of females, 2010-2014 .....................................................................41

Table 2.25: Commencing medical student projections, 2015 .................................................41

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Table 2.26: Medical students: Domestic, international and proportion of females, 2010-2014 ........................................................................................42

Table 2.27: Domestic medical school graduates in Australian universities, by state/territory, 2009-2013 ............................................................................43

Table 2.28: International medical school graduates in Australian universities by state/territory, 2009-2013 .................................................................................44

Table 2.29: Medical graduates: Domestic, international and proportions of females, 2009-2013.......................................................................................................45

Table 2.30: Medical graduates by type of student place: Number and proportion of places, 2012-2013 ........................................................................46

Table 2.31: Domestic medical students expected to graduate from Australian universities: Projected numbers by state/territory, 2014-2019 ..............................47 Table 2.32: International medical students expected to graduate from Australian universities: Projected numbers by state/territory, 2014-2019 .............................48 Table 2.33: Medical students expected to graduate from Australian universities:

Projected number of domestic and international students, 2014-2019 .................49

CHAPTER 3: PREVOCATIONAL MEDICAL TRAINING

Table 3.1: Commencing postgraduate year 1 trainees or supervised training positions: Total, females and proportion of females by doctor category and state/territory, 2014 ....................................................................................52

Table 3.2: Commencing postgraduate year 1 trainees or supervised training positions (RA2-RA5) by state/territory, 2014 ....................................................................54

Table 3.3: Commencing postgraduate year 1 trainees by state/territory, 2010-2014 .............55 Table 3.4: Commencing doctors in postgraduate year 2 training positions: Total, females and proportion of females by doctor category and state/territory, 2014 ................56 Table 3.5: Postgraduate year 2 commencements by state/territory, 2010-2014 ...................57

CHAPTER 4: VOCATIONAL MEDICAL TRAINING

Table 4.1: Basic training: Positions/posts and facilities/programs by medical specialty, 2014 .......................................................................................61

Table 4.2: Advanced training: Positions/posts and facilities/programs by medical specialty, 2014 .....................................................................................62

Table 4.3: Vocational training positions/trainees by medical specialty, 2014 .........................64 Table 4.4: Basic trainees and first-year basic trainees by medical specialty and state/territory, 2014 ..........................................................................................66

Table 4.5: Female basic trainees by medical specialty and state/territory, 2014 ....................67 Table 4.6: Vocational training positions/trainees: Total, basic, female basic and first-year basic trainees, 2010-2014 ..................................................................68

Table 4.7: Basic training positions/trainees by medical specialty, 2010-2014 .......................68 Table 4.8: Basic training positions/trainees by state/territory, 2010-2014 ............................69 Table 4.9: First-year basic trainees by medical specialty, 2010-2014 ...................................69

Table 4.10: First-year basic trainees by state/territory, 2010-2014 ........................................70

Table 4.11: Proportion of female basic trainees by medical specialty, 2010-2014 ...................70

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Table 4.12: Proportion of female basic trainees by state/territory, 2010-2014 ........................71 Table 4.13: Advanced training positions/trainees by medical specialty and state/territory, 2014 ....................................................................................72

Table 4.14: Proportion of advanced training positions/trainees by medical specialty and state/territory, 2014 ....................................................................................73

Table 4.15: First-year advanced positions/trainees by medical specialty and state/territory, 2014 .......................................................................................... 74

Table 4.16: Female advanced trainees by medical specialty and state/territory, 2014 .............75 Table 4.17: Advanced trainees undertaking part-time training by medical specialty and state/territory, 2014 ....................................................................................77

Table 4.18: Advanced trainee discontinuations by state/territory, 2010-2014 .........................78 Table 4.19: Obstetrics and gynaecology advanced trainees: Total, proportion of total and females by subspecialty, 2014 .....................................................................78

Table 4.20: Pathology advanced trainees: Total, proportion of total and females by subspecialty, 2014 ........................................................................................79

Table 4.21: Pathology advanced trainees by subspecialty and state/territory, 2014 .................79 Table 4.22: Physician adult medicine advanced trainees: Total, proportion of total and females by subspecialty, 2014 .....................................................................80

Table 4.23: Physician adult medicine advanced trainees by subspecialty and state/territory, 2014 ..........................................................................................81

Table 4.24: Physician paediatric and child health advanced trainees: Total, proportion of total and females by subspecialty, 2014 .........................................................82

Table 4.25: Physician paediatric and child health advanced trainees by subspecialty and state/territory, 2014 ....................................................................................83

Table 4.26: Surgical advanced trainees: Total, proportion of total and females by subspecialty, 2014 ............................................................................................84

Table 4.27: Surgical advanced trainees by subspecialty and state/territory, 2014 ...................84 Table 4.28: Vocational training positions/trainees: Total, advanced, female advanced and part-time advanced trainees, 2010-2014 .....................................................85

Table 4.29: Advanced training positions/trainees by medical specialty, 2010-2014 ................86 Table 4.30: Advanced training positions/trainees by state/territory, 2010-2014 ......................87 Table 4.31: Proportion of female advanced trainees by medical specialty, 2010-2014 ............88 Table 4.32: Proportion of female advanced trainees by state/territory, 2010-2014 ..................89 Table 4.33: Advanced trainees undertaking part-time training by medical

specialty, 2010-2014 ........................................................................................90

Table 4.34: General practice trainees: Registrars, first-year registrars and female registrars by state/territory and training consortium, 2014 ...................................91

Table 4.35: General practice rural pathway trainees by state/territory, 2014 ...........................92 Table 4.36: Vocational trainees sitting a final or fellowship examination: Trainees sitting and proportion passing by medical specialty, 2013 ...................................92

Table 4.37: Vocational trainees undertaking additional examinations: Numbers and proportions passing by medical specialty, 2013 ..................................................94

Table 4.38: Vocational trainees who passed final or fellowship examination by medical specialty, 2009-2013 ........................................................................................97

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Table 4.39: Proportion of vocational trainees sitting a final or fellowship examination who passed by medical specialty, 2009-2013 .................................98

Table 4.40: New fellows: Total, females and overseas trained specialists by medical specialty, 2013 ...................................................................................100

Table 4.41: New fellows by medical specialty and state/territory, 2013 ................................101 Table 4.42: Female new fellows by medical specialty and state/territory, 2013 .....................102 Table 4.43: New fellows by medical specialty, 2009-2013 ..................................................103

Table 4.44: New fellows by state/territory, 2009-2013 ........................................................104

Table 4.45: Proportion of female new fellows by medical specialty, 2009-2013....................105 Table 4.46: Proportion of female new fellows by state/territory, 2009-2013 .........................106 Table 4.47: Obstetrics and gynaecology subspecialties: New fellows, females and proportion of females by subspecialty, 2013 ....................................................106

Table 4.48: Pathology subspecialties: New fellows, females and proportion of females by subspecialty, 2013 ......................................................................... 107

Table 4.49: Physician adult medicine subspecialties: New fellows, females and proportion of females by subspecialty, 2013 .....................................................108

Table 4.50: Physician paediatric and child health subspecialties: New fellows, females and proportion of females by subspecialty, 2013 ..................................109

Table 4.51: Surgical subspecialties: New fellows, females and proportion of females by subspecialty, 2013 ......................................................................... 110

Table 4.52: Fellows: Total, number and proportion of females, and new fellows and proportion of all fellows by medical specialty, 2013 ..................................... 111

Table 4.53: Fellows by medical specialty and state/territory, 2013 ....................................... 112

Table 4.54: Female fellows by medical specialty and state/territory, 2013 ............................ 113 Table 4.55: Pathology fellows: Total, females and proportion of females by subspecialty, 2013 .......................................................................................... 114

Table 4.56: Physician adult medicine fellows: Total, females and proportion of females by subspecialty, 2013 ......................................................................... 115

Table 4.57: Physician paediatrics and child health fellows: Total, females and proportion of females by subspecialty, 2013 ..................................................... 116

Table 4.58: Surgical fellows: Total, females and proportion of females by subspecialty, 2013 ...................................................................................... 117

CHAPTER 5: INTERNATIONAL SUPPLY

Table 5.1: Major classes of primary visa granted to medical practitioners, 2009-2010 to 2013-2014 ............................................................................... 121

Table 5.2: Primary visa applications granted to medical practitioners by visa subclass: Top 10 citizenship countries, 2013-14 ...............................................122

Table 5.3: Primary visa holders where the occupation is medical practitioner by visa subclass, 2012-13 and 2013-14 ...............................................................122

Table 5.4: International medical graduates: Applications assessment through Competent Authority Pathway, 2013 ................................................................ 125

Table 5.5: International medical graduates: Applications assessed through Standard Pathway AMC examination, 2013 ......................................................126

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Table 5.6: International medical graduates: Workplace-based assessment through Standard Pathway, 2013 ..................................................................... 128

Table 5.7: Specialist assessment process by medical specialty, 2013 ................................ 131 Table 5.8: Substantially comparable specialist applications by country of training and medical speciality, 2013 ................................................................ 132

Table 5.9: Overseas trained doctors with Section 19AB exemptions, 2014 .........................134 Table 5.10: Overseas trained doctors by state/territory, 2014 ..............................................134

CHAPTER 6: SPECIAL PURPOSE TRAINING PROGRAMS

Table 6.1: Providers on approved 3GA programs placements, 2004-05 to 2013-14 ...........139

APPENDIX B: MEDICAL COLLEGE TRAINING REQUIREMENTS

Table B1: Summary of specialty training requirements and entry time, 2013 .....................148 Table B2: Summary of specialty part-time training requirements, 2013 ............................. 151 Table B3: Summary of specialty interrupted training requirements, 2013 ...........................153

APPENDIX D: EXTENDED DATA TREND TABLES

Table D1: Commencing medical students: Domestic, international and proportion of females, 2000-2014 ...................................................................209

Table D2: Commencing medical students by university and state/territory, 2005-2014 .....................................................................................................210

Table D3: Commencing domestic medical students by university and state/territory, 2005-2014 ............................................................................... 212

Table D4: Commencing international medical students by university and state/territory, 2005-2014 ............................................................................... 214

Table D5: Medical students in Australian universities, 2000-2014 ....................................216

Table D6: Medical students: Domestic, international and total by state/territory, 2005-2014 ............................................................................... 217

Table D7: Domestic medical school graduates from Australian universities, 1997-2013 ...... 219 Table D8: Medical graduates: Domestic, international and proportion of domestic, international and females, 1999-2013 ..............................................................220

Table D9: Medical graduates: Domestic, international and total by state/territory, 2004-2013 .....................................................................................................221

Table D10: Postgraduate year 1: Commencing trainees or supervised training places by state/territory, 2004-2014 ................................................................223

Table D11: Postgraduate year 2: Commencing doctors by state/territory, 2004-2014 .....................................................................................................224

Table D12: Basic training positions/trainees by medical speciality, 2000-2014 ....................225 Table D13: Basic training positions/trainees by state/territory, 2000-2014 ..........................226 Table D14: Basic training first-year positions/trainees by medical speciality, 2000-2014.....................................................................................................227

Table D15: Basic training first-year positions/trainees by state/territory, 2000-2014 ............228 Table D16: Basic trainees: Proportion of females by medical speciality, 2000-2014 .............229 Table D17: Basic trainees: Proportion of females by state/territory, 2000-2014 ...................230

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Table D18: Vocational training positions/trainees: Total, basic, female basic and first-year basic trainees, 2000-2014 ................................................................231

Table D19: Advanced training positions/trainees by medical speciality, 1997-2014 ..............232 Table D20: Advanced training positions/trainees by state/territory, 1997-2014 ....................234 Table D21: Advanced training first-year positions/trainees by medical speciality, 1997-2014 .....................................................................................................235

Table D22: Advanced training first-year positions/trainees by state/territory, 1997-2014 .....................................................................................................237

Table D23: Advanced trainees: Proportion of females by medical speciality, 1997-2014 .....................................................................................................238

Table D24: Advanced trainees: Proportion of females by state/territory, 1997-2014 .............239 Table D25: Vocational training positions/trainees: Total, advanced, female advanced and part-time advanced trainees, 1997-2014 .........................240 Table D26: New fellows by medical speciality, 2000-2013 ................................................. 241

Table D27: New fellows by state/territory, 2000-2013 ........................................................243

Table D28: New female fellows by state/territory, 2000-2013 .............................................244

Table D29: New fellows: Proportion of females by medical speciality, 2000-2013 ................245 Table D30: New fellows: Proportion of females by state/territory, 2000-2013 ......................246 Table D31: Fellows by medical speciality, 2008-2013 ........................................................ 247

Table D32: Fellows by state/territory, 2008-2013 ..............................................................249

Table D33: Female fellows by state/territory, 2008-2013 ...................................................249

Table D34: Fellows: Proportion of females by medical speciality, 2008-2013 .......................250 Table D35: Fellows: Proportion of females by state/territory, 2008-2013 .............................250

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List of Figures

FIGURE DESCRIPTION PAGE

EXECUTIVE SUMMARY

Figure 1: Medical students by type of student place: Number and proportion of places, 2014 ..................................................................................... 2

Figure 2: Commencing medical students by age groups, 2013 ............................................ 3

Figure 3: Domestic and international medical graduates, 1999-2013 .................................. 4

Figure 4: Projections of domestic and international medical graduates, 2013-2019 .............. 4 Figure 5: Postgraduate year 1 commencements, 2005-2014 ............................................. 5

Figure 6: Postgraduate year 2 commencements, 2005-2014 ............................................. 6

Figure 7: Vocational medical trainees, 2000-2014 ............................................................. 7

Figure 8: Vocational trainee positions by medical specialty, 2014 ......................................... 8

Figure 9: New fellows by gender, 2000-2013 ..................................................................... 9

Figure 10: Proportion of new fellows by medical specialty, 2013 .......................................... 10

Figure 11: Country of training of overseas trained specialists with approved applications, 2013 ...................................................................................................12

CHAPTER 5: INTERNATIONAL SUPPLY

Figure 5.1: Overseas trained doctors in Major cities by state/territory, 2014 ........................ 135 Figure 5.2: Overseas trained doctors in Inner regional areas by state/territory, 2014 ............ 135 Figure 5.3 Overseas trained doctors in Outer regional areas by state/territory, 2014 ........... 136 Figure 5.4: Overseas trained doctors in Remote and Very remote areas by

state/territory, 2014 ........................................................................................ 136

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Acronyms ABS Australian Bureau of Statistics

ACD Australasian College of Dermatologists

ACEM Australasian College for Emergency Medicine

ACRRM Australian College of Rural and Remote Medicine

ACSP Australasian College of Sports Physicians

AGPT Australian General Practice Training Program

AMC Australian Medical Council

AMDSP Approved Medical Deputising Services Program

ANU Australian National University

ANZCA Australian and New Zealand College of Anaesthetists

ANZCA-FPM Australian and New Zealand College of Anaesthetists - Faculty of Pain Medicine

APEDP Approved Private Emergency Department Program

APSPP Approved Placements for Sports Physicians

ASGC-RA Australian Standard Geographical Classification - Remoteness Area

AST Advanced Specialist Training

BMP Bonded Medical Places Scheme

CCT Core clinical training

CICM College of Intensive Care Medicine of Australia and New Zealand

CMO Career Medical Officer

COAG Council of Australian Governments

CPMEC Confederation of Postgraduate Medical Education Councils

DWS District of Workforce Shortage

FACRRM Fellowship of the Australian College of Rural and Remote Medicine

FARGP Fellowship in Advanced Rural General Practice

FGAMS Foreign graduates of an accredited medical school

FTE Full-time equivalent

GPET General Practice Education and Training Ltd

HECS-HELP Higher Education Contribution Scheme - Higher Education Loan Program

HMO Hospital Medical Officer

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MTRP 18th Report

MBBS Bachelor of Medicine and Bachelor of Surgery

MCQ Multiple Choice Questionnaire

MD Doctor of Medicine

MDANZ Medical Deans Australia and New Zealand Inc.

MRBS Medical Rural Bonded Scholarship Scheme

MSOD Medical Schools Outcomes Database

MTRP Medical Training Review Panel

PESCI Pre-employment structured clinical interview

PG Postgraduate

PGPPP Prevocational General Practice Placements Program

PGY1 Postgraduate Year 1 (also known as Intern year)

PGY2 Postgraduate Year 2

PGY3 Postgraduate Year 3

PREP Physician Readiness for Expert Practice

PRRT Primary Rural and Remote Training

QCRD Queensland Country Relieving Doctors Program

RACDS Royal Australasian College of Dental Surgeons

RACGP Royal Australian College of General Practitioners

RACMA Royal Australasian College of Medical Administrators

RACP Royal Australasian College of Physicians

RACP-AChAM Royal Australasian College of Physicians - Australasian Chapter of Addiction Medicine

RACP-AChPM Royal Australasian College of Physicians - Australasian Chapter of Palliative Medicine

RACP-AFOEM Royal Australasian College of Physicians - Australasian Faculty of Occupational and Environmental Medicine

RACP-AFPHM Royal Australasian College of Physicians - Australasian Faculty of Public Health Medicine

RACP-AFRM Royal Australasian College of Physicians - Australasian Faculty of Rehabilitation Medicine

RACP-AM Royal Australasian College of Physicians - Adult Medicine Division

RACP-PCH Royal Australasian College of Physicians - Paediatrics and Child Health

RACS Royal Australasian College of Surgeons

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RANZCO Royal Australian and New Zealand College of Ophthalmologists

RANZCOG Royal Australian and New Zealand College of Obstetricians and Gynaecologists

RANZCP Royal Australian and New Zealand College of Psychiatrists

RANZCR Royal Australian and New Zealand College of Radiologists

RCPA Royal College of Pathologists of Australasia

RLRP Rural Locum Relief Program

RMO Resident Medical Officer

RRMA Rural, Remote and Metropolitan Areas (Classification System)

RTP Regional Training Provider

RVTS Remote Vocational Training Scheme

RWA Rural Workforce Agency

SET Surgical Education and Training

TMO Trainee Medical Officer

TROMPs Temporary Resident Other Medical Practitioners Program

UG Undergraduate

UNE University of New England

UNSW University of New South Wales

UQ University of Queensland

UWA University of Western Australia

UWS University of Western Sydney

Symbols and other usages - Nil or rounded to zero

.. Not applicable

na Not available

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MTRP 18th Report

EXECUTIVE SUMMARY The Medical Training Review Panel (MTRP) was formed under legislation in 1997 to report to the Commonwealth Minister for Health on the activities of the MTRP and provide data on medical training opportunities in Australia. Over the years, through its annual report, the Panel has provided a comprehensive picture of medical education and training, supplementing this with other data on the medical workforce supply.

The eighteenth annual report of the MTRP, like the previous reports, provides information on university, prevocational and vocational medical training positions, students and trainees, examination results and college fellows. Information is also included on overseas trained medical practitioners who are seeking to work or currently work in Australia.

The report was compiled by the Australian Government Department of Health, with oversight by the MTRP.

Data were provided by the Medical Deans Australia and New Zealand Inc. (Medical Deans), state and territory health departments through their postgraduate medical councils, specialist medical colleges, General Practice Education and Training Limited (GPET) and the Australian Medical Council (AMC). Selected administrative data from the Australian Government Department of Health and the Australian Government Department of Immigration and Border Protection have also been included.

To aid readability, tables in the body of the report present time series information on the last five years for which data were available. Data for all years are included in Appendix D and where possible date back to 1997, which was the first year of annual reporting by the MTRP. For the purposes of the Executive Summary, the latest available data have been summarised and trends in the data have been examined across all years for which national data were available.

University Medical Training In Australia, professional entry level medical education is provided by university medical schools as four to six year bachelor degree or largely four year postgraduate master level degree courses. There are 18 universities with accredited medical schools, and a number of these were established in the last ten years. All of these universities have now produced graduates. The University of Melbourne was the first to commence Doctor of Medicine (MD) program in 2011 and had the first cohort of postgraduate degree graduates in 2014.

In 2014, there were 16,837 medical students studying in Australian universities. This was a decrease of less than one percent (157 or 0.9%) from 2013. Almost half (8,132 or 48.3%) of these students were undertaking a four-year course. This was slightly higher than in 2013 (7,805 or 45.9%).

Over three-quarters of all places in 2014 were Commonwealth-supported (13,351 or 79.3%). This is similar to previous years, with 78.4% of students receiving Commonwealth support in 2013 and 78.8% in 2012. Figure 1 shows that the majority of these students (9,587 or 71.8%) received support through the Higher Education Contribution Scheme - Higher Education Loan Program (HECS-HELP) only. The remaining students were in bonded places receiving assistance through the Bonded Medical Places (BMP) Scheme and the Medical Rural Bonded Scholarship (MRBS) Scheme.

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MTRP 18th Report

Students participating in the BMP Scheme have a return of service obligation to work in a District of Workforce Shortage (DWS) as identified by the Commonwealth, for a period of time equal to the length of the medical degree. However, up to half of the return of service obligation can be met while completing prevocational and vocational training.

Recipients of the MRBS Scheme scholarship are required to work for six continuous years in locations within Australian Standard Geographical Classification - Remoteness Areas (ASGC-RA) 2 to 5. MRBS Scheme doctors start their six year commitment to work in rural Australia after completing their vocational training.

In addition, medical students can be supported by scholarships through a variety of other sources, namely the state or territory, the university or other institutions and, for international students, their home country.

Overall, international students occupied 2,453 or 14.6% of places. These students were studying as private or sponsored students and were not Australian citizens, permanent residents or New Zealand citizens. This proportion decreased from 2013. A small proportion of Australian citizens (936 or 5.6% of medical students) also pay fees.

Other fee-paying, 0.6% (97)

Commonwealth-supported HECS-HELP only, 56.9% (9,587)

Commonwealth-supported BMP Scheme, 19.8% (3,327)

Commonwealth-supported MRBS Scheme, 2.6% (437)

Domestic fee-paying, 5.6% (936)

International fee-paying, 14.6% (2,453)

Source: Medical Deans Australia and New Zealand Inc

In 2014, 275 medical students identified that they were of Aboriginal or Torres Strait Islander descent. Although this is a small proportion of all medical students, it represents an increase of 5.4% from 2013 and is over two-and-a-half times the number of students who identified themselves as Aboriginal and/or Torres Strait Islander people(s) in 2006 (99).

Of the total medical students, 3,737 were in the first year of their medical studies and 3,185 or 85.2% of these were domestic students.

Most students were under the age of 25 years when they commenced their medical studies. Data from 2013 shows that just over three quarters (76.6%) of students were under 25 years

Figure 1: Medical students by type of student place: Number and proportion of places, 2014

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MTRP 18th Report

Adult medicine and general practice were among the most preferred types of future medical practice for students in their final year of medical school and in their first postgraduate year (PGY1). Males ranked surgery as their most popular preference, while females favoured general practice.

Domestic students with a rural background comprised just over a quarter of all commencing domestic students (878 or 27.6%).

Over the last decade, the total number of commencing medical students has almost doubled, with the intake increasing by 1,617 or 76.3% from 2,120 in 2004 to 3,737 in 2014. This was primarily due to increases in the number of commencing domestic students, which rose by 87.5% compared with an increase of 31.1% for international students.

These increases are mirrored in the number of medical graduates each year. In 2013 there were 3,441 medical graduates, over double the 1,400 graduates in 1999 (Figure 3). The increase in numbers graduating annually fluctuated slightly up until 2006, but since then there have been marked annual changes.

The trend is somewhat different between graduating domestic and international students. International students constituted just 10.3% (or 144 of 1,400 graduates) in 1999, the first year for which data on these graduates were published. Since then the number has more than trebled, rising to 497 graduating international students in 2013. The number has also increased as a proportion of all medical graduates, reaching a peak of 19.5% in 2009. The proportions of graduating international students have seen a downward trend since 2009, where it decreased to 14.4% of all medical graduates in 2013.

(Figure 2). A further 16.2% were aged between 25 and 29 years and 7.2% were 30 years or older. Over half (57.3%) of the medical students commencing in 2013 began their studies after finishing another degree.

40 years and over, 34, 1.0%

Less than 20 years, 941, 26.8%

20-24 years, 1,747, 49.8%

25-29 years, 570, 16.2%

30-34 years, 162, 4.6%

35-39 years, 57, 1.6%

Source: Medical Schools Outcomes Database

Figure 2: Commencing medical students by age groups, 2013

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MTRP 18th Report

The number of domestic students graduating each year increased from 1,256 in 1999 to 2,944 in 2013.

In 2013, 2,765 or 80.4% of medical graduates were Commonwealth-supported, with the majority of these in HECS-HELP only places. Almost three-quarters of fee-paying graduates were international students (74.5%).

Source: Medical Deans Australia and New Zealand Inc

From 2012 to 2013, the actual number of graduates increased by 4.8% rising from 3,284 to 3,441. It is projected that there will be 3,549 medical graduates in 2014, with a further small increase anticipated in 2015 (to 3,712). Based on current student enrolments it is expected that the number of medical graduates will be 3,763 in 2019 (Figure 4).

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000 International

Domestic

2013 Actual 2014 2015 2016 2017 2018 2019

Medical graduates

Source: Medical Deans Australia New Zealand Inc

Figure 3: Domestic and international medical graduates, 1999-2013

Figure 4: Projections of domestic and international medical graduates, 2013-2019

International Domestic

Medical graduates

3,500

0

500

1,000

1,500

2,000

2,500

3,000

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2011 2012 2013 2010

International Domestic

Medical graduates

3,500

0

500

1,000

1,500

2,000

2,500

3,000

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2011 2012 2013 2010

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MTRP 18th Report

Prevocational Medical Training Satisfactory completion of the first postgraduate year (PGY1) is required before junior doctors are eligible for general registration. After PGY1, and prior to starting vocational training, most doctors spend one or more years working in public, private or community settings to gain more clinical experience.

In 2014, there were 3,287 trainees commencing PGY1 (Figure 5). This was an increase of 169 (5.4%) from 2013.

Just over four-fifths (2,651 or 80.7%) of all PGY1 trainees commenced training in the state or territory where they completed their medical degree.

PGY1 commencements have increased substantially each year, with the exception of 2007, showing an overall increase of 1,665 or 102.7% trainees from 2005 to 2014.

0

500

1,000

1,500

2,000

2,500

3,000

3,500

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

PGY1 commencements

Source: State and Territory government health departments

In 2014, there were 3,107 doctors who were identified as commencing in postgraduate year 2 (PGY2) supervised medical training positions across Australia. This was a decrease of 87 or 2.7% from the previous year (Figure 6). This is likely to be an underestimation of the true numbers of doctors undertaking their second year of prevocational training, as unknown numbers may be recruited by health services.

The number of PGY2 commencements appears to have increased substantially in recent years. However, it is difficult to ascertain the true extent of the increase due to differences in the way prevocational trainees are actually contracted and methodological issues in obtaining data as a result of differences in the data captured through the various state and territory reporting systems.

Over two-thirds (2,343 or 75.4%) of all Australian trained PGY2 doctors commenced their second year of training in the state or territory in which they were trained in previously, compared with 351 or 11.3% who came from interstate.

Figure 5: Postgraduate year 1 commencements, 2005-2014

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MTRP 18th Report

0

500

1,000

1,500

2,000

2,500

3,000

3,500

2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

PGY2 commencements

Source: State and Territory government health departments

Not all junior doctors go on to train in a medical specialty. A number continue to work in hospital settings in non-vocational career roles, typically as career medical officers (CMOs).

While a number of specialist medical colleges may accept entrants to vocational training programs directly following completion of PGY1, most require applicants to have completed the PGY2 in general prevocational training.

Vocational Medical Training Most junior doctors seek entry into specialist or vocational training, which leads to a fellowship from an accredited specialist medical college. In 2014, training was provided through the specialist medical colleges and, in the case of general practice, General Practice Education and Training Ltd (GPET) and a network of Regional Training Providers. Vocational training programs were accredited by the Australian Medical Council (AMC). Each college had its own training program and requirements.

Data covers all Australian trainees, as well as international medical graduates who were registered vocational trainees and who were working or training in an accredited training position, post, facility or program.

There were 19,158 vocational trainees in 2014 (Figure 7). This is over two and a half times the number reported in 2000 (7,262 vocational trainees).

In 2014, there were 6,367 basic trainees, representing one third (33.2%) of all trainees. There has been a constant increase in the number of basic trainees since 2005, mainly due to some colleges having introduced basic training as a pre-requisite to entry into their advanced training programs. Of the total number of basic trainees, 1,666 or 26.2% were in their first year.

In total, there were 12,791 advanced trainees in 2014, making up a larger proportion (66.8%) of the total number of trainees. The increase in basic trainees has resulted in advanced trainees

Figure 6: Postgraduate year 2 commencements, 2005-2014

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MTRP 18th Report

declining as a proportion of all trainees. However, total advanced trainee numbers have risen by 111.1% since 2005.

2000 2001 2002 2003 2005 2004 2006 2007 2008 2009 2010 2011 2012

Vocational medical trainees

Total Advanced Basic

2013 2014

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

Source: Medical colleges

The education and training requirements of each medical specialty depend on the type of clinical medical practice, but commonly include basic and advanced training. Where required, a trainee can only apply for and compete for a position on an advanced specialist training program after successfully completing a basic training program or at a minimum PGY2.

Approximately one-third (33.0%) of all vocational trainees positions were in specialties governed by the Royal Australasian College of Physicians (RACP), such as addiction medicine, adult medicine, occupational and environmental medicine, paediatrics, palliative medicine, public health medicine, rehabilitation medicine and sexual health medicine, with 23.0% in adult medicine (Figure 8). Almost one-quarter (23.4%) of all vocational trainee positions were in general practice and 11.0% were in emergency medicine.

Figure 7: Vocational medical trainees, 2000-2014

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MTRP 18th Report

Other specialties, 3.9%

General practice, 23.4%

Intensive care, 2.8%

Radiodiagnosis, 2.1%

Psychiatry, 6.7%

Ophthalmology, 0.8% Paediatrics, 7.7%

Obstetrics and Gynaecology, 2.8%

Dermatology, 0.5%

Emergency medicine, 11.0%

Pathology, 2.8%

Adult medicine, 23.0%

Surgery, 5.7%

Anaesthesia, 6.6%

Source: Medical colleges

Fellowship When medical practitioners finish their vocational training and have met all other requirements of the relevant specialist medical college, they are eligible to apply for fellowship of that college.

There were 2,954 new college fellows in 2013 (Figure 9). This is a significant increase since 2000, when the data were first collected, with the number of new fellows almost trebling (162.3%) from 1,126. The number of new fellows reported in 2013 slightly decreased from 2012, as new fellows who live overseas have been excluded from the total.

In 2013, over two-fifths (1,341 or 45.4%) of all new fellows were females.

Approximately one-quarter (710 or 24%) of new fellows were overseas trained specialists who had completed the requirements of the specialist medical colleges and were deemed substantially comparable with specialists trained by the medical college in Australia.

Figure 8: Vocational trainee positions by medical specialty, 2014

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MTRP 18th Report

0

500

1,000

1,500

2,000

2,500

3,000

3,500

Females Males

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2011 2012 2013 2010

New fellows

Source: Medical colleges

The proportion of new fellows in each medical specialty is shown in Figure 10. The proportionate split has remained approximately the same across the specialties over recent years, with two-fifths of all new fellows in general practice. General practice had the largest increase over the last five years in terms of absolute numbers, with 213 more new fellows in 2013 than in 2009. There were also large increases in the number of new fellows in anaesthesia (59), radiodiagnosis (56) and adult medicine (41) in 2013 over 2009.

Ophthalmology had the greatest proportional increase with the number of new fellows increasing from 11 to 36 (227.3%) between 2009 and 2013, radiodiagnosis also showed substantial growth in the last five years (127.3%).

The significance of the increased training activity and consequently the number of new fellows can be put into perspective by looking at it in relation to the total number of college fellows. There were 50,704 fellows of medical colleges reported as actively practising in their specialty.

Figure 9: New fellows by gender, 2000-2013

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MTRP 18th Report

Surgery, 6.5%

General practice, 40.0%

Intensive care, 1.8%

Radiodiagnosis, 3.4%

Psychiatry, 4.8%

Ophthalmology, 1.2%

Paediatrics, 4.5%

Obstetrics and gynaecology, 2.3%

Dermatology, 0.8%

Emergency medicine, 3.9%

Pathology, 3.3%

Adult medicine, 14.8%

Other specialties, 3.6%

Anaesthesia, 9.1%

Source: Medical colleges

Overall, new fellows represented 5.8% of all college fellows in 2013. The proportion of each college’s fellows who were new fellows varied greatly across specialties, with the largest proportions of new fellows (8.6%) in pathology and RACP (jointly), followed by emergency medicine (7.9%), intensive care medicine (7.3%) and radiation oncology (7.0%).

Female Medical Training In 2014, females comprised approximately half of the students commencing medical studies (52.3% domestic and 50.4% international students). Slightly different proportions of females (52.8% domestic and 49.1% international) were reported for medical graduates.

The proportion of female medical graduates has decreased slightly (0.8%) from 2012 to 52.3% in 2013. In vocational training, 53.9% of all basic trainees and 52.6% of advanced trainees were females in 2014. This proportion was far higher in some specialties, with females comprising three-fifths or more of advanced vocational trainees in obstetrics and gynaecology (74.5%), paediatrics (72.8%), public health medicine (72.8%), sexual health medicine (69.2%), rehabilitation medicine (66.3%), and general practice (63.1%). Oral and maxillofacial surgery (10.5%), sport and exercise medicine (22.0%) and surgery (27.5%) had low proportions of female advanced trainees in 2014.

The proportion of females who became new fellows in 2013 is somewhat lower than the proportion undertaking vocational training, remaining relatively stable at around two-fifths of the total new fellows each year since 2000. There were 1,341 new female fellows in 2013 (45.4%).

In 2013, 17,783 or 35.1% of all college fellows were females.

Figure 10: Proportion of new fellows by medical specialty, 2013

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MTRP 18th Report

International Supply of Medical Practitioners Overseas trained medical practitioners form a key part of the medical workforce in Australia, not only in rural and remote areas, but in metropolitan and regional areas.

In 2013-14, there were 2,650 visas granted to medical practitioners across the two main subclasses - 457 and 442/402. Almost half (44.1%) of visas under the main classes were granted to applicants from the United Kingdom and Republic of Ireland. Just 5.1% and 2.2% of the medical practitioners granted visas came from Canada and the United States of America respectively. More recently, larger numbers of international recruits have come from a number of Asian countries. In 2013-14, almost a third (28.5%) of all applications (visas under subclasses 457 and 442/402) was granted to medical practitioners from Malaysia (8.2%), India (6.9%), Sri Lanka (4.6%), Iran (3.2%), Singapore (3.2%) and Pakistan (2.4%).

In July 2006, the Council of Australian Governments (COAG) agreed to the introduction of a nationally consistent assessment process for international medical graduates and overseas trained specialists. This process now consists of three main assessment streams: the Competent Authority Pathway, the Standard Pathway and Specialist Pathway. The Australian Medical Council is responsible for processing applications by international medical graduates and overseas trained specialists.

In 2013, the Australian Medical Council assessed a total of 1,123 applicants through the Competent Authority Pathway, with 662 applicants being granted Australian Medical Council Certificates, allowing them to apply for general registration. Just over two-thirds of the Australian Medical Council Certificates granted in 2013 were to international medical graduates from the United Kingdom.

Under the Standard Pathway 1,508 international medical graduates passed the Multiple Choice Questionnaire (MCQ) examination and 1,055 passed the Australian Medical Council clinical examinations. A total of 76 international medical graduates passed workplace-based assessment of their clinical skills and knowledge by an AMC-accredited authority.

There were 2,234 overseas trained specialists who applied to be recognised as a specialist under the Specialist Pathway to registration in 2013. Medical colleges conduct the assessments of comparability to Australian standards for the specialists and found 349 substantially comparable. These specialists were still required to complete periods of oversight and workplace based assessments by most medical colleges before being recommended to specialist registration. A further 335 specialists were deemed as partially comparable and requiring further training and/or examinations.

Of the 349 overseas trained specialists who were recognised as substantially comparable, over half (179 or 51.3%) were trained in the United Kingdom and the Republic of Ireland. This is a decrease in the number approved from these countries in 2012 (311 or 59.4%). The next largest number of overseas trained specialists (Figure 11) found substantially comparable in 2013 came from India (50 or 14.3%).

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MTRP 18th Report

India, 14.3%

South Africa, 7.2%

New Zealand, 0.3%

Canada, 1.7%

Other, 18.1%

United States of America, 7.2%

United Kingdom and Ireland, 51.3%

Source: Australian Medical Council administrative data

Under Section 19AA of the Health Insurance Act 1973 (the Act), Special Purpose Training Programs provide for those doctors who are seeking vocational recognition, but who are not involved in a specialist training program. Some of these programs specifically cover medical practitioners who have trained overseas to assist with their integration into the Australian workforce.

At June 2014, there were 11,138 overseas trained doctors with section 19AB exemptions restricting their practice to Districts of Workforce Shortage (DWS).

Although overseas trained doctors comprise a higher proportion of the medical workforce in more remote areas of Australia, the majority work in Major cities and Inner regional areas.

There is considerable variation between states and territories in the overall and relative numbers of overseas trained doctors. Queensland has relatively high numbers across all regions. Western Australia has relatively higher numbers of overseas trained general practitioners in Remote and Very remote areas. New South Wales has many across all regions with a lower portion in Remote and Very remote areas. Victoria continues to have a higher number of overseas trained general practitioners in its Major cities and Inner regional areas. Generally across all regions there are more overseas trained general practitioners than specialists for each state/territory, except Queensland in Remote and Very remote areas, Tasmania in Inner regional areas and the Australian Capital Territory in Major cities.

Figure 11: Country of training of overseas trained specialists with approved applications, 2013

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MTRP 18th Report

Chapter 1 INTRODUCTION The eighteenth annual report of the Medical Training Review Panel (MTRP) documents the availability of training places at the undergraduate, prevocational and vocational levels. The report also includes information about special purpose programs and national projects related to the education and training of medical practitioners. The MTRP report is tabled annually in Parliament and distributed to key medical educational stakeholders and jurisdictions as well as being made available to other interested parties and the wider community via the internet1.

The report presents the latest annual information on the different stages in the university medical education and vocational training pathways, and also includes analysis of trends and patterns in the supply of the medical workforce, where possible back to 1997, the first year of MTRP reporting. Data on medical practitioners who have trained overseas and have applied, or are now working in Australia, are also included.

Medical Training Review Panel Structure and Responsibilities The MTRP was established as a time-limited committee in June 1997 by the then Minister for Health and Family Services under Section 3GC of the Health Insurance Act 1973 (the Act). The terms of reference of the committee were to monitor the availability and take-up of medical training places by Hospital Medical Officers (HMOs) who come under the proficiency standards created by the Health Insurance Act 1973 (No. 2) 1996. The MTRP was made a permanent body in 2001 to ensure that the monitoring and reporting function continued in the future. In 2009, a review of the functions of the MTRP was undertaken. This reaffirmed the important role that the MTRP plays, both as a forum bringing together key stakeholders in medical education and training and also as an advisory group informing work in relation to medical education and training in this country.

Member organisations of the MTRP are appointed by Ministerial determination and include Medical Deans Australia and New Zealand Inc. (Medical Deans), the accredited specialist medical colleges, the Australian Medical Council (AMC), the Australian Medical Students’ Association (AMSA), the Confederation of Postgraduate Medical Education Councils (CPMEC), the Australian Medical Association Council of Doctors-in-Training (AMACDT), the Australian General Practice Network (AGPN), Rural Doctors Association of Australia (RDAA), Australian Salaried Medical Officers Federation (ASMOF), General Practice Education and Training Ltd (GPET), state and territory health departments and the Commonwealth. It is chaired by the Australian Government Department of Health. A full list of member organisations and members is provided at Appendix A.

To assist with carrying out its duties, the MTRP is empowered to establish subcommittees as needed. The Clinical Training Subcommittee and the Data Subcommittee have been established for a number of years and have been involved in various activities reported in this and previous MTRP reports. The Rural Subcommittee was created in 2010. Summary information of these is provided below and more detailed information is at Appendix A.

1 Reports are available on the Australian Government Department of Health website at: http://www.health.gov.au/internet/main/publishing.nsf/Content/work-pubs-mtrp

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MTRP 18th Report

- The Clinical Training Subcommittee was formed to monitor and report on the activities and progress being made to ensure that there are adequate clinical training positions for the increasing number of new medical graduates.

- The Data Subcommittee has provided advice in relation to the content of this and previous annual reports and the specifications of the data that these cover.

- The Rural Subcommittee was established to consider rural medical training issues.

Report Structure The report presents background information and data on the various components of medical education and training as follows.

University Medical Education Chapter 2 covers medical students enrolled in Australian universities, including information on numbers enrolled in each medical school by year of study, types of places, domestic and international student breakdowns, projections of the numbers expected to graduate over the next five years. Some data on students commencing medical studies collected through the Medical Schools Outcomes Database (MSOD) project have been included to provide additional information on the characteristics of students.

Prevocational Medical Training Chapter 3 covers the number of prevocational junior doctors in training in the intern year or postgraduate year 1 (PGY1) and postgraduate year 2 (PGY2) positions across Australia.

Vocational Medical Training Chapter 4 covers information on 2014 trainees by specialty and state and territory, and the results of college examinations in 2013. Data on new and total fellows for each of the medical colleges for 2013 are also included.

International Supply Chapter 5 presents information on those doctors trained overseas (commonly referred to as international medical graduates), applying to work and working as medical practitioners in Australia. It provides a description of the Australian Medical Council process of assessment, and the number of overseas trained doctors and specialists seeking to practise medicine in Australia and the country in which they trained. Data are presented on approved working visas issued by the Australian Government Department of Immigration and Border Protection to medical practitioners. Information is also provided on medical practitioners who trained overseas who provided Medicare-funded services and how they are distributed across Australia.

Special Purpose Training Programs Chapter 6 presents information on the range of special purpose training programs operating under Section 3GA of the Act. This allows medical practitioners undertaking postgraduate education or participating in approved workforce programs to provide professional services that attract Medicare benefits.

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Appendices The appendices contain more detailed information on the membership of MTRP and its subcommittees (Appendix A), and summary information about college training requirements (Appendix B).

A glossary of the main terms used throughout the report is provided at Appendix C.

The latest available data and, where possible, trend data for the previous five years have been presented in the main body of the report. Tables showing data from previous years (where possible back to 1997, the first year of MTRP reporting) have been included at Appendix D.

Appendices E and F contain the specifications used for collection of the data collated in this report and the difference in terminology between medical college training programs and those of the MTRP report.

Notes on the Data and its Preparation

Data Sources Data for the MTRP report were supplied by a range of organisations.

Information on medical students was supplied by Medical Deans Australia and New Zealand Inc. (Medical Deans) from its Student Statistics Collection and from the Medical Schools Outcomes Database (MSOD) Project. Medical Deans is the peak national and cross-Tasman professional body representing entry-level medical education, training and research in Australia and New Zealand. The Student Statistics Collection is collated annually at the time of enrolment and includes all students. The MSOD Project collects data longitudinally by survey of individual students at all medical schools to create comprehensive demographic, educational and career intentions information.

Data on the first (internship) and second years of prevocational training were supplied by state and territory health departments. Information on Commonwealth Medical Internship initiative was provided by the Australian Government Department of Health.

In 2014, vocational training data relating to doctors pursuing specialist training were provided by each of the specialist medical colleges. GPET, as well as the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM), provided data on general practice training. Given these multiple sources, efforts have been made to ensure that there is no double counting of trainees.

Administrative data for Chapter 5 on international supply were sourced from the Australian Medical Council, the Australian Government Department of Immigration and Border Protection and the Australian Government Department of Health.

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MTRP 18th Report

Data Quality Issues The quality of the MTRP report, as a single reference point covering all aspects of medical education and training, is dependent on the provision and collation of comprehensive information from all contributors. Data templates and specifications defining each data element and the periods covered have been developed for all areas of the report with the assistance of members of the Data Subcommittee.

The specifications used in compilation of this report are attached in Appendix E. The MTRP has endeavoured to ensure the source data are according to the data specifications, but where this is not possible and data differ from the provided specifications, this is duly noted in the report.

These continued enhancements have greatly improved the comparability of data between state and territories and specialties within tables. This has, however, affected comparability of data across years. Where this is known to have significantly impacted the analysis of time series data, cautions have been noted.

There are a number of areas in which there have been attempts to source more and/or improved information, in particular to quantify activity in relation to the training and supervision of international medical graduates and specialists and the country from which they obtained their primary medical qualifications and previously worked. It is hoped that specialist medical colleges will introduce new data items that will allow this information to be presented in future reports.

The MTRP is dedicated to continue working with state and territories, specialist medical colleges and relevant external agencies to improve the data and provide more comprehensive information in medical training as necessary to inform policy and planning decisions.

Reporting Periods Given the differing collection methodologies for different data, the year for which data are reported varies. The majority of data presented in the report are for 2014 with most data reported as at 30 June 2014.

The exceptions to these are MSOD statistics, data on medical graduates, college examinations, new and total college fellows, which are reported for the previous calendar year, 2013.

Data on international medical graduates and overseas trained specialists are also reported for 2013, however, where data are for 2014, this is noted.

Examination of Trends The MTRP report has been produced annually since 1997. Tables in the body of the report present information pertaining to the latest five years. Where data were available from the previous years, this has been included in Appendix D.

In some cases data from previous years have been updated or amended. Where this has occurred, it is duly noted. Therefore, caution should be used when comparing data with that of previous editions of this report. Data can vary between years where its scope has changed due to more detailed specifications and different interpretations of what was required in previous reports. An effort has been made to note where there are significant differences in the way data have been collected or reported across years, or there have been changes in requirements, such as in relation to the training provided.

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Medical College Acronyms and Specialties Data on vocational training have been provided by specialist medical colleges and are reported by medical specialty. Table 1.1 provides a guide to the full names of the medical colleges, the acronym used for these throughout the report and the associated specialties under which data are reported.

Acronym College name Specialty

ACD Australasian College of Dermatologists Dermatology

ACEM Australasian College for Emergency Medicine Emergency medicine

ACRRM Australian College of Rural and Remote Medicine General practice

ACSP Australasian College of Sports Physicians Sport and exercise medicine

ANZCA Australian and New Zealand College of Anaesthetists Anaesthesia

Faculty of Pain Medicine Pain medicine

CICM College of Intensive Care Medicine of Australia and New Zealand Intensive care

RACDS Royal Australasian College of Dental Surgeons Oral and maxillofacial surgery

RACGP Royal Australian College of General Practitioners General practice

RACMA Royal Australasian College of Medical Administrators Medical administration

RACP Royal Australasian College of Physicians  

Australasian Faculty of Occupational and Environmental Medicine

Occupational and environmental medicine

Australasian Faculty of Public Health Medicine Public health medicine

Australasian Faculty of Rehabilitation Medicine Rehabilitation medicine

Adult Medicine Division Adult medicine

Paediatrics and Child Health Division Paediatrics

Australasian Chapter of Addiction Medicine Addiction medicine

Australasian Chapter of Palliative Medicine Palliative medicine

Australasian Chapter of Sexual Health Medicine Sexual health medicine

RACS Royal Australasian College of Surgeons Surgery

RANZCO Royal Australian and New Zealand College of Ophthalmologists Ophthalmology

RANZCOG Royal Australian and New Zealand College of Obstetricians and Gynaecologists Obstetrics and gynaecology

RANZCP Royal Australian and New Zealand College of Psychiatrists Psychiatry

RANZCR Royal Australian and New Zealand College of Radiologists Radiodiagnosis

Faculty of Radiation Oncology Radiation oncology

RCPA Royal College of Pathologists of Australasia Pathology

Joint Pathology - Royal Australasian College of Physicians and Royal College of Pathologists of Australasia Pathology

Table 1.1: Medical colleges: Acronyms, names and specialties

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MTRP 18th Report

Chapter 2 UNIVERSITY MEDICAL EDUCATION AND TRAINING The latest data on medical students studying at Australian universities are presented in this chapter which analyses trends over the last five years. Additional data, where available, are presented in Appendix D. This information has been included in the MTRP report since 2006.

Medical Students In Australia, university medical schools accredited by the Australian Medical Council provide professional entry level medical education. There are 18 universities with accredited medical schools in Australia, and a number of these were established in the last ten years. All of these universities have now produced graduates.

In the past, most medical doctors completed a five or six-year Bachelor of Medicine and Bachelor of Surgery (MBBS) degree to gain a professional entry level qualification. However, over the years an increasing number of four-year (graduate-entry) programs have been introduced.

Traditionally, these medical school programs resulted in a bachelor degree qualification. However, from 2015 approximately 45% of medical schools, representing nearly 50% of commencing domestic students will have moved to a Doctor of Medicine or equivalent program, resulting in graduates with a masters level qualification. The first of these was the University of Melbourne which commenced this program in 2011 and had the first cohort of masters graduates in 2014.

With the combination of graduate entry and Doctor of Medicine programs, over 60% of medical schools2 in Australia require seven years of tertiary study to attain a professional entry level medical qualification, which accounts for nearly 60% of commencing domestic students. This change is consistent with trends in other health professional programs moving into post graduate courses.

Current programs integrate pre-clinical and clinical components throughout the program and incorporate clinical experience from early in the course. However, the most significant clinical exposure occurs in the latter years of the program.

Medical students gain clinical exposure in a range of clinical settings and via simulation. Throughout their professional entry level medical program, students are provided with the skills, knowledge and attributes to move to the next phase of their training, which is the prevocational phase (prior to specialty training).

2 Some of these schools also offer additional entry pathways resulting in shorter tertiary education periods.

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Current Data In 2014, there were 16,837 medical students studying in Australian universities (Table 2.1). Of these, 4,388 (26.1%) were undertaking a six-year course, 4,317 (25.6%) were undertaking a five-year course and 8,132 (48.3%) were undertaking a four-year course.

University  Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Total

6-year course Adelaide 150 151 197 185 183 167 1,033

James Cook 214 219 195 170 191 162 1,151

Melbourne UG(a) 0 0 0 4 8 6 18

UNSW 295 297 256 263 287 280 1,678

UWA UG(b) 0 0 0 166 182 160 508

Subtotal 659 667 648 788 851 775 4,388

5-year course Bond(c) 94 92 95 81 84 .. 446

Monash UG(d) 310 318 311 304 236 .. 1,479

Newcastle/UNE 194 213 202 220 206 .. 1,035

Tasmania 117 120 104 108 113 .. 562

UWA PG(b),(c) 0 0 52 67 53 .. 172

UWS 127 120 123 123 130 .. 623

Subtotal 842 863 887 903 822 .. 4,317

4-year course ANU 93 98 82 91 .. .. 364

Deakin 134 136 138 136 .. .. 544

Flinders 166 167 151 131 .. .. 615

Griffith 153 152 153 143 .. .. 601

Melbourne MD(a) 347 326 319 313 .. .. 1,305

Monash PG(d) 81 85 88 80 .. .. 334

Notre Dame Sydney 120 121 112 109 .. .. 462

Notre Dame Fremantle 113 108 89 108 .. .. 418

Queensland(e) 413 438 435 435 .. .. 1,721

Sydney 298 293 297 315 .. .. 1,203

UWA MD(b) 233 0 0 0 .. .. 233

Wollongong 85 82 85 80 .. .. 332

Subtotal 2,236 2,006 1,949 1,941 .. .. 8,132

Total 3,737 3,536 3,484 3,632 1,673 775 16,837

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

(a) Undergraduate program last intake was in 2008. Master (MD) program commenced in 2011. (b) There were no enrolments into UWA PG or UG courses. All students now enrol into UWA MD course from 2014. (c) These courses are slightly less than 5 years in duration - Bond 4.8 years and UWA PG 4.7 years. (d) Excludes all offshore programs, including Monash Malaysia. (e) Excludes all offshore programs, including UQ Ochsner.

Source: Medical Deans Australia and New Zealand Inc

Table 2.1: Medical students in Australian universities, 2014

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In 2014, 14,384 or 85.4% of all students were domestic students (Table 2.2). A domestic student is defined as being an Australian or New Zealand citizen, or an Australian permanent resident. Of these, 3,611 (25.1%) students were undertaking a six-year course, 3,676 (25.6%) were undertaking a five-year course and 7,097 (49.3%) were undertaking a four-year course.

University Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Total

6-year course Adelaide 116 120 172 164 156 138 866

James Cook 182 184 174 155 164 141 1,000

Melbourne UG(a) 0 0 0 3 8 6 17

UNSW 214 235 199 203 233 227 1,311

UWA UG(b) 0 0 0 136 151 130 417

Subtotal 512 539 545 661 712 642 3,611

5-year course Bond(c) 94 92 95 79 82 .. 442

Monash UG 242 265 248 255 188 .. 1,198

Newcastle/UNE 173 186 176 187 174 .. 896

Tasmania 99 100 79 86 86 .. 450

UWA PG(b),(c) 0 0 43 67 53 .. 163

UWS 108 100 103 109 107 .. 527

Subtotal 716 743 744 783 690 .. 3,676

4-year course ANU 90 97 81 88 .. .. 356

Deakin 129 131 132 134 .. .. 526

Flinders 152 142 131 113 .. .. 538

Griffith 150 148 147 142 .. .. 587

Melbourne MD(a) 302 293 285 292 .. .. 1,172

Monash PG 76 77 83 65 .. .. 301

Notre Dame Sydney 120 121 112 109 .. .. 462

Notre Dame Fremantle 113 108 89 108 .. .. 418

Queensland 306 328 315 335 .. .. 1,284

Sydney 229 226 221 264 .. .. 940

UWA MD(b) 210 0 0 0 .. .. 210

Wollongong 80 73 76 74 .. .. 303

Subtotal 1,957 1,744 1,672 1,724 .. .. 7,097

Total 3,185 3,026 2,961 3,168 1,402 642 14,384

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

(a) Undergraduate program last intake was in 2008. Master (MD) program commenced in 2011. (b) There were no enrolments into UWA PG or UG courses. All students now enrol into UWA MD course from 2014. (c) These courses are slightly less than 5 years in duration - Bond 4.8 years and UWA PG 4.7 years.

Source: Medical Deans Australia and New Zealand Inc

In 2014, 2,453 or 14.6% of all students were international students (Table 2.3). An international student is defined as a student studying onshore in Australia as a private or sponsored student who is not an Australian or New Zealand citizen, or permanent resident. Of these, 777 (31.7%) were undertaking a six-year course, 641 (26.1%) were undertaking a five-year course and 1,035 (42.2%) were undertaking a four-year course.

Table 2.2: Domestic medical students in Australian universities, 2014

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University Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Total

6-year course              

Adelaide 34 31 25 21 27 29 167

James Cook 32 35 21 15 27 21 151

Melbourne UG(b) 0 0 0 1 0 0 1

UNSW 81 62 57 60 54 53 367

UWA UG(c) 0 0 0 30 31 30 91

Subtotal 147 128 103 127 139 133 777

5-year course              

Bond(d) 0 0 0 2 2 .. 4

Monash UG(e) 68 53 63 49 48 .. 281

Newcastle/UNE 21 27 26 33 32 .. 139

Tasmania 18 20 25 22 27 .. 112

UWA PG(c),(d) 0 0 9 0 0 .. 9

UWS 19 20 20 14 23 .. 96

Subtotal 126 120 143 120 132 .. 641

4-year course              

ANU 3 1 1 3 .. .. 8

Deakin 5 5 6 2 .. .. 18

Flinders 14 25 20 18 .. .. 77

Griffith 3 4 6 1 .. .. 14

Melbourne MD(b) 45 33 34 21 .. .. 133

Monash PG(e) 5 8 5 15 .. .. 33

Notre Dame Sydney 0 0 0 0 .. .. 0

Notre Dame Fremantle 0 0 0 0 .. .. 0

Queensland(f) 107 110 120 100 .. .. 437

Sydney 69 67 76 51 .. .. 263

UWA MD(c) 23 0 0 0     23

Wollongong 5 9 9 6 .. .. 29

Subtotal 279 262 277 217 .. .. 1,035

Total 552 510 523 464 271 133 2,453

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

(a) International students are those studying onshore in Australia as private or sponsored students who are not Australian or New Zealand citizens, or permanent residents. (b) Undergraduate program last intake was in 2008. Master (MD) program commenced in 2011. (c) There were no enrolments into UWA PG or UG courses. All students now enrol into UWA MD course from 2014. (d) These courses are slightly less than 5 years in duration - Bond 4.8 years and UWA PG 4.7 years. (e) Excludes all offshore programs, including Monash Malaysia. (f) Excludes all offshore programs, including UQ Ochsner.

Source: Medical Deans Australia and New Zealand Inc

There were an additional 998 international students in 2014, studying in Australian offshore programs3 (Table 2.4). This represented 28.9% of the total international students.

3 While these programs are primarily delivered offshore, the majority of these students spend limited educational time in Australia during their degree.

Table 2.3: International(a) medical students in Australian universities, 2014

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  Total Proportion of total international students (%)

International Medical University (IMU) 30 0.9

Monash Malaysia 621 18.0

Queensland University Ochsner (USA) 347 10.1

Total 998 28.9

Source: Medical Deans Australia and New Zealand Inc

Types of Student Places In Australia a student undertaking medical studies may occupy either:

- a Commonwealth-supported university place (CSP), where the student is required to pay for only part of the cost of his or her degree through HECS-HELP; or

- a full fee-paying place, which is funded entirely by the tuition fees paid by the student.

Some medical students occupying Commonwealth-supported university places are participating in the Bonded Medical Places (BMP) Scheme or have received scholarships through the Medical Rural Bonded Scholarship (MRBS) Scheme, which commenced in 2004 and 2001 respectively.

Students participating in the BMP Scheme have a return of service obligation to work in a District of Workforce Shortage (DWS) as identified by the Commonwealth, for a period of time equal to the length of the medical degree. However, up to half of the return of service obligation can be met while completing prevocational and vocational training.

Recipients of the MRBS Scheme scholarship are required to work for six continuous years in locations within Australian Standard Geographical Classification - Remoteness Areas (ASGC-RA) 2 to 5. MRBS Scheme doctors start their six year commitment to work in rural Australia after completing their vocational training.

The Northern Territory government supports another unique program - the Northern Territory Medical Program. This program is a Northern Territory government funded program that funds all 24 student placements through a return of service obligation program.

Table 2.5 provides detailed information on the number and types of places available at each university in 2014.

Over three-quarters of all university places each year are Commonwealth-supported. In 2014, there were 13,351 Commonwealth-supported places or 79.3% of all places.

Approximately one-fifth (20.1%) of all medical students were fee-paying in 2014. Just fewer than three-quarters of full fee-paying places were occupied by international students and this number is similar among commencing students (72.1%) in Table 2.6 and all medical students (72.4%) in Table 2.5.

Table 2.4: International students studying in Australian offshore programs, 2014

A total of 621 or 18.0% of international students were studying in Monash Malaysia and 347 or 10.1% were in Ochsner (USA) program of Queensland University.

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Commonwealth- supported places

Fee-paying

Domestic International(a) Other(b) Total

Adelaide 863 3 167 0 1,033

ANU 356 0 8 0 364

Bond 0 442 4 0 446

Deakin 524 1 18 1 544

Flinders 448 0 77 90 615

Griffith 587 0 14 0 601

James Cook 996 4 151 0 1,151

Melbourne MD 999 173 133 0 1,305

Melbourne UG 17 0 1 0 18

Monash PG 294 7 33 0 334

Monash UG 1,190 8 281 0 1,479

Newcastle/UNE 894 2 139 0 1,035

Notre Dame Sydney 240 222 0 0 462

Notre Dame Fremantle 413 5 0 0 418

Queensland 1,253 25 437 6 1,721

Sydney 919 21 263 0 1,203

Tasmania 450 0 112 0 562

UNSW 1,294 17 367 0 1,678

UWA MD 210 0 23 0 233

UWA PG 163 0 9 0 172

UWA UG 417 0 91 0 508

UWS 521 6 96 0 623

Wollongong 303 0 29 0 332

Total 13,351 936 2,453 97 16,837

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia. (b) Includes medical students on state health department bonded medical scholarships.

Source: Medical Deans Australia and New Zealand Inc

Table 2.6 provides detailed information on the number and types of places available at each university in 2014 for commencing students.

Similarly to Table 2.5, over three-quarters of all university places for commencing students were Commonwealth-supported. Of the 3,737 commencing medical students in 2014, 2,940 students or 78.7% were in these places.

Table 2.5: Medical students by type of student place and university, 2014

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  Commonwealth- supported places

Fee-paying places    

Domestic International(a) Other(b) Total

Adelaide 116 0 34 0 150

ANU 90 0 3 0 93

Bond 0 94 0 0 94

Deakin 129 0 5 0 134

Flinders 121 0 14 31 166

Griffith 150 0 3 0 153

James Cook 182 0 32 0 214

Melbourne MD(c) 260 42 45 0 347

Monash PG 74 2 5 0 81

Monash UG 240 2 68 0 310

Newcastle/UNE 173 0 21 0 194

Notre Dame Sydney 55 65 0 0 120

Notre Dame Fremantle 109 4 0 0 113

Queensland 305 1 107 0 413

Sydney 228 1 69 0 298

Tasmania 99 0 18 0 117

UNSW 211 3 81 0 295

UWA MD(c) 210 0 23 0 233

UWS 108 0 19 0 127

Wollongong 80 0 5 0 85

Total 2,940 214 552 31 3,737

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia. (b) Includes medical students on state health department bonded medical scholarships. (c) UWA and University of Melbourne now only admit students to their MD programs.

Source: Medical Deans Australia and New Zealand Inc

Table 2.7 provides further information on recent trends in the proportion of student places.

In 2014, the majority of Commonwealth-supported students occupied HECS-HELP only places (9,587 places or 71.8% of Commonwealth-supported places), whereas 3,764 or 28.2% of Commonwealth-supported students had a return of service obligation under either the MRBS Scheme or BMP Scheme, in addition to contributing to the cost of their education under HECS-HELP.

Eleven years after the commencement of the BMP Scheme, there were 3,327 students in BMP Scheme places. This was a slight decrease from 2013 (by 49 students). However, from 2010 to 2014 the number of students supported through this scheme had increased by 641 places or 23.9%.

Table 2.6: Commencing medical students by type of student place and university, 2014

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The number of students in the MRBS Scheme also increased from 2013 (by 21 students or 5.0%). However, the number of students in MRBS Scheme places remained relatively constant since 2010, ranging between 480 students in 2010 and 437 students in 2014. The number of MRBS Scheme students as a proportion of all student places decreased from 3.1% in 2010 to 2.6% in 2014, while the number of BMP Scheme students as a proportion of all students increased from 17.4% in 2010 to 19.8% in 2014.

The proportion of domestic fee-paying students was in steady decline for three years since 2010 (5.9% of all students in 2010 to 4.7% of all students in 2012). But the proportion of domestic fee-paying students increased in 2013 (to 5.1%) and 2014 (to 5.6%).

Over the last five years the absolute number of international fee-paying students has plateaued, but the proportion has decreased slightly from 15.9% in 2010 to 14.6% in 2014.

  2010 2011 2012 2013 2014

Medical students

Commonwealth-supported 11,873 13,016 13,289 13,315 13,351

HECS-HELP only 8,707 9,435 9,538 9,621 9,587

BMP Scheme 2,686 3,122 3,282 3,278 3,327

MRBS Scheme 480 459 469 416 437

Fee-paying 3,356 3,364 3,492 3,598 3,389

Domestic 905 829 801 871 936

International(a) 2,451 2,535 2,691 2,727 2,453

Other(b) 231 111 87 81 97

Total 15,460 16,491 16,868 16,994 16,837

Proportion of places (%)

Commonwealth-supported 76.8 78.9 78.8 78.4 79.3

HECS-HELP only 56.3 57.2 56.5 56.6 56.9

BMP Scheme 17.4 18.9 19.5 19.3 19.8

MRBS Scheme 3.1 2.8 2.8 2.4 2.6

Fee-paying 21.7 20.4 20.7 21.2 20.1

Domestic 5.9 5.0 4.7 5.1 5.6

International(a) 15.9 15.4 16.0 16.0 14.6

Other(b) 1.5 0.7 0.5 0.5 0.6

Total 100.0 100.0 100.0 100.0 100.0

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia. (b) Includes medical students on state health department bonded medical scholarships.

Source: Medical Deans Australia and New Zealand Inc

Table 2.7: Medical students by type of student place: Number and proportion of places, 2010-2014

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Scholarships Students can receive scholarships through a variety of sources.

Data was collected through the Medical Schools Outcomes Database (MSOD) project from 3,511 medical students (95.7% of the total 3,669) commencing their studies in 2013. Of these, 367 (10%) students stated that they received a scholarship to support them in their medical studies (Table 2.8).

Source of scholarships Students Proportion (%)

Commonwealth scholarships 99 27.0

State scholarships 8 2.2

Scholarships provided by Australian universities 211 57.5

Scholarships provided by home country to international students 28 7.6

Scholarships provided by other institutions 8 2.2

Unnamed 13 3.5

Total 367 100.0

Source: Medical Schools Outcomes Database

Student Characteristics Data from MSOD provide insights into who is undertaking medical studies. Data are recorded for the 3,511 students (95.7% of the total 3,669) who completed the MSOD entry requirements in 2013.

Just over three-quarters (76.6%) of students commencing their medical studies in 2013 were under the age of 25 years (Table 2.9).

Age group Male Female

Proportion female (%) Total

Proportion of total (%)

Less than 20 years 403 538 57.2 941 26.8

20-24 years 898 849 48.6 1,747 49.8

25-29 years 294 276 48.4 570 16.2

30-34 years 91 71 43.8 162 4.6

35-39 years 29 28 49.1 57 1.6

40 years and over 21 13 38.2 34 1.0

Total 1,736 1,775 50.6 3,511 100.0

Source: Medical Schools Outcomes Database

Just over half (57.3%) of the medical students commencing in 2013 began their studies after finishing another degree, with 84% of these having completed a tertiary qualification in science, medical science and health and/or allied health (Table 2.10).

Table 2.9: Commencing medical students by sex and age, 2013

Table 2.8: Commencing medical students source of scholarships, 2013

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Discipline of prior degree Undergraduate entry Graduate entry Total

Science(a) 33 626 659

Medical Science(b) 24 431 455

Health/Allied Health(c) 46 531 577

Humanities 10 122 132

Commerce/Business/Law 8 72 80

Physical sciences(d) 2 47 49

Other/unknown 5 56 61

Total 128 1,885 2,013

(a) B.Sci, B Applied Sci (no or unclear major), Vet Sci, Liberal Arts, B Sci in Human Movement, biotechnology, human kinetics, exercise science and psychology. (b) B. Medical Science, pathology, biochemistry, microbiology, haematology, histopathology, cytology and immunology. (c) Radiography, nursing, optometry, podiatry, speech pathology, orthodontics, nutrition, public health and tropical medicine,

occupational therapy, kinesiology, naturopathy, pharmacy, physiotherapy, dentistry, dental surgery, oral health, prosthetics and orthotics. (d) B Eng, B Computer Science, architecture, urban planning, electronics, surveying, IT and mathematics.

Source: Medical Schools Outcomes Database

The majority (93.6%) of these students entered a graduate-entry medical program. Just less than three quarters (74.1%) had bachelor degrees, 16.4% had completed honours, graduate diploma or certificate and 9.3% of these students had a master or doctoral degree. Only 1.1% (39) of commencing students in 2013 reported having a Doctoral qualification at entry to medical studies (Table 2.11).

Level of prior degree Undergraduate entry

Proportion undergraduate entry (%) Graduate

entry

Proportion graduate entry (%) Total

PhD 2 1.6 37 2.0 39

Master 21 16.4 139 7.4 160

Graduate Diploma/Certificate 5 3.9 53 2.8 58

Honours 10 7.8 257 13.6 267

Bachelor 82 64.1 1,396 74.1 1,478

Associate Degree 2 1.6 0 0 2

Other/unknown 6 4.7 3 0.2 9

Total 128 100.0 1,885 100.0 2,013

(a) Based on all individuals who reported previous qualifications.

Source: Medical Schools Outcomes Database

Information on the preferred type of medical practice as reported in the MSOD questionnaire by students in their final year of a medical degree and by postgraduate year 1 (PGY1) trainees is provided in Table 2.12 and Table 2.13.

Table 2.10: Commencing medical students discipline of highest tertiary qualification completed, 2013

Table 2.11: Commencing medical students level of highest prior tertiary qualification by medical degree entry program(a), 2013

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The most popular preferred types of medical practice among male graduates were surgery and adult medicine, followed by general practice (309, 230 and 156 respectively).

Female graduates noted general practice, adult medicine and paediatrics and child health most often as their first preference for type of medical practice (313, 226 and 197 respectively).

Preference 1 Preference 2 Preference 3

Specialty Male Female Male Female Male Female

Addiction medicine 1 2 3 4 5 4

Adult medicine/internal medicine 230 226 118 137 67 99

Anaesthesia 117 76 88 70 79 62

Dermatology 12 32 8 13 11 20

Emergency medicine 102 127 114 121 97 108

General practice 156 313 102 160 130 133

Indigenous health 1 3 4 7 4 10

Intensive care medicine 34 25 63 47 68 38

Medical administration (e.g. managing a hospital) 0 1 8 3 12 13

Non-specialist hospital practice (e.g. career as a medical officer in a hospital) 2 3 1 2 7 7

Obstetrics and gynaecology 28 139 25 80 18 63

Occupational and environmental medicine 0 1 0 1 1 2

Ophthalmology 31 24 18 14 19 15

Oral and maxillofacial surgery 7 1 6 3 9 1

Paediatrics and child health 67 197 60 113 45 93

Pain medicine 1 1 5 3 3 6

Palliative medicine 5 8 4 15 9 20

Pathology 6 9 5 3 8 7

Psychiatry 36 46 30 31 22 25

Public health medicine 4 7 2 8 11 22

Radiation oncology 10 4 8 3 10 10

Radiology 37 14 20 13 32 13

Rehabilitation medicine 2 3 3 2 1 6

Rural and remote medicine 23 34 12 29 14 26

Sexual health medicine 2 2 3 11 5 16

Sport and exercise medicine 8 5 24 10 21 19

Surgery 309 131 75 40 57 39

Other 56 34 9 14 12 17

(a) Data were collected from 2,873 medical students in their final year who answered the MSOD questionnaire.

Source: Medical Schools Outcomes Database

Table 2.13 illustrates the distribution of postgraduate year 1 (PGY 1) trainee preferences for different specialised areas of medicine.

Table 2.12: Preferred type of medical practice in final year of medical degree by gender (a), 2013

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Preferences varied by gender, with male choices varying from first to third preferences. Specialties indicated as a first preference for males were surgery, general practice and adult medicine (163, 131 and 127 respectively). Specialties listed as a second preference for males were adult medicine, general practice and anaesthesia (31, 30 and 27 respectively). Third preferences for male PGY 1 trainees included general practice (37) and adult medicine (24), followed by anaesthesia (17) and intensive care medicine (also 17).

Female choices were more consistent than for males from first to third preferences. Specialties consistently indicated by females were general practice and adult medicine (225 and 162 respectively as a first preference, 45 and 36 as a second preference, 44 and 24 as a third preference). The third specialty favoured by female PGY 1 trainees varied from first to third preference, with paediatrics and child health in a first preference, emergency medicine in a second preference and anaesthesia in third (92, 25 and 15 respectively).

Specialty

Preference 1 Preference 2 Preference 3 Male Female Male Female Male Female

Addiction medicine 0 1 0 1 1 2

Adult medicine/internal medicine 127 162 31 36 24 24

Cardiology 14 15 na na na na

Endocrinology 5 10 na na na na

Gastroenterology and Hepatology 10 6 na na na na

General Medicine 3 5 na na na na

Geriatric Medicine 2 6 na na na na

Haematology 6 3 na na na na

Immunology and Allergy 0 1 na na na na

Infectious Disease 11 3 na na na na

Medical Oncology 1 9 na na na na

Nephrology 2 6 na na na na

Neurology 9 13 na na na na

Respiratory and Sleep Medicine 4 0 na na na na

Rheumatology 2 4 na na na na

Anaesthesia 74 41 27 17 17 15

Dermatology 4 13 0 3 4 6

Dual Vocational Training Program 8 1 2 1 4 2

Emergency medicine 38 70 20 25 14 14

General practice 131 225 30 45 37 44

Indigenous health 1 2 1 4 1 5

Intensive care medicine 15 9 25 15 17 14

Medical administration (e.g. managing a hospital) 1 3 0 3 7 3

Non-specialist hospital practice (e.g. career as a medical officer in a hospital) 0 0 1 0 3 4

Obstetrics and gynaecology 13 60 3 17 2 13

Ophthalmology 17 16 4 2 2 2

Oral and maxillofacial surgery 3 1 1 0 1 0

Table 2.13: Preferred type of medical practice in postgraduate year 1 by gender(a), 2013

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MTRP 18th Report

Specialty

Preference 1 Preference 2 Preference 3 Male Female Male Female Male Female

Paediatrics and child health 33 92 4 19 9 11

Clinical Genetics 0 1 na na na na

Community Child Health 0 2 na na na na

General Paediatrics 2 17 na na na na

Neonatal and Perinatal Medicine 1 4 na na na na

Paediatric Cardiology 0 4 na na na na

Paediatric Emergency Medicine 2 0 na na na na

Paediatric Endocrinology 1 1 na na na na

Paediatric Gastroenterology and Hepatology 2 0 na na na na

Paediatric Haematology 0 1 na na na na

Paediatric Infectious Diseases 0 1 na na na na

Paediatric Intensive Care Medicine 0 1 na na na na

Paediatric Palliative Medicine 1 0 na na na na

Paediatric Medical Oncology 1 5 na na na na

Pain medicine 0 0 1 1 1 1

Palliative medicine 1 6 1 5 4 7

Pathology 6 11 4 3 3 2

Psychiatry 24 30 7 9 5 7

Public health medicine 6 3 3 5 2 4

Radiation Oncology 3 6 2 2 1 2

Radiology 27 13 10 7 3 3

Rehabilitation medicine 2 1 1 1 4 3

Rural and remote medicine 14 15 3 7 3 11

Sexual health medicine 3 2 1 3 2 5

Sport and Exercise Medicine 2 3 1 0 7 1

Surgery 163 80 21 10 11 7

Cardiothoracic Surgery 5 1 na na na na

General Surgery 25 24 na na na na

Neurosurgery 5 4 na na na na

Orthopaedic Surgery 32 7 na na na na

Otolaryngology - Head and Neck Surgery 10 3 na na na na

Paediatric Surgery 2 1 na na na na

Plastic Surgery 9 9 na na na na

Urology 7 1 na na na na

Vascular Surgery 6 3 na na na na

Other 10 13 2 4 3 9

(a) Data were collected from 1,656 medical students in PGYI who answered the MSOD questionnaire.

Source: Medical Schools Outcomes Database

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MTRP 18th Report

In 2013, a total of 626 international students of the 3,511 commencing medical students completing the MSOD entry questionnaire reported that they held temporary or other entry permits to Australia (Table 2.14). The highest numbers of international students came from Singapore (24.3%), Canada (16.3%), Malaysia (14.9%) and United States of America (14.7%).

  Country of birth Students Proportion (%)

Singapore 152 24.3

Canada 102 16.3

Malaysia 93 14.9

United States of America 92 14.7

Korea, Republic of (South) 23 3.7

Hong Kong (SAR of China) 22 3.5

India 15 2.4

Indonesia 12 1.9

All other (where n≤10) 115 18.4

Total 626 100.0

Source: Medical Schools Outcomes Database

Aboriginal and/or Torres Strait Islander Students Data on the Aboriginal and/or Torres Strait Islander people(s) status of medical students is available from two sources, Medical Deans Student Statistical Collection and the MSOD. Data from these two sources cannot necessarily be reconciled, so both are presented below as each provides different insights into the number of Aboriginal and/or Torres Strait Islander people(s) studying medicine.

The number and proportion of commencing medical students reporting that they are of Aboriginal and/or Torres Strait Islander descent when completing the MSOD entry questionnaire have risen slightly over the years from 37 or 1.2% of students in 2008, to 59 or 1.7% in 2013 (Table 2.15).

  2008 2009 2010 2011 2012 2013

Aboriginal and/or Torres Strait Islander students 37 38 47 69 48 59

Non-Aboriginal and/or Torres Strait Islander students 3,180 3,113 3,064 3,483 3,403 3,438 Unknown 18 10 4 10 20 14

Total 3,235 3,161 3,115 3,562 3,471 3,511

Proportion of Aboriginal and/or Torres Strait Islander students (%) 1.2 1.2 1.5 1.9 1.4 1.7

Source: Medical Schools Outcomes Database

Table 2.14: International commencing medical students holding temporary or ‘other’ entry permits by place of birth, 2013

Table 2.15: Commencing medical students by Aboriginal and/or Torres Strait Islander status, 2008-2013

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Data from Medical Deans shows that there have been significant increases each year in the overall number of Aboriginal and/or Torres Strait Islander people(s) studying medicine.

In 2014, there was a total of 275 medical students studying in Australian universities who reported being of Aboriginal and/or Torres Strait Islander descent (Table 2.16), an increase of 177.8% over the nine years from 2006.

  2006 2007 2008 2009 2010 2011 2012 2013 2014

Aboriginal and/or Torres Strait Islander students 99 125 129 137 161 218 226 261 275

Annual change (%)   26.3 3.2 6.2 17.5 35.4 3.7 15.5 5.4

Source: Medical Deans Australia and New Zealand Inc

Rural Exposure Exposure to rural and remote settings, whether through living, schooling and/or undertaking medical studies or training there, is shown to have a positive impact on the likelihood of medical professionals practising in rural and remote areas.

The Rural Clinical Training and Support (RCTS) program provides funding to participating universities for the establishment and support of medical student training in rural areas, and supports 17 rural clinical schools nationally. The RCTS program aims to improve the range of rural health care services and strengthen the health workforce in rural communities across Australia.

Participating Australian medical schools are required to meet a range of objectives set out in the program parameters, including:

- providing at least 4 weeks rural training for all medical students; - having at least 25% of their medical students undertake at least one year of clinical training in a rural area; - providing high-quality training of medical students in rural and remote areas; - having at least 25% of their yearly student intake of rural origin; - maintaining and enhancing measures to increase the number of Aboriginal and Torres Strait

Islander medical student graduates; and - facilitating an increase in rural health and workforce research, rural health advocacy and a raised awareness of rural and remote health issues.

The RCTS is a component initiative of the Rural Health Multidisciplinary Training (RHMT) program, which also supports 11 University Departments of Rural Health, six dental schools that offer rural dental placements and the John Flynn Placement Program.

Data on students who have a rural background are collected by medical schools.

In 2014, 878 or 27.6% of commencing domestic students reported that they had lived in a rural or remote area prior to commencing their medical studies (Table 2.17). This is in line with the proportion of 27% in 2012 and 27.1% in 2013.

The proportion of domestic students with a rural background was roughly one quarter in each state and territory.

Table 2.16: Aboriginal and/or Torres Strait Islander medical students studying in Australian universities, 2006-2014

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University

Commonwealth or State supported Full-fee paying

Proportion of all domestic students with a rural

background (%)(a),(h) Male Female Total Male Female Total

New South Wales

Newcastle/UNE 19 27 46 0 0 0 26.6

Notre Dame Sydney(b) 7 6 13 3 3 6 15.8

Sydney 29 29 58 0 0 0 25.3

UNSW 34 22 56 0 0 0 26.2

UWS(c) 4 2 6 0 0 0 5.6

Wollongong 21 32 53 0 0 0 66.3

Total NSW 114 118 232 3 3 6 25.8

Victoria

Deakin 23 13 36 0 0 0 27.9

Melbourne MD(d) 36 29 65 1 0 1 21.9

Monash PG 13 10 23 0 0 0 30.3

Monash UG 45 26 71 0 0 0 29.3

Total VIC 117 78 195 1 0 1 26.2

Queensland

Bond(e),(f) 0 0 0 0 0 0 0

Griffith (e) 7 5 12 0 0 0 8.0

Queensland 30 54 84 0 0 0 27.5

James Cook 71 34 105 0 0 0 57.7

Total QLD 108 93 201 0 0 0 27.5

Western Australia

Notre Dame Fremantle(g) 14 14 28 0 0 0 24.8

UWA PG 33 18 51 0 0 0 24.3

Total WA 47 32 79 0 0 0 24.5

South Australia

Adelaide 23 7 30 0 0 0 25.9

Flinders 17 29 46 0 0 0 30.3

Total SA 40 36 76 0 0 0 28.4

Tasmania

Tasmania 28 33 61 0 0 0 61.6

Australian Capital Territory

ANU 20 7 27 0 0 0 30.0

Total 474 397 871 4 3 7 27.6

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

(a) Rural background is based on residency for at least five years from the commencement of primary school in an area classified as RA2 to RA5 under the Australian Standard Geographical Classification - Remoteness Areas (ASGC-RA) system.

(b) University of Notre Dame Sydney achieved a rural origin proportion of 32.7% against the RCTS program criteria, see footnote (h) below. (c) University of Western Sydney is not subject to the RCTS rural origin target.

Table 2.17: Commencing domestic students with a rural background(a) by state/territory, 2014

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(d) University of Melbourne achieved a rural origin proportion of 26.0% against the RCTS program criteria, see footnote (h) below. (e) Bond and Griffith Universities do not participate in the Commonwealth RCTS program. (f) Bond University does not collect data on rurality. (g) University of Notre Dame Fremantle achieved a rural origin proportion of 26.5% against the RCTS program criteria, see

footnote (h) below. (h) The Rural Clinical Training and Support (RCTS) program requires that a number of Australian medical students equal to at least 25% of the University’s medical student CSP allocation must come from a rural background.

Source: Australian Government Department of Health and Medical Deans Australia and New Zealand Inc

Attrition Rates The attrition rates report on the number of students that have permanently ceased candidature in a medical degree but do not include students who have deferred study or transferred to other medical schools.

In 2013, of 3,185 only 48 (1.5%) commencing domestic students (23 male and 25 female students) discontinued their medical degree in the first year (Table 2.18).

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University Male Female Total

Proportion of total commencing domestic students who ceased candidature (%)

New South Wales

Newcastle/UNE 1 2 3 6.3

Notre Dame Sydney 1 0 1 2.1

Sydney 4 0 4 8.3

UNSW 0 0 0 0

UWS 2 0 2 4.2

Wollongong 1 1 2 4.2

Total NSW 9 3 12 25.0

Victoria

Deakin 1 0 1 2.1

Melbourne MD 0 0 0 0

Monash PG 1 1 2 4.2

Monash UG 4 9 13 27.1

Total VIC 6 10 16 33.3

Queensland

Bond 0 0 0 0

Griffith 2 4 6 12.5

Queensland 2 0 2 4.2

James Cook 1 1 2 4.2

Total QLD 5 5 10 20.8

Western Australia

Notre Dame WA 0 0 0 0

UWA MD 0 0 0 0

UWA PG 0 0 0 0

UWA UG 0 0 0 0

Total WA 0 0 0 0

South Australia

Adelaide 1 1 2 4.2

Flinders 1 3 4 8.3

Total SA 2 4 6 12.5

Tasmania

Tasmania 1 2 3 6.3

Australian Capital Territory

ANU 0 1 1 2.1

Total 23 25 48 100.0

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

Source: Medical Deans Australia and New Zealand Inc

Table 2.18: Commencing domestic medical students: Attrition rates, 2013

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In 2013, a total of 17 out of 552 (3.1%) commencing international students (9 male and 8 female students) discontinued their medical degree in the first year (Table 2.19).

University Male Female Total

Proportion of total commencing domestic students who ceased candidature (%)

New South Wales

Newcastle/UNE 0 1 1 5.9

Notre Dame Sydney 0 0 0 0

Sydney 2 1 3 17.6

UNSW 2 3 5 29.4

UWS 2 0 2 11.8

Wollongong 0 0 0 0

Total NSW 6 5 11 64.7

Victoria

Deakin 0 0 0 0

Melbourne MD 0 1 1 5.9

Monash PG 1 0 1 5.9

Monash UG 0 0 0 0

Total VIC 1 1 2 11.8

Queensland

Bond 0 0 0 0

Griffith 0 0 0 0

Queensland 1 0 1 5.9

James Cook 1 0 1 5.9

Total QLD 2 0 2 11.8

Western Australia

Notre Dame WA 0 0 0 0

UWA MD 0 0 0 0

UWA PG 0 0 0 0

UWA UG 0 0 0 0

Total WA 0 0 0 0

South Australia

Adelaide 0 0 0 0

Flinders 0 0 0 0

Total SA 0 0 0 0

Tasmania

Tasmania 0 1 1 5.9

Australian Capital Territory

ANU 0 1 1 5.9

Total 9 8 17 100.0

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia.

Source: Medical Deans Australia and New Zealand Inc

Table 2.19: Commencing international(a) medical students: Attrition rates, 2013

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The attrition numbers and proportions over the period 2008-2013 have been variable (Table 2.20). A higher proportion of commencing domestic students (over 70%) have discontinued their degree compared with commencing international students. The gender breakdown has also been variable.

  2008 2009 2010 2011 2012 2013

Change 2008-2013 (%)

Domestic 75 53 70 63 84 48 -36.0

Proportion domestic (%) 78.1 71.6 78.7 70.8 83.2 73.8 -5.5

Proportion female (%) 54.7 64.2 48.6 42.9 53.6 52.1 -4.8

International 21 21 19 26 17 17 -19.0

Proportion international (%) 21.9 28.4 21.3 29.2 16.8 26.2 19.6

Proportion female (%) 42.9 52.4 36.8 42.3 29.4 47.1 9.7

Total 96 74 89 89 101 65 -32.3

Annual change   -22 15 0 12 -36  

Annual change (%)   -22.9 20.3 0 13.5 -35.6  

(a) Attrition rates report on the number of students that have permanently ceased candidature in a medical degree. This does not include students who have deferred study or transferred to other medical schools.

Source: Medical Deans Australia and New Zealand Inc

Attrition rates for medical courses are anticipated to be relatively low when compared to other courses and this is relevant to numbers of both commencing and continuing students. However, the highest attrition from a medical course occurs at the period of commencing studies.

The next set of tables provides information about attrition rates for continuing students. A continuing student is a student enrolled in any year of a medical program other than commencing.

In 2013, 65 of 11,199 (0.58%) continuing domestic students (27 male and 38 female students) discontinued their medical degree beyond the commencing period (Table 2.21).

Table 2.20: Commencing medical students: Attrition(a) rates, 2008-2013

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University Male Female Total

Proportion of total

continuing domestic students who ceased candidature (%)

New South Wales

Newcastle/UNE 1 5 6 9.2

Notre Dame Sydney 0 0 0 0

Sydney 3 6 9 13.8

UNSW 6 3 9 13.8

UWS 1 5 6 9.2

Wollongong 0 0 0 0

Total NSW 11 19 30 46.2

Victoria

Deakin 1 2 3 4.6

Melbourne MD 0 0 0 0

Melbourne UG 2 0 2 3.1

Monash PG 0 0 0 0

Monash UG 0 0 0 0

Total VIC 3 2 5 7.7

Queensland

Bond 0 1 1 1.5

Griffith 2 0 2 3.1

Queensland 3 1 4 6.2

James Cook 5 7 12 18.5

Total QLD 10 9 19 29.2

Western Australia

Notre Dame WA 0 2 2 3.1

UWA MD 0 0 0 0

UWA PG 0 2 2 3.1

UWA UG 0 0 0 0

Total WA 0 4 4 6.2

South Australia

Adelaide 2 3 5 7.7

Flinders 1 0 1 1.5

Total SA 3 3 6 9.2

Tasmania

Tasmania 0 1 1 1.5

Australian Capital Territory

ANU 0 0 0 0

Total 27 38 65 100.0

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

Source: Medical Deans Australia and New Zealand Inc

Table 2.21: Continuing domestic medical students: Attrition rates, 2013

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In comparison to domestic students, 26 of 1,901 (1.4%) continuing international students (19 male and 7 female students) discontinued their medical degree beyond the commencing period in 2013 (Table 2.22).

University Male Female Total

Proportion of total continuing international students who ceased candidature (%)

New South Wales

Newcastle/UNE 1 0 1 3.8

Notre Dame Sydney 0 0 0 0

Sydney 1 1 2 7.7

UNSW 4 0 4 15.4

UWS 2 3 5 19.2

Wollongong 1 0 1 3.8

Total NSW 9 4 13 50.0

Victoria

Deakin 0 0 0 0

Melbourne MD 0 0 0 0

Monash PG 0 0 0 0

Monash UG 0 1 1 3.8

Total VIC 0 1 1 3.8

Queensland

Bond 0 0 0 0

Griffith 0 0 0 0

Queensland 4 1 5 19.2

James Cook 2 0 2 7.7

Total QLD 6 1 7 26.9

Western Australia

Notre Dame WA 0 0 0 0

UWA MD 0 0 0 0

UWA PG 0 0 0 0

UWA UG 3 0 3 11.5

Total WA 3 0 3 11.5

South Australia

Adelaide 1 1 2 7.7

Flinders 0 0 0 0

Total SA 1 1 2 7.7

Tasmania

Tasmania 0 0 0 0

Australian Capital Territory

ANU 0 0 0 0

Total 19 7 26 100.0

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia.

Source: Medical Deans Australia and New Zealand Inc

Table 2.22: Continuing international(a) medical students: Attrition rates, 2013

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The attrition numbers and proportions of continuing medical students over the period 2008-2013 have also been variable (Table 2.23). A higher proportion of continuing domestic students have discontinued their degree compared with continuing international students. The gender breakdown has also been variable.

University 2008 2009 2010 2011 2012 2013

Change 2008-2013 (%)

Domestic 75 82 75 81 110 65 -13.3

Proportion domestic (%) 87.2 77.4 80.6 77.1 79.7 71.4 -18.1

Proportion female (%) 50.7 48.8 54.7 64.2 50.0 58.5 15.4

International 11 24 18 24 28 26 136.4

Proportion international (%) 12.8 22.6 19.4 22.9 20.3 28.6 123.4

Proportion female (%) 36.4 50.0 38.9 33.3 50.0 26.9 -26.1

Total 86 106 93 105 138 91 5.8

Annual change   20 -13 12 33 -47  

Annual change (%)   23.3 -12.3 12.9 31.4 -34.1  

(a) Continuing student is a student enrolled in any year of a medical program other than commencing. (b) Attrition rates report on the number of students that have permanently ceased candidature in a medical degree. This does not include students who have deferred study or transferred to other medical schools.

Source: Medical Deans Australia and New Zealand Inc 

Trends The number of commencing medical students increased from 2010 to 2011 (301 more commencements in 2011 compared to 2010), but decreased in both 2012 (by 84 students) and 2013 (by 17 students). It slightly increased again in 2014 by 68 students (1.9%).

However, overall the number of commencing medical students has remained relatively steady over the last five years, increasing by only 7.7%, from 3,469 in 2010 to 3,737 in 2014 (Table 2.24).

Over the same five year period, the number of domestic commencing students increased by 245 students or 8.3%, while the number of international commencing students increased by only 23 students or 4.3%.

The proportion of female domestic students commencing medical studies remained relatively stable over the last five years - around half the number of all commencing medical students were females. However, the proportion of female international students tended to be slightly less than half of all commencing international students, except 2014 where the number was similar.

Table 2.23: Continuing(a) medical students: Attrition(b) rates, 2008-2013

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  2010 2011 2012 2013 2014

Domestic 2,940 3,241 3,035 3,033 3,185

Proportion female (%) 52.9 50.9 48.1 51.2 52.3

International(b),(c) 529 529 651 636 552

Proportion female (%) 42.5 47.6 47.5 45.6 50.4

Total 3,469 3,770 3,686 3,669 3,737

Annual change 301 -84 -17 68

Annual change (%) 8.7 -2.2 -0.5 1.9

(a) Based on the commencing year of the medical program. (b) International students are those studying onshore in Australia as private or sponsored students who are not Australian or New Zealand citizens, or permanent residents. (c) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia.

Source: Medical Deans Australia and New Zealand Inc

Projections suggest that 3,719 medical students will commence their studies in Australian universities in 2015 (Table 2.25). Of these, 3,150 (84.7%) are expected to be domestic students and 569 (15.3%) international students. This is slightly less (by 18 students or -0.5%) than the actual number of students who commenced medical studies in 2014.

University Domestic International(b) Total

Adelaide 116 34 150

ANU 90 4 94

Bond 95 - 95

Deakin 135 12 147

Flinders 135 30 165

Griffith 150 10 160

James Cook 165 30 195

Melbourne 295 40 335

Monash 325 65 390

Newcastle/UNE 170 24 194

Notre Dame Sydney 120 - 120

Notre Dame Fremantle 110 - 110

Queensland 320 90 410

Sydney 228 80 308

Tasmania 100 20 120

UNSW 208 68 276

UWA 209 30 239

UWS 105 20 125

Wollongong 74 12 86

Total 3,150 569 3,719

(a) These numbers are projections only and are subject to change. (b) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia.

Source: Medical Deans Australia and New Zealand Inc

Table 2.24: Commencing medical students: Domestic, international and proportion of females(a), 2010-2014

Table 2.25: Commencing medical student projections(a), 2015

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Between 2010 and 2014, there was an increase of 1,440 students (9.4%) of the total number of medical students studying in Australian universities (Table 2.26). Over the same period, the number of domestic students increased proportionally more than the number of international students, rising by 11.1% to 14,384 students. The number of international students has increased by only 0.1% to 2,453.

  2010 2011 2012 2013 2014

Domestic 12,946 13,956 14,177 14,267 14,384

Proportion female (%) 54.2 53.0 51.5 51.2 51.3

Annual change (%) 7.0 7.8 1.6 0.6 0.8

International(b),(c),(d) 2,451 2,535 2,691 2,727 2,453

Proportion female (%) 50.1 49.1 48.7 47.3 48.8

Annual change (%) 1.1 3.4 6.2 1.3 -10.0

Total 15,397 16,491 16,868 16,994 16,837

Annual change 1,094 377 126 -157

Annual change (%) 7.1 2.3 0.7 -0.9

(a) Data cover all years of study. (b) International students are those studying as private or sponsored students who are not Australian or New Zealand citizens or permanent residents. (c) From 2009-2013 data include the UQ Ochsner cohort. (d) From 2014 data exclude all offshore programs, including UQ Ochsner and Monash Malaysia.

Source: Medical Deans Australia and New Zealand Inc

Medical Graduates

Current Data In 2013, a total of 3,441 students graduated from Australian medical schools. Of these, 2,944 or 85.6% were domestic students (Table 2.27).

Trends Each year the number of domestic medical graduates has increased. The increase was 6.0% from 2012 to 2013 and there was an overall increase of 53.7% in domestic graduates across the last five years from 2009 to 2013 (Table 2.29).

From 2009 to 2013 the number of domestic medical graduates increased in each state and territory. The greatest increases were in New South Wales and Victoria by 90.4% and 85.4% respectively (Table 2.27).

Table 2.26: Medical students: Domestic, international and proportion of females(a), 2010-2014

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University 2009 2010 2011 2012 2013

Change 2009-2013

Change 2009-2013 (%)

New South Wales

Newcastle/UNE 85 104 70 140 147 62 72.9

Notre Dame Sydney .. .. 103 106 107 .. ..

Sydney 208 221 222 237 231 23 11.1

UNSW 163 166 187 198 203 40 24.5

UWS .. .. 86 91 108 .. ..

Wollongong .. 63 67 66 72 .. ..

Total NSW 456 554 735 838 868 412 90.4

Victoria

Deakin .. .. 109 123 136 .. ..

Melbourne 198 212 234 231 240 42 21.2

Monash 165 181 219 290 297 132 80.0

Total VIC 363 393 562 644 673 310 85.4

Queensland

Bond 55 74 81 69 85 30 54.5

Griffith 116 151 133 150 144 28 24.1

Queensland 279 332 290 307 314 35 12.5

James Cook 82 94 88 92 136 54 65.9

Total QLD 532 651 592 618 679 147 27.6

Western Australia

Notre Dame Fremantle 80 86 98 104 114 34 42.5

UWA 182 207 172 165 183 1 0.5

Total WA 262 293 270 269 297 35 13.4

South Australia

Adelaide 83 94 97 111 127 44 53.0

Flinders 74 102 109 113 111 37 50.0

Total SA 157 196 206 224 238 81 51.6

Tasmania

Tasmania 73 89 67 97 104 31 42.5

Australian Capital Territory

ANU 72 83 75 87 85 13 18.1

Total 1,915 2,259 2,507 2,777 2,944 1,029 53.7

Annual change 344 248 270 167    

Annual change (%)   18.0 11.0 10.8 6.0    

Source: Medical Deans Australia and New Zealand Inc

Table 2.27: Domestic medical school graduates in Australian universities, by state/territory, 2009-2013

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The number of international students graduating from Australian medical schools fluctuated over the period 2009-2013 with an overall increase of 32 graduates or 6.9% (Table 2.28).

University 2009 2010 2011 2012 2013

Change 2009-2013

Change 2009-2013 (%)

New South Wales

Newcastle/UNE 21 21 20 29 23 2 9.5

Notre Dame Sydney .. .. .. .. 0 .. ..

Sydney 54 35 32 38 48 -6 -11.1

UNSW 36 55 36 46 58 22 61.1

UWS .. .. .. 9 7 .. ..

Wollongong .. 4 10 11 8 .. ..

Total NSW 111 115 98 133 144 33 29.7

Victoria

Deakin .. .. 0 1 4 .. ..

Melbourne 97 90 89 83 86 -11 -11.3

Monash 74 94 70 67 62 -12 -16.2

Total VIC 171 184 159 151 152 -19 -11.1

Queensland

Bond 4 1 1 1 2 -2 -50.0

Griffith 2 0 0 .. 0 -2 -100.0

Queensland 67 77 98 130 114 47 70.1

James Cook 2 3 2 3 2 0 0

Total QLD 75 81 101 134 118 43 57.3

Western Australia

Notre Dame Fremantle 0 0 0 0 0 .. ..

UWA 15 25 27 21 28 13 86.7

Total WA 15 25 27 21 28 13 86.7

South Australia

Adelaide 38 40 21 24 24 -14 -36.8

Flinders 28 14 19 19 11 -17 -60.7

Total SA 66 54 40 43 35 -31 -47.0

Tasmania

Tasmania 21 11 28 16 12 -9 -42.9

Australian Capital Territory

ANU 6 4 4 9 8 2 33.3

Total 465 474 457 507 497 32 6.9

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia.

Source: Medical Deans Australia and New Zealand Inc

Table 2.28: International(a) medical school graduates in Australian universities, by state/territory, 2009-2013

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Table 2.29 shows that approximately half of all medical graduates, both domestic and international, were females (52.8% for domestic and 49.1% for international in 2013).

  2009 2010 2011 2012 2013

Change 2009-2013 (%)

Domestic 1,915 2,259 2,507 2,777 2,944 53.7

Proportion domestic (%) 80.5 82.7 84.6 84.6 85.6 6.3

Proportion female (%) 54.1 54.1 55.0 53.2 52.8 -2.4

International(a) 465 474 457 507 497 6.9

Proportion international (%) 19.5 17.3 15.4 15.4 14.4 -26.1

Proportion female (%) 51.6 54.2 51.6 52.9 49.1 -4.8

Total 2,380 2,733 2,964 3,284 3,441 44.6

Annual increase (%)   14.8 8.5 10.8 4.8  

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia.

Source: Medical Deans Australia and New Zealand Inc

In 2013, 80.4% of medical graduates were Commonwealth-supported (Table 2.30).

Table 2.29: Medical graduates: Domestic, international and proportions of females, 2009-2013

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  2012 2013

Change 2012-2013

Change 2012-2013 (%)

Medical Graduates

Commonwealth-supported 2,612 2,765 153 5.9

HECS-HELP only 1,879 1,931 52 2.8

BMP Scheme 633 733 100 15.8

MRBS Scheme 100 101 1 1.0

Fee-paying 663 667 4 0.6

Domestic 156 170 14 9.0

International(a) 507 497 -10 -2.0

Other 9 9 0 0

Total 3,284 3,441 157 4.8

Proportion of places (%)

Commonwealth-supported 79.5 80.4    

HECS-HELP only 57.2 56.1    

BMP Scheme 19.3 21.3    

MRBS Scheme 3.0 2.9    

Fee-paying 20.2 19.4    

Domestic 4.8 4.9    

International 15.4 14.4    

Other 0.3 0.3    

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia.

Source: Medical Deans Australia and New Zealand Inc

Projected Numbers of Graduates Table 2.31 shows the projected number of domestic medical graduates up until 2019. These figures are based on current and planned enrolments as of 2014. Attrition has not been factored into these figures.

The number of domestic medical graduates is projected to rise from 3,056 in 2014 to 3,173 in 2019. This is an overall increase of 3.8% over the five years from 2014 to 2019.

Table 2.30: Medical graduates by type of student place: Number and proportion of places, 2012-2013

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University 2014 2015 2016 2017 2018 2019

New South Wales

Newcastle/UNE 174 187 176 186 173 170

Notre Dame Sydney 109 112 121 120 120 120

Sydney 264 221 226 229 228 228

UNSW 227 233 203 199 235 214

UWS 107 109 103 100 108 105

Wollongong 74 76 73 80 74 74

Total NSW 955 938 902 914 938 911

Victoria

Deakin 134 132 131 129 135 135

Melbourne MD 292 285 293 302 295 295

Melbourne PG 0 0 0 0 0 0

Melbourne UG 6 8 3 0 0 0

Monash PG 65 83 77 76 75 75

Monash UG 188 255 248 265 242 250

Total VIC 685 763 752 772 747 755

Queensland

Bond 82 79 95 92 94 95

Griffith 142 147 148 150 150 150

Queensland 335 315 328 306 320 320

James Cook 141 164 155 174 184 182

Total QLD 700 705 726 722 748 747

Western Australia

Notre Dame Fremantle 108 89 108 113 110 110

UWA PG 53 67 43 0 0 0

UWA UG 130 151 136 0 0 0

UWA MD 0 0 0 210 209 209

Total WA 291 307 287 323 319 319

South Australia

Adelaide 138 156 164 172 120 116

Flinders 113 131 142 152 135 135

Total SA 251 287 306 324 255 251

Tasmania

Tasmania 86 86 79 100 99 100

Australian Capital Territory

ANU 88 81 97 90 90 90

Total 3,056 3,167 3,149 3,245 3,196 3,173

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

(a) No allowance has been made for student attrition.

Source: Medical Deans Australia and New Zealand Inc

Table 2.31: Domestic medical students expected to graduate from Australian universities: Projected numbers(a) by state/territory, 2014-2019

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The projected numbers of international students to graduate from Australian universities are also expected to increase, rising by 19.7% from 493 in 2014 to 590 in 2019 (Table 2.32).

University 2014 2015 2016 2017 2018 2019

New South Wales

Newcastle/UNE 32 33 26 27 21 24

Notre Dame Sydney 0 0 0 0 0 0

Sydney 51 76 67 69 80 80

UNSW 58 57 70 57 62 81

UWS 23 14 20 20 19 20

Wollongong 6 9 9 5 12 12

Total NSW 170 189 192 178 194 217

Victoria

Deakin 2 6 5 5 12 12

Melbourne MD 21 34 33 45 40 40

Melbourne PG 0 0 0 0 0 0

Melbourne UG 0 0 1 0 0 0

Monash PG 15 5 8 5 5 5

Monash UG 48 49 63 53 68 60

Total VIC 86 94 110 108 125 117

Queensland

Bond 2 2 0 0 0 0

Griffith 1 6 4 3 10 10

Queensland 100 120 110 107 90 90

James Cook 21 27 15 21 35 32

Total QLD 124 155 129 131 135 132

Western Australia

Notre Dame Fremantle 0 0 0 0 0 0

UWA PG 0 0 9 0 0 0

UWA UG 30 31 30 0 0 0

UWA MD 0 0 0 23 30 30

Total WA 30 31 39 23 30 30

South Australia

Adelaide 29 27 21 25 31 34

Flinders 18 20 25 14 30 30

Total SA 47 47 46 39 61 64

Tasmania

Tasmania 27 22 25 20 18 20

Australian Capital Territory

ANU 9 7 1 3 10 10

Total 493 545 542 502 573 590

UG - undergraduate PG - postgraduate MD - Doctor of Medicine

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia. (b) No allowance has been made for student attrition.

Source: Medical Deans Australia and New Zealand Inc

Table 2.32: International(a) medical students expected to graduate from Australian universities: Projected numbers(b) by state/territory, 2014-2019

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Table 2.33 summarises the number of domestic and international students projected to graduate from Australian universities between 2014 and 2019.

In total, 3,763 medical students are expected to graduate in 2019, 6.0% more than predicted for 2014. This is 9.4% higher than the actual number of medical students who graduated in 2013 (3,441) and 58.1% higher than the 2,380 medical students who graduated in 2009.

 

2014 2015 2016 2017 2018 2019

Change 2014-2019 (%)

Domestic 3,056 3,167 3,149 3,245 3,196 3,173 3.8

International(b) 493 545 542 502 573 590 19.7

Total 3,549 3,712 3,691 3,747 3,769 3,763 6.0

Change from previous year   163 -21 56 22 -6  

Change from previous year (%)   4.6 -0.6 1.5 0.6 -0.2  

(a) Attrition has not been factored into the numbers provided. (b) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia.

Source: Medical Deans Australia and New Zealand Inc

Table 2.33: Medical students expected to graduate from Australian universities: Projected number of domestic and international students(a), 2014-2019

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Chapter 3 PREVOCATIONAL MEDICAL TRAINING This chapter details the number of junior doctors undertaking postgraduate prevocational training across Australia. Data have been provided by state and territory health departments through their postgraduate medical councils and the Australian Government Department of Health, and covers training activities up to June 2014.

Background Medical graduates of Australian universities are predominantly employed through public health services and enter the medical workforce as interns or postgraduate year 1 (PGY1) doctors. Junior doctors are required to satisfactorily complete an intern year before being granted general medical registration. All medical practitioners, including junior doctors, are registered through a single national board, the Medical Board of Australia (MBA).

In order to satisfy MBA registration requirements, interns undertake a series of rotations to enable them to experience a range of clinical situations and service environments. These rotations must be accredited in accordance with guidelines developed by the state and territory postgraduate medical councils or medical education and training units. These placements must ensure adequate case-mix, service, teaching, supervision and assessment.

Most junior doctors work for at least one, and often for two or more years after their intern year, in the public hospital system and community health services, to gain more clinical experience with greater levels of responsibility prior to commencing a vocational training program. An important goal of this experience is to consolidate the clinical skills developed during university training and the intern year, and to equip junior doctors with the prerequisite experience and procedural skills for entry into specialist or vocational training programs.

Generally, training at the prevocational level involves rotating between clinical departments in regional and urban public hospitals with some rotation from urban hospitals to regional and rural hospitals and community settings, including general practice. These rotations are intended to give junior doctors experience of a broader range of clinical settings, and meet service delivery needs.

Although a number of specialist medical colleges may accept entrants to vocational training programs directly following completion of postgraduate year 1, most prefer applicants to have completed a second or even third year of prevocational training (PGY2 and PGY3). Doctors in this period of prevocational on-the-job training are usually referred to as ‘Resident Medical Officers’ (RMOs). The term ‘Hospital Medical Officer’ (HMO) is used in Victoria and the term ‘Trainee Medical Officer’ (TMO) in South Australia.

Not all PGY2 and PGY3 doctors will enter vocational specialist training. This is because some are waiting for a place in their selected vocational training specialty, but others will leave the medical workforce, pursue a research career, choose to work as locums or continue to work in hospital settings in a non-vocational career role, typically as Career Medical Officers (CMOs). Most CMOs work in hospital settings, and a number of CMOs acquire other postgraduate qualifications related to their roles, such as early management of severe trauma, advanced paediatric life support or emergency life support.

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When interpreting and analysing these prevocational data, caution is needed. This is because the numbers presented are sometimes estimates, with administration systems often not capturing data in a way that matches the breakdown of information for MTRP reporting purposes. Consequently, the number of trainees, particularly PGY2 doctors, is an underestimate. Also, some states and territories have different prevocational training processes. For instance, in New South Wales, trainees are employed on two year contracts covering both PGY1 and PGY2 training. As a result, the number of PGY2 positions advertised each year and offered does not reflect the total number of PGY2 positions available.

Attempts to capture all training and supervisory activities have continued this year through broadening the specifications, to include supervision and additional training of overseas trained doctors as necessary for recognition of their qualifications within Australia. The degree to which state and territory administration systems have been able to accurately capture this information is unknown.

Postgraduate Year 1

Current Data In 2014, there were 3,287 trainees commencing PGY1. Of these, over half (51.4%) were females (Table 3.1).

Just over eighty percent (2,651 or 80.7%) of all PGY1 trainees commenced training in the state or territory in which they completed their medical degree. A further 274 trainees (8.3%) were trained in Australia, but commenced their PGY1 training in another state or territory.

International students who graduated from an Australian medical school occupied 277 (8.4%) of the PGY1 positions. The number of PGY1 positions in each state and territory approximately matched the distribution of the population as a whole.

The Commonwealth provided funding for additional medical internship positions in 2014 through the Commonwealth Medical Internships (CMI) initiative. As domestic medical students are guaranteed an internship by states and territories under a 2006 Council of Australian Governments agreement, CMI positions are only available to eligible international full-fee paying medical graduates who completed all of their medical degree in Australia (except for university approved rotations offshore).

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NSW VIC(a) QLD SA WA TAS NT ACT AUS

All commencing PGY1 trainees

Australian trained local (own state) 812 649 603 201 262 54 0 70 2,651

- Commonwealth-supported 757 na 537 198 262 50 0 70 1,874

- Full-fee paying 55 na 66 3 0 4 0 0 128

Australian trained local (interstate) 90 25 56 36 12 5 36 14 274

- Commonwealth-supported 79 na na 29 12 3 0 14 137

- Full-fee paying 11 na na 7 0 2 0 0 20

New Zealand medical graduates 2 0 1 0 0 0 0 0 3

International students who graduated from an Australian medical school 53 79 34 41 38 12 8 12 277

- Own state 53 (c)78 33 29 25 0 0 8 226

- Interstate 0 1 1 12 13 12 0 4 43

Australian Medical Council graduates 0 0 1 0 0 5 0 0 6

Total state/territory funded trainees 957 753 695 278 312 76 44 96 3,211

Eligible international students who graduated from an onshore Australian medical school and were placed by the Commonwealth(b) .. .. 61 .. 15 .. .. .. 76

Total 957 753 756 278 327 76 44 96 3,287

Proportion of total trainees (%) 29.1 22.9 23.0 8.5 9.9 2.3 1.3 2.9 100.0

Females

Australian trained local (own state) 423 361 294 106 149 29 0 40 1,402

- Commonwealth-supported 402 na 255 106 149 26 0 40 978

- Full-fee paying 21 na 39 0 0 3 0 0 63

Australian trained local (interstate) 36 10 36 16 10 4 23 10 145

- Commonwealth-supported 32 na na 12 10 3 0 10 67

- Full-fee paying 4 na na 4 0 1 0 0 9

New Zealand medical graduates 0 0 0 0 0 0 0 0 0

International students who graduated from an Australian medical school 28 42 19 21 17 5 4 3 139

- Own state 28 (d)42 19 13 10 0 0 0 112

- Interstate 0 0 0 8 7 5 4 3 27

Australian Medical Council graduates 0 0 1 0 0 4 0 0 5

Total state/territory funded trainees 487 413 350 143 176 42 27 53 1,691

Eligible international students who graduated from an onshore Australian medical school and were placed by the Commonwealth(b) .. .. na .. na .. .. .. na

Total 487 413 350 143 176 42 27 53 1,691

Proportion females (%)

Australian trained local (own state) 52.1 55.6 48.8 52.7 56.9 53.7 0 57.1 52.9

Table 3.1: Commencing postgraduate year 1 trainees or supervised training positions: Total, females and proportion of females by doctor category and state/territory, 2014

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  NSW VIC(a) QLD SA WA TAS NT ACT AUS

- Commonwealth-supported 53.1 na 47.5 53.5 56.9 52.0 0 57.1 52.2

- Full-fee paying 38.2 na 59.1 na 0 75.0 0 0 49.2

Australian trained local (interstate) 40.0 40.0 64.3 44.4 83.3 80.0 63.9 71.4 52.9

- Commonwealth-supported 40.5 na 0 41.4 83.3 100.0 0 71.4 48.9

- Full-fee paying 36.4 na 0 57.1 0 50.0 0 0 45.0

New Zealand medical graduates 0 0 0 na 0 0 0 0 0

International students who graduated from an Australian medical school 52.8 53.2 55.9 51.2 44.7 41.7 50.0 25.0 50.2

- Own state 52.8 53.8 57.6 44.8 40.0 0 0 0 49.6

- Interstate 0 0 0 66.7 53.8 41.7 0 75.0 62.8

Australian Medical Council graduates 0 0 100.0 na 0 80.0 0 0 83.3

Total state/territory funded trainees 50.9 54.8 50.4 51.4 56.4 55.3 61.4 55.2 52.7 Eligible international students who graduated from an onshore Australian medical school and were placed by the Commonwealth(b) .. .. na .. na .. .. .. na

Total 50.9 54.8 46.3 51.4 53.8 55.3 61.4 55.2 51.4

(a) Victoria does not collect data regarding the fee status of domestic students studying in Victoria or interstate. (b) Includes PGY1 positions funded by the Commonwealth Government under the Commonwealth Medical Internships Initiative 2014. (c) Includes 10 graduates of an Australian Medical Council Accredited Overseas University (Monash Malaysia). (d) Includes 6 female graduates of an Australian Medical Council Accredited Overseas University (Monash Malaysia).

Source: Australian Government Department of Health and state and territory government health departments

Internship in Rural Location Rural areas are classified as RA2 to RA5 under the Australian Standard Geographical Classification - Remoteness Areas (ASGC-RA) system.

In 2014, there were 666 rural intern positions (Table 3.2) where PGY1 trainees could undertake the majority of their internship in a rural location. The largest number of positions was 260 in Queensland, followed by Victoria (143) and New South Wales (131).

There were 617 PGY1 trainees undertaking a rural internship - a type of internship when all or majority of it is undertaken in an RA2-RA5 hospital.

In addition to unfilled Rural Preferential Recruitment positions being filled by interns on rotation, in 2014 there were 157 rotational positions in rural hospitals in Australia. The highest number of rural based intern positions filled on rotation by PGY1 trainees from a metropolitan hospital was in Victoria (83), followed by Western Australia (33).

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NSW VIC QLD SA WA TAS NT ACT AUS

Rural intern positions where postgraduate year 1 trainees can undertake majority of their internship in a rural location (d)131 143 260 6 6 76 44 .. 666

Postgraduate year 1 trainees undertaking rural internship (RA2-RA5)(b) (e)82 143 260 6 6 76 44 .. 617

Rotational positions (RA2-RA5)(c) (f)17 83 na 19 33 0 na (g)5 157

(a) Rural area classified as RA2 to RA5 under the Australian Standard Geographical Classification - Remoteness Areas (ASGC-RA) system. (b) Rural internship is a type of internship when all or majority of it is undertaken in an RA2-RA5 hospital. (c) Rotational positions are the rural based intern positions that are filled on rotation by doctors from a metropolitan hospital. (d) These positions are recruited to Rural Hospitals via the Rural Preferential Recruitment (RPR) Pathway. Maitland and Tweed

Heads Hospitals have RA1 classification but are part of RPR. (e) Number of rural hospital positions filled via RPR pathway. The remaining 32 unfilled RPR positions were filled using trainees in the network from metropolitan hospitals on rotation to rural hospitals. (f) Rotational positions in rural hospitals are in addition to unfilled RPR positions being filled by interns on rotation. (g) These rotational positions were NSW funded positions in NSW hospitals filled by ACT PGY1 trainees.

Source: State and territory government health departments

Trends The number of PGY1 commencements continued to increase, with 893 additional interns (37.3% increase) commencing their training in 2014 compared with 2010 (Table 3.3).

The increase in number of trainees commencing their first year of prevocational training appear to be considerably greater in some jurisdictions over the period of 2010 to 2014, in particular the Australian Capital Territory and New South Wales with 54.8% and 45.7% increase in numbers respectively.

Table 3.2: Commencing postgraduate year 1 trainees or supervised training positions (RA2-RA5)(a) by state/territory, 2014

Table 3.3: Commencing postgraduate year 1 trainees by state/territory, 2010-2014

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NSW VIC QLD SA WA TAS NT ACT AUS

Rural intern positions where postgraduate year 1 trainees can undertake majority of their internship in a rural location (d)131 143 260 6 6 76 44 .. 666

Postgraduate year 1 trainees undertaking rural internship (RA2-RA5)(b) (e)82 143 260 6 6 76 44 .. 617

Rotational positions (RA2-RA5)(c) (f)17 83 na 19 33 0 na (g)5 157

(a) Rural area classified as RA2 to RA5 under the Australian Standard Geographical Classification - Remoteness Areas (ASGC-RA) system. (b) Rural internship is a type of internship when all or majority of it is undertaken in an RA2-RA5 hospital. (c) Rotational positions are the rural based intern positions that are filled on rotation by doctors from a metropolitan hospital. (d) These positions are recruited to Rural Hospitals via the Rural Preferential Recruitment (RPR) Pathway. Maitland and Tweed

Heads Hospitals have RA1 classification but are part of RPR. (e) Number of rural hospital positions filled via RPR pathway. The remaining 32 unfilled RPR positions were filled using trainees in the network from metropolitan hospitals on rotation to rural hospitals. (f) Rotational positions in rural hospitals are in addition to unfilled RPR positions being filled by interns on rotation. (g) These rotational positions were NSW funded positions in NSW hospitals filled by ACT PGY1 trainees.

Source: State and territory government health departments

Trends The number of PGY1 commencements continued to increase, with 893 additional interns (37.3% increase) commencing their training in 2014 compared with 2010 (Table 3.3).

The increase in number of trainees commencing their first year of prevocational training appear to be considerably greater in some jurisdictions over the period of 2010 to 2014, in particular the Australian Capital Territory and New South Wales with 54.8% and 45.7% increase in numbers respectively.

Table 3.2: Commencing postgraduate year 1 trainees or supervised training positions (RA2-RA5)(a) by state/territory, 2014

Table 3.3: Commencing postgraduate year 1 trainees by state/territory, 2010-2014

2010 2011 2012 2013 2014

Change 2010-2014 (%)

New South Wales 657 756 (c)849 (d)923 (e)957 45.7

Victoria 557 625 698 707 753 35.2

Queensland (b)558 (b)644 (b)663 678 695 24.6

South Australia 230 247 256 276 278 20.9

Western Australia 240 267 282 300 312 30.0

Tasmania 58 71 73 75 76 31.0

Northern Territory 32 35 41 44 44 37.5

Australian Capital Territory 62 78 88 93 96 54.8

Commonwealth Funded(a) .. .. .. 22 76 ..

Australia 2,394 2,723 2,950 3,118 3,287 37.3

Change from previous year (%) 13.7 8.3 5.7 5.4

(a) Includes PGY1 positions funded by the Commonwealth Government under the Additional Medical Internships Initiative 2013 and Commonwealth Medical Internships Initiative 2014. (b) Approximate numbers only based on acceptances registered in eRecruitment system. (c) Total number of intern positions available for 2012 was 850. (d) Total number of intern positions available for 2013 was 927. (e) Total number of intern positions available for 2014 was 959.

Source: Australian Government Department of Health and state and territory government health departments

Postgraduate Year 2

Current Data There were 3,107 doctors in postgraduate year 2 (PGY2) training positions in 2014. Over half of these (53.8%) were females. Data on the doctors commencing PGY2 training are provided in Table 3.4.

Just over three quarters (75.4%) of doctors commenced their second year of prevocational medical training in the state or territory in which they were trained previously, compared with 11.3% from interstate.

International students who completed their medical degree in Australia occupied 237 or 7.6% of all PGY2 positions and a further 109 or 3.5% of positions were occupied by Australian Medical Council certificate holders.

Comparison cannot be reliably made across the states and territories due to unique inclusions and limitations on the data that can be extracted from the various systems.

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NSW VIC QLD SA WA TAS NT ACT AUS

All commencing PGY2 doctors

Australian trained local (own state) 742 584 525 166 237 40 0 49 2,343

Australian trained local (interstate) 73 63 64 21 65 8 41 16 351

New Zealand medical graduates 1 2 1 4 3 0 1 0 12

International students who graduated from an Australian medical school 38 74 59 46 3 0 0 17 237

Australian Medical Council graduates 23 7 22 1 25 15 13 3 109

Other/unspecified 35 12 0 0 0 8 0 0 55

Total 912 (a)742 671 238 333 71 55 85 3,107

Females

Australian trained local (own state) 401 299 256 98 141 21 0 35 1,251

Australian trained local (interstate) 45 35 33 12 31 4 16 8 184

New Zealand medical graduates 0 2 1 2 1 0 1 0 7

International students who graduated from an Australian medical school 23 39 29 24 2 0 0 3 120

Australian Medical Council graduate 16 7 16 0 14 10 7 3 73

Other/unspecified 26 6 0 0 0 6 0 0 38

Total 511 388 335 136 189 41 24 49 1,673

Proportion females (%)

Australian trained local (own state) 54.0 51.2 48.8 59.0 59.5 52.5 0 71.4 53.4

Australian trained local (interstate) 61.6 55.6 51.6 57.1 47.7 50.0 39.0 50.0 52.4

New Zealand medical graduates 0 100.0 100.0 50.0 33.3 0 100.0 0 58.3

International students who graduated from an Australian medical school 60.5 52.7 49.2 52.2 66.7 0 0 17.6 50.6

Australian Medical Council graduates 69.6 100.0 72.7 0 56.0 66.7 53.8 100.0 67.0

Other/unspecified 74.3 50.0 0 0 0 75.0 0 0 69.1

Total 56.0 52.3 49.9 57.1 56.8 57.7 43.6 57.6 53.8

(a) This figure only reflects the number of PGY2 positions advised by health services to include the Victorian hospital medical offer match. Health services exempted at least 37 positions from the match, so the number is underestimated.

Source: State and territory government health departments

Table 3.4: Commencing doctors in postgraduate year 2 training positions: Total, females and proportion of females by doctor category and state/territory, 2014

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Trends The number of PGY2 commencements reported has increased by 794 or 34.3% since 2010 (Table 3.5), rising from 2,313 trainees in 2010 to 3,107 in 2014. Comparisons across years and between state and territories should be undertaken with caution due to data quality issues.

The commencements appear to have increased in all states and territories from 2010 to 2014, except for Tasmania, with a decrease of 10.1% during this period. The biggest increases over the period 2010 to 2014 were in Queensland (41.6%), Western Australia (38.2%), Australian Capital Territory (37.1%) and Victoria (36.6%). However, there are a number of problems with the quality of the data provided by states and territories and the ability to extract the data accurately from the various administrative systems.

2010 2011 2012 2013 2014

Change 2010-2014 (%)

New South Wales (a)686 617 803 881 912 32.9

Victoria (b)543 (e)585 (g)644 (i)742 742 36.6

Queensland (c)474 (c)575 (c)734 683 671 41.6

South Australia 183 (f)189 (h)244 (h)356 238 30.1

Western Australia 241 330 469 (j)308 333 38.2

Tasmania (d)79 103 87 104 71 -10.1

Northern Territory 45 64 47 56 55 22.2

Australian Capital Territory 62 58 73 64 85 37.1

Australia 2,313 2,521 3,101 3,194 3,107 34.3

Change from previous year (%) -1.7 9.0 23.0 3.0 -2.7

(a) Includes 85 IMGs working in PGY2 positions registered under the Competent Authority or Standard Pathways. (b) Although there were 543 HMO2 positions included in the Computer Matching Process (the Match), only 503 were matched. There were 13 unmatched candidates who accepted vacant positions. Total number of doctors who started their PGY2 training via the Match was 516. The remaining 27 positions could be filled outside the Match (e.g. by

IMGs).

(c) Commencement data is approximate and is based upon the total number of acceptances registered in the eRecruitment system. (d) Actual allocation is not available. Figures based on number of offers made. (e) A total of 632 HMO2 positions were included in the Computer Matching Process and only 581 positions were

matched. From these 15 matched candidates declined their offer and 19 unmatched candidates accepted a position. Total number of doctors who started their PGY2 training via the Match was 585. A further 47 PGY2 posts were directly recruited by health services. (f) Includes only the number of PGY2 commencing who completed internship in SA. (g) A total of 667 HMO2 positions were included in the computer matching process and 644 positions were matched. Of the 644 matched positions, 18 candidates declined their Victorian offer. All HMO positions (i.e. 667) were filled either from candidates who participated in the Match (and were unmatched) or via direct recruitment of a health service. This figure is based on incomplete data and only reflects the number of PGY2 positions advised by health services to include in the Victorian HMO match. Health services are able to exempt positions from the matching process so the number is an underestimate. (h) Data based on number of job offers made to PGY2 doctors via SA MET centralised process. Additional employment occurs outside of this process. (i) A total of 708 HMO2 positions were included in the HMO Computer Match and of these, 689 positions were matched. 17 of the 689 matched candidates subsequently declined their offer. A further 36 candidates were offered and accepted a HMO2 position. A further 34 positions were directly recruited by health services. (j) New data checking process has enabled cleaner data and ensures the capture of PGY2 only.

Source: State and territory government health departments

Table 3.5: Postgraduate year 2 commencements by state/territory, 2010-2014

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Chapter 4 VOCATIONAL MEDICAL TRAINING This chapter reports on vocational training. It presents data on the number of vocational medical training places in 2014 and the results of college examinations held in 2013 for each of the specialty areas. All data were current as at July 2014.

The following data have been provided by all of the specialist medical colleges and associated faculties, and General Practice Education and Training Limited (GPET). In December 2014 GPET was abolished and its functions were transferred to the Australian Government Department of Health.

Data for the last five years are presented where applicable. Tables containing data reported for these and earlier years are located in Appendix D.

Vocational Medical Training in Australia Following completion of university medical education and the intern year, the majority of medical graduates decide to undertake specialist medical practice. In order to do this, they must complete a recognised medical specialty training program.

Training is provided through the specialist medical colleges and, in the case of general practice, through GPET and a network of Regional Training Providers. The training programs are accredited by the Australian Medical Council (AMC).

The AMC is an independent national standards body for medical education and training. The AMC acts as an external accreditation entity for the purposes of the Health Practitioner Regulation National Law. There is no single entry point to vocational training. Specialty training programs start in either the second or third postgraduate year, but not all who enter vocational training do so at the earliest opportunity.

To gain entry into a training program in their chosen specialty, individuals must succeed in a competitive selection process for a fixed number of accredited training positions (posts), or a place in an accredited facility or an accredited training program. The number of trainee positions offered is also dependent on the health services’ capacity to accept trainees.

The management of vocational training varies across the states and territories. The jurisdictions and health services work with the medical colleges to address particular challenges, such as improving trainee supervision in public hospitals, developing statewide training programs and addressing need for generalists or sub/super specialists. They also offer the training posts/facilities to be accredited.

Some specialist medical colleges differentiate their vocational training programs into basic and advanced components. Where required, basic training is the entry point for specialist training and must be completed before progressing to advanced training. Advanced specialist trainees then work in a series of training positions, in which they are supervised and mentored by appropriately qualified specialists. The combination of these training positions constitutes the individual’s advanced training program.

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Supervision of junior trainees (junior registrars) is usually undertaken by a specialist and/or a senior trainee (senior registrar) in association with a specialist. Over time, the registrar takes increasing responsibility for decision making about patient management and learns a wider range of practical skills.

Specialist vocational training was traditionally undertaken in teaching hospitals for most specialties, however, it is now undertaken across all public hospitals. A number of factors, including capacity constraints in the public hospital system and recognition that training needs to better reflect where healthcare is delivered, have seen an expansion over the last few years of specialist training positions to private hospitals and community settings.

All specialist colleges now assess their trainees at multiple time-points during training with a range of assessment techniques. Most colleges use written, oral and/or clinical examinations and the majority have an exit examination. A range of other in-training assessments of both a formative and summative nature are also utilised, so that the full range of knowledge, skills and behaviours, including communication, team work and other forms of professional behaviour, can be assessed.

The time required to complete vocational training programs varies between three to seven full time years, depending upon the specialty. Further information on the specific requirements for each specialty is outlined in Appendix B.

General Practice Training The Australian General Practice Training (AGPT) program is a postgraduate vocational training program for doctors wishing to pursue a career in general practice. The AGPT program provides training towards fellowship of the Royal Australian College of General Practitioners (RACGP) and/or fellowship of the Australian College of Rural and Remote Medicine (ACRRM) and is delivered through 17 Regional Training Providers (RTPs) across Australia. Until the end of 2014 the AGPT program was managed by GPET, which was owned and funded by the Australian Government to deliver training to the standards set by the RACGP and the ACRRM. The RACGP and the ACRRM are, in turn, accredited by the Australian Medical Council.

Registrars can choose between the rural pathway and the general pathway of the AGPT program. The general practice training programs usually take three years to complete, if undertaken through the RACGP, and four years, if undertaken through the ACRRM, but may take longer under some circumstances. An additional year is required for doctors taking the Fellowship in Advanced Rural General Practice (FARGP) through the RACGP. Training is primarily completed through a combination of hospital terms and general practice clinics although differences exist between the RACGP and ACRRM endpoints.

Rural pathway registrars undertake their training in rural and remote areas, as defined by the Australian Standard Geographical Classification - Remoteness Area (ASGC-RA) as Remoteness Areas 2 to 5. Metropolitan-based general pathway trainees are also required to undertake at least one placement in a rural and/or outer metropolitan area.

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The Remote Vocational Training Scheme (RVTS) provides an alternative route to vocational recognition for medical practitioners working in remote areas who find that leaving their practice to undertake the AGPT program is not viable. RVTS registrars are eligible to sit for fellowship of the RACGP and ACRRM.

More details about these programs are included in Chapter 6.

The ACRRM offers the Independent Pathway as a third AMC accredited training pathway to achieve fellowship of the college (FACRRM). The Independent Pathway is most suited to experienced doctors. It is a self-funded pathway.

Changes to College Training in Australia

College of Intensive Care Medicine of Australia and New Zealand The College of Intensive Care Medicine of Australia and New Zealand (CICM) introduced a new curriculum and trainee selection policy for trainees who registered from 1 January 2014 onwards. The total training time will remain at 6 years, consisting of a minimum of 42 months spent in accredited intensive care medicine training, 12 months of anaesthesia, 12 months of medicine (including 6 months of emergency or acute medicine) and 6 months in an elective placement. Trainees are also required to complete a term in paediatrics in an approved unit and at least 3 months of training must be undertaken in a rural hospital (paediatric and rural requirements may be completed in a discipline other than intensive care medicine).

Australasian College of Dermatologists Trainees commencing in 2014 at the Australasian College of Dermatologists (ACD) are required to prepare and have published one major quality publication or three minor publications in one or more of the approved journals as listed on the ACD Website. Trainees who commenced prior to 2014 are only required to prepare and publish two papers of a significant nature on a dermatological subject.

Australasian College for Emergency Medicine Basic training is in the process of being removed from the Australasian College for Emergency Medicine (ACEM) Training Program. From 20 June 2014 ACEM is no longer processing registrations for basic training. Commencing 1 January 2016, PGY1 and PGY2 will no longer be part of the ACEM Training Program structure. Workplace-based assessments are being used in pilot sites for advanced training in 2014; from 2015, these will be a requirement of training in all Emergency Medicine Terms.

Further information on the individual training programs for each specialty is outlined in Appendix B.

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Accredited Training Tables 4.1 and 4.2 present data on basic and advanced accredited training available in 2014. Medical colleges differ in their approaches to accrediting training. The majority of medical colleges accredit positions or posts. For some of these, all positions or posts will be filled, while for others the number of accredited positions/posts equates with the possible number of trainees that could occupy the identified places available at the beginning of the year. Some medical colleges accredit facilities, including hospitals, laboratories and other sites, to undertake training, or accredit programs that can be run in a number of sites. For example, the RACP accredits both facilities and posts, depending on specific training programs offered.

Data on the number of positions or posts and facilities or programs that have been accredited to undertake training are reported in Table 4.1 for those colleges where basic training is a requirement.

Medical specialty College Accreditation approach

Positions/Posts Facilities/Programs

Adult medicine RACP(a) (d)2,699 170

Anaesthesia ANZCA .. 96

Dermatology ACD 45 44

Emergency medicine ACEM .. 123

General practice

 

RACGP(b) .. ..

ACRRM(c) 2 ..

Intensive care CICM 25 na

Obstetrics and gynaecology RANZCOG 376 104

Ophthalmology RANZCO 54 ..

Paediatrics RACP(a) (d)818 102

Psychiatry RANZCP .. 19

(a) For basic training RACP accredits hospitals, not positions. (b) RACGP no longer distinguishes between ‘Basic’ and ‘Advanced’ positions. All training posts were identical and referred to as ‘Training posts’. (c) ACRRM accepts posts accredited by State Postgraduate Medical Councils for this stage of training but also has

standards to accredit posts if required. The number of Postgraduate Medical Council accredited posts was not included in this figure, only posts by ACRRM. (d) The number of approved programs was based on the number of trainees in Australia. It did not include trainees based overseas.

Source: Medical colleges

All medical colleges provide some form of accredited advanced training. These data are presented in Table 4.2.

Table 4.1: Basic training: Positions/posts and facilities/programs by medical specialty, 2014

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Medical specialty College Accreditation approach

Positions/Posts Facilities/Programs

Addiction medicine RACP .. (h)30

Adult medicine RACP .. (i)173

Anaesthesia ANZCA .. 103

Anaesthesia - pain medicine ANZCA .. (j)25

Dermatology ACD 54 44

Emergency medicine ACEM .. 123

General practice RACGP (e)2,001 (e)17

ACRRM 840 ..

Intensive care CICM 103 ..

Medical administration RACMA (f)92 ..

Obstetrics and gynaecology(a) RANZCOG 165 ..

Occupational and environmental medicine(b) RACP 92 ..

Ophthalmology RANZCO (g)60 ..

Oral and maxillofacial surgery RACDS 38 ..

Paediatrics RACP .. (k)131

Palliative medicine(c) RACP .. ..

Pathology(d) RCPA 307 354

Pathology and RACP (jointly) RCPA/RACP 236 ..

Psychiatry RANZCP .. 61

Public health medicine RACP 130 93

Radiation oncology RANZCR 117 44

Radiodiagnosis RANZCR 410 107

Rehabilitation medicine RACP .. 108

Sexual health medicine RACP .. 32

Sport and exercise medicine ACSP 41 ..

Surgery RACS 2,419 504

(a) Advanced training positions were not officially accredited other than prospective approval of the post. (b) Training settings were not formally accredited for occupational and environmental medicine however training positions were approved prospectively. (c) Palliative medicine sites were included with those from adult medicine. (d) Positions/Posts are the number of trainees. Facilities/Programs are the number of individually accredited laboratories

by discipline within Australia. Please note that some may not have current trainees. (e) RACGP no longer distinguishes between ‘Basic’ and ‘Advanced’ positions. All training posts are identical and referred to as ‘Training posts’. (f) Includes only Australian candidates. Excludes 31 Accelerated Pathway (AP) candidates. RACMA had a number of

candidates who were not required to undertake supervised training in an accredited position as they were on the Accelerated Pathway to Fellowship. (g) Includes year 3 and 4 trainees only who are in accredited posts. Trainees in year 5 (final year) do not have to be in accredited posts, instead they must have an individual program of training approved which is specific to their training

needs or interests. This is often a Fellowship position in Australia or overseas. (h) Number of sites currently accredited. Not all sites have current active trainee(s). (i) Number of individual sites/hospitals accredited. Each site may be accredited for a number of programs. (j) Includes three level 2 units accredited to provide 6 months training. (k) Number of individual sites/hospitals accredited. Each site may be accredited for a number of programs.

Source: Medical colleges

Table 4.2: Advanced training: Positions/posts and facilities/programs by medical specialty, 2014

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Vocational Training Data In 2014, there were 19,158 vocational training positions/trainees (Table 4.3). The largest number was in general practice, which across the two colleges had 4,486 training positions/trainees, demonstrating a 9.8% increase from the previous year (4,087 in 2013). The second largest group was in adult medicine (4,398), followed by emergency medicine (2,111), paediatrics (1,480), psychiatry (1,286) and anaesthesia, including anaesthesia - pain medicine (1,273).

Data covers all Australian trainees, as well as international medical graduates who are registered vocational trainees and who are working, being supervised or training in an accredited training position, post, facility or program. A number of medical colleges provide training overseas. Australian trainees within these overseas programs are included in the data, whereas non-Australian trainees are excluded.

It should be noted that numbers reported for some specialties differ sometimes across tables. This is primarily due to variation in what is included in the numbers in respect to New Zealand and other overseas trainees. In addition, there were a number of trainees located in more than one state and territory who could not be allocated to any one particular state/territory. These trainees have been counted in both, but the total number of trainees for that specialty only includes the physical headcount. Differences in inclusions are duly noted in the table footnotes where applicable.

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Medical specialty Basic trainees Advanced trainees Total college trainees

Addiction medicine .. 22 22

Adult medicine 2,699 1,699 4,398

Anaesthesia 543 664 1,207

Anaesthesia - pain medicine .. 66 66

Dermatology 45 54 99

Emergency medicine(a) 756 1,355 2,111

General practice

- GPET(b) .. 4,315 4,315

- ACRRM(c) .. 171 171

Intensive care 208 336 544

Medical administration .. 115 115

Obstetrics and gynaecology 376 165 (h)541

Occupational and environmental medicine .. 92 92

Ophthalmology 54 (f)90 144

Oral and maxillofacial surgery .. 38 38

Paediatrics(a) 818 662 1,480

Palliative medicine(d) .. 28 28

Pathology .. 307 307

Pathology and RACP (jointly) .. 236 236

Psychiatry (e)868 (g)418 1,286

Public health medicine .. 81 81

Radiation oncology .. 117 117

Radiodiagnosis .. 410 410

Rehabilitation medicine .. 202 202

Sexual health medicine .. 13 13

Sport and exercise medicine .. 41 41

Surgery .. 1,094 1,094

Total 6,367 12,791 19,158

(a) Paediatric emergency medicine vocational trainees were counted in both emergency medicine and paediatrics. They cannot be attributed to one or the other only due to the possibility that paediatric emergency trainees may also be undertaking another paediatric specialty.

(b) Figures are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. (c) Includes registrars on the Independent Pathway only. (d) Includes Chapter trainees only. Excludes Clinical Diploma Chapter trainees as the training program was not leading to fellowship of RACP or AChPM.

(e) Includes trainees from the 2012 Fellowship Program - 245 in Stage 1 and 104 in Stage 2. (f) Includes 5th year trainees, 10 of which are completing their final year overseas. (g) Includes 215 fellows completing subspecialty training. (h) Excludes overseas trained specialists referred to as Specialist International Medical Graduates (SIMGs) by RANZCOG.

Source: Medical colleges and GPET

Table 4.3: Vocational training positions/trainees by medical specialty, 2014

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Basic Training Periods of defined basic training prior to an individual commencing the advanced training program are required by nine specialties. Table 4.4 and Table 4.5 provide data on trainees for these specialties.

Some colleges have programs which do not distinguish between basic and advanced trainees. For example, Royal Australasian College of Surgeons (RACS) has an integrated program, the Surgical Education and Training (SET) program, which does not distinguish between basic and advanced trainees. Data on these programs are reported in the sections dealing with advanced training.

It should be noted that ACRRM only has two basic training posts recorded in this section. The reason for this is that the training program for ACRRM has three stages of training: Core Clinical Training (CCT), Primary Rural and Remote Training (PRRT) and Advanced Specialised Training (AST). In the MTRP report CCT is now defined as basic training and PRRT and AST as advanced training. ACRRM accepts posts accredited by state postgraduate medical councils for the CCT stage of training but also has standards to accredit posts if required. The number of state postgraduate medical councils accredited posts is not included in this section, only posts accredited by ACRRM. Therefore, the majority of posts accredited by ACRRM are included in Advanced Training.

There have not been any ACRRM Independent Pathway trainees recorded in Table 4.7 under basic training, as doctors on this pathway are experienced and are awarded recognised prior learning for the first year of training. Therefore, all data relating to ACRRM Independent Pathway trainees are reported in the sections dealing with advanced training.

Further information on the training requirements for each specialty is provided in Appendix B.

In total, there were 6,367 basic trainees, representing 33.2% of all vocational trainees in 2014 (Table 4.3). This represents a 5.1% increase on the 6,056 basic vocational trainees from 2013. Growth of almost 140% from the 2,653 trainees undertaking basic vocational training in 2005 was mainly related to the introduction by many colleges of additional basic training as a pre-requisite to entry to advanced training as well as the requirement for RACP trainees in their first year of training to register with the college.

The specialty with the largest number of basic trainees was adult medicine with 2,699 (Table 4.4).

Of the total number of basic trainees, 1,666 were in their first year. Over one-third (662 or 39.7%) of these basic trainees were in their first year of adult medicine. About one-sixth (277 or 16.6%) were commencing their first year of basic training in emergency medicine and 13.0% (216) were commencing in psychiatry.

All current ACEM trainees in basic training are considered in the same year (provisional training year, at least PGY3). This shows trainees who registered with ACEM for this current calendar year.

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Medical specialty NSW VIC QLD SA WA TAS NT ACT AUS

  All basic trainees

Adult medicine 661 810 577 215 299 58 21 58 2,699

Anaesthesia 203 117 114 41 35 15 5 13 543

Dermatology 11 17 11 3 2 0 0 1 45

Emergency medicine 238 140 197 54 84 17 11 15 756

Intensive care 61 27 67 15 26 1 6 5 208

Obstetrics and gynaecology 120 108 79 21 23 12 1 12 376

Ophthalmology 17 15 9 3 4 2 2 2 54

Paediatrics 242 199 172 60 98 22 8 17 818

Psychiatry(a) 271 217 188 64 73 19 12 24 868

Total 1,824 1,650 1,414 476 644 146 66 147 6,367

  First-year basic trainees

Adult medicine 93 266 149 58 65 14 3 14 662

Anaesthesia 80 47 46 9 5 8 1 5 201

Dermatology 6 9 7 3 0 0 0 1 26

Emergency medicine 83 54 73 19 29 11 3 5 277

Intensive care 2 1 2 0 0 0 0 0 5

Obstetrics and gynaecology 30 24 19 4 5 3 0 3 88

Ophthalmology 5 8 4 1 2 1 1 1 23

Paediatrics 29 40 49 10 27 6 3 4 168

Psychiatry(b) 63 56 48 18 20 4 4 3 216

Total 391 505 397 122 153 47 15 36 1,666

(a) First-year numbers include Stage 1 and Stage 2 trainees that started in the 2012 Fellowship program. (b) Includes Stage 1 trainees that started in 2014 and existing trainees in Stage 1.

Source: Medical colleges

In 2014, just over half (3,433 or 53.9%) of all basic trainees were females (Table 4.5). The specialty with the largest number of females was adult medicine, with 1,327 female basic trainees. However, the proportion of females was much higher in two particular specialties, obstetrics and gynaecology and paediatrics in which 81.6% and 72.9% respectively of all trainees were females.

Table 4.4: Basic trainees and first-year basic trainees by medical specialty and state/territory, 2014

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Medical specialty NSW VIC QLD SA WA TAS NT ACT AUS

  Female basic trainees

Adult medicine 328 438 250 111 137 21 14 28 1,327

Anaesthesia 94 51 47 15 15 7 4 7 240

Dermatology 7 13 5 3 2 0 0 0 30

Emergency medicine 113 53 95 23 36 8 7 8 343

Intensive care 24 13 22 8 10 0 4 3 84

Obstetrics and gynaecology 94 93 62 18 17 11 1 11 307

Ophthalmology 5 6 4 1 2 (b)0 (b)0 (b)1 19

Paediatrics 171 144 120 53 76 14 7 11 596

Psychiatry(a) 137 118 100 41 50 18 5 18 487

Total 973 929 705 273 345 79 42 87 3,433

  Proportion of all basic trainees (%)

Adult medicine 49.6 54.1 43.3 51.6 45.8 36.2 66.7 48.3 49.2

Anaesthesia 46.3 43.6 41.2 36.6 42.9 46.7 80.0 53.8 44.2

Dermatology 63.6 76.5 45.5 100.0 100.0 0 0 0 66.7

Emergency medicine 47.5 37.9 48.2 42.6 42.9 47.1 63.6 53.3 45.4

Intensive care 39.3 48.1 32.8 53.3 38.5 0 66.7 60.0 40.4

Obstetrics and gynaecology 78.3 86.1 78.5 85.7 73.9 91.7 100.0 91.7 81.6

Ophthalmology 29.4 40.0 44.4 33.3 50.0 0 0 50.0 35.2

Paediatrics 70.7 72.4 69.8 88.3 77.6 63.6 87.5 64.7 72.9

Psychiatry 50.6 54.4 53.2 64.1 68.5 94.7 41.7 75.0 56.1

Total 53.3 56.3 49.9 57.4 53.6 54.1 63.6 59.2 53.9

(a) Includes Stage 1 and Stage 2 trainees that started in the 2012 Fellowship program. (b) The proportion of female trainees in ACT, NT and TAS varies according to rostered rotations.

Source: Medical colleges

Trends in Basic Training It can be seen in Table 4.6 the proportion of female basic trainees has increased every year since 2010.

Since 2013, the number of first-year basic trainees has continued to decrease. However, it should be noted that figures for earlier years are not comparable due to training program changes. This includes the introduction of basic training in some specialties prior to commencing advanced training.

Table 4.5: Female basic trainees by medical specialty and state/territory, 2014

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Total college trainees

Basic training positions/ trainees

Female basic trainees

Proportion female (%)

First-year basic trainees

Proportion first-year (%)

2010 14,679 5,040 2,498 49.6 1,244 24.7

2011 15,478 5,264 2,672 50.8 1,425 27.1

2012 16,740 5,744 2,962 51.6 1,805 31.4

2013 17,888 6,056 3,235 53.4 1,669 27.6

2014 19,158 6,367 3,433 53.9 1,666 26.2

Change 2010-2014 (%) 30.5 26.3 37.4 8.8 33.9 6.0

Source: Medical colleges

The total number of basic trainees between 2010 and 2014 has increased by 26.3% (Table 4.7). However, there were medical specialties that have had larger increases than the total, namely paediatrics (47.7%) and adult medicine (42.6%). Anaesthesia, dermatology and ophthalmology remained relatively stable over the past five years.

Medical specialty 2010 2011 2012 2013 2014

Change 2010-2014 (%)

Adult medicine 1,893 1,951 2,197 2,475 2,699 42.6

Anaesthesia 504 617 615 555 543 7.7

Dermatology 42 44 42 46 45 7.1

Emergency medicine 803 785 821 727 756 -5.9

General practice

- ACRRM(a) 50 141 0 0 0 -100.0

Intensive care 167 152 192 199 208 24.6

Obstetrics and gynaecology 295 330 354 356 376 27.5

Ophthalmology 55 53 55 53 54 -1.8

Paediatrics 554 530 664 812 818 47.7

Psychiatry 677 661 804 833 (b)868 28.2

Surgery .. .. .. .. .. ..

Total 5,040 5,264 5,744 6,056 6,367 26.3

(a) Includes registrars on the Independent Pathway only. In 2010-2011 ACRRM reported those in Primary Rural and Remote Training as basic trainees, now reported as advanced trainees. (b) Includes Stage 1 and Stage 2 trainees that started in the 2012 Fellowship program.

Source: Medical colleges

Table 4.6: Vocational training positions/trainees: Total, basic, female basic and first-year basic trainees, 2010-2014

Table 4.7: Basic training positions/trainees by medical specialty, 2010-2014

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The basic trainee numbers by states and territories (Table 4.8) show that numerically the increases in 2014 compared with 2010 were greatest in Victoria (375) and New South Wales (332). As a proportion, the growth was greatest in Western Australia (47.4%), followed by the Australian Capital Territory (40%) and Tasmania (37.7%).

The number of basic trainees in most jurisdictions increased each year between 2010 and 2014, though the size of the increase varies according to jurisdiction size and available training capacity. Some of these increases have been minor, particularly in small jurisdictions, however, these increases are consistent with their size and available training capacity.

  NSW VIC QLD SA WA TAS NT ACT AUS

2010 1,492 1,275 1,148 424 437 106 53 105 5,040

2011 1,508 1,388 1,189 419 481 130 42 107 5,264

2012 1,607 1,548 1,285 478 537 134 46 109 5,744

2013 1,710 1,603 1,382 469 583 132 53 124 6,056

2014 1,824 1,650 1,414 476 644 146 66 147 6,367

Change 2010-2014 (%) 22.3 29.4 23.2 12.3 47.4 37.7 24.5 40.0 26.3

Source: Medical colleges

Behind the increases in overall basic trainee numbers are major increases in some specialities’ trainee intake (Table 4.9). The number of first-year basic trainees for paediatrics increased by over a third from 123 in 2010 to 168 in 2014. Adult medicine increased its intake of first-year basic trainees by over a quarter from 522 in 2010 to 662 in 2014.

Medical specialty 2010 2011 2012 2013 2014

Change 2010-2014 (%)

  First-year basic trainees

Adult medicine 522 583 610 585 662 26.8

Anaesthesia(a) 240 321 314 215 201 -16.3

Dermatology 23 20 26 22 26 13.0

Emergency medicine .. .. 240 241 277 ..

Intensive care 11 7 9 28 5 -54.5

Obstetrics and gynaecology 77 87 83 89 88 14.3

Ophthalmology 25 26 28 25 23 -8.0

Paediatrics 123 142 181 151 168 36.6

Psychiatry(b) 223 239 314 313 216 -3.1

Total 1,244 1,425 1,805 1,669 1,666 33.9

(a) Introductory training period is now for a period of 6 months. (b) Includes Stage 1 trainees that started in 2014 and existing trainees in Stage 1. This is a modified definition for the 2012 Fellowship program.

Source: Medical colleges

Table 4.8: Basic training positions/trainees by state/territory, 2010-2014

Table 4.9: First-year basic trainees by medical specialty, 2010-2014

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Table 4.10 shows the numbers of first-year basic trainees in each state and territory for the period 2010 to 2014. Overall, first year basic trainees have increased by over a third from 1,244 in 2010 to 1,666 in 2014, an increase of 33.9%.

  NSW VIC QLD SA WA TAS NT ACT AUS

  First-year basic trainees

2010 350 341 267 124 100 22 16 24 1,244

2011 387 410 298 124 130 39 15 22 1,425

2012 407 545 420 146 190 50 17 30 1,805

2013 397 494 402 132 154 38 15 37 1,669

2014 391 505 397 122 153 47 15 36 1,666

Change 2010-2014 (%) 11.7 48.1 48.7 -1.6 53.0 113.6 -6.3 50.0 33.9

 Source: Medical colleges

Table 4.11 shows the proportion of female basic trainees in each specialty. The table highlights the fluctuations in the number of female basic trainees in specialties from one year to another. The proportion of female basic trainees in obstetrics and gynaecology has increased year on year from 2010 to 2014. The year 2014 was the fourth consecutive year where female basic trainees comprised over half (53.9%) of all basic trainees.

Medical specialty 2010 2011 2012 2013 2014

Change 2010-2014 (%)

  Proportion female (%)  

Adult medicine 47.4 49.9 48.9 49.5 49.2 3.7

Anaesthesia 45.0 45.9 46.0 45.8 44.2 -1.8

Dermatology 64.3 63.6 45.2 56.5 66.7 3.7

Emergency medicine 38.2 39.4 42.4 42.9 45.4 18.8

General practice - ACRRM(a) 26.0 16.3 .. .. .. ..

Intensive care 33.5 24.3 32.2 40.2 40.4 20.6

Obstetrics and gynaecology 69.8 77.6 79.0 80.6 81.6 17.0

Ophthalmology 40.0 43.4 41.8 34.0 35.2 -12.0

Paediatrics 67.9 70.6 72.7 71.4 72.9 7.3

Psychiatry 54.1 55.4 53.4 54.5 (b)56.1 3.7

Total 49.6 50.8 51.6 53.4 53.9 8.7

Total female trainees 2,498 2,672 2,962 3,235 3,433 37.4

(a) Includes registrars on the Independent Pathway only. In 2010-2011 ACRRM reported those in Primary Rural and Remote Training as basic trainees, now reported as advanced trainees. (b) Includes Stage 1 and Stage 2 trainees that started in the 2012 Fellowship program.

Source: Medical colleges

Table 4.10: First-year basic trainees by state/territory, 2010-2014

Table 4.11: Proportion of female basic trainees by medical specialty, 2010-2014

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Table 4.12 provides data on female basic trainees by state and territories. Greater fluctuations are generally seen in those jurisdictions with smaller basic trainee numbers.

  NSW VIC QLD SA WA TAS NT ACT AUS

  Proportion female (%)

2010 51.3 56.0 42.0 50.0 49.7 29.2 41.5 51.4 49.6

2011 52.2 56.5 44.5 48.2 49.5 40.8 52.4 53.3 50.8

2012 51.9 55.6 46.9 51.5 52.0 44.0 52.2 51.4 51.6

2013 53.6 57.0 48.8 53.9 53.9 45.5 58.5 58.9 53.4

2014 53.3 56.3 49.9 57.4 53.6 54.1 63.6 59.2 53.9

 Source: Medical colleges

Advanced Training In 2014, there were 12,791 advanced vocational training positions/trainees in programs in Australia (Table 4.13). This constitutes two thirds (66.8%) of the total number of vocational training positions/trainees. General practice had the highest number of advanced trainees (4,486), followed by adult medicine (1,699), emergency medicine (1,355) and surgery (1,094).

Table 4.13 also shows the distribution of advanced training positions/trainees across states and territories.

Table 4.12: Proportion of female basic trainees by state/territory, 2010-2014

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Medical specialty NSW VIC QLD SA WA TAS NT ACT AUS

Addiction medicine 9 2 5 2 3 1 0 0 22

Adult medicine 543 520 296 144 120 28 14 34 1,699

Anaesthesia 195 164 168 44 63 12 7 11 664

Anaesthesia - pain medicine 25 22 8 3 3 4 0 1 66

Dermatology 18 18 8 6 4 0 0 0 54

Emergency medicine(a) 380 342 316 97 158 19 22 21 1,355

General practice

- GPET(b) 1,441 899 948 333 447 134 113 (f).. 4,315

- ACRRM(c) 48 21 68 5 20 2 7 0 171

Intensive care 104 94 69 27 22 6 3 11 336

Medical administration 33 27 32 1 12 3 4 3 115

Obstetrics and gynaecology 46 46 40 15 9 5 2 2 165

Occupational and environmental medicine 29 10 22 4 22 2 1 2 92

Ophthalmology(d) 42 22 8 7 9 1 1 0 90

Oral and maxillofacial surgery 6 11 9 4 4 1 1 2 38

Paediatrics(a) 226 159 115 58 82 6 11 5 662

Palliative medicine(e) 3 9 6 7 2 1 0 0 28

Pathology 108 77 51 20 29 9 5 8 307

Pathology and RACP (jointly) 91 67 34 16 19 1 0 8 236

Psychiatry 151 130 73 20 30 9 1 4 418

Public health medicine 23 16 10 6 8 2 6 10 81

Radiation oncology 52 24 24 5 2 3 1 6 117

Radiodiagnosis 122 104 84 46 36 6 0 12 410

Rehabilitation medicine 91 51 34 14 5 5 0 2 202

Sexual health medicine 5 4 0 2 2 0 0 0 13

Sport and exercise medicine 17 15 7 0 2 0 0 0 41

Surgery 395 306 199 83 92 4 4 11 1,094

Total 4,203 3,160 2,634 969 1,205 264 203 153 12,791

(a) Emergency medicine and paediatrics data account for trainees undertaking paediatric emergency medicine. (b) Figures are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. (c) Includes registrars on the Independent Pathway only. (d) Includes 10 trainees who are completing their final year of training overseas. (e) Includes Chapter trainees only. Excludes Clinical Diploma Chapter trainees as the training program was not leading to

fellowship of RACP or AChPM. (f) ACT data included in NSW figures for general practice, GPET.

Source: Medical colleges and GPET

Table 4.13: Advanced vocational training positions/trainees by medical specialty and state/territory, 2014

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Overall, advanced trainees were reasonably well distributed across states and territories when compared with their relative proportions of the Australian population. For the larger specialties, the proportions of trainees roughly mirrored the relative proportions of the population in each state and territory (Table 4.14).

Medical specialty NSW VIC QLD SA WA TAS NT ACT

Proportion (%)

Addiction medicine 40.9 9.1 22.7 9.1 13.6 4.5 0 0

Adult medicine 32.0 30.6 17.4 8.5 7.1 1.6 0.8 2.0

Anaesthesia 29.4 24.7 25.3 6.6 9.5 1.8 1.1 1.7

Anaesthesia - pain medicine 37.9 33.3 12.1 4.5 4.5 6.1 0 1.5

Dermatology 33.3 33.3 14.8 11.1 7.4 0 0 0

Emergency medicine 28.0 25.2 23.3 7.2 11.7 1.4 1.6 1.5

General practice                

- GPET(a) 33.4 20.8 22.0 7.7 10.4 3.1 2.6 (e)..

- ACRRM(b) 28.1 12.3 39.8 2.9 11.7 1.2 4.1 0

Intensive care 31.0 28.0 20.5 8.0 6.5 1.8 0.9 3.3

Medical administration 28.7 23.5 27.8 0.9 10.4 2.6 3.5 2.6

Obstetrics and gynaecology 27.9 27.9 24.2 9.1 5.5 3.0 1.2 1.2

Occupational and environmental medicine 31.5 10.9 23.9 4.3 23.9 2.2 1.1 2.2

Ophthalmology 46.7 24.4 8.9 7.8 10.0 1.1 1.1 0

Oral and maxillofacial surgery 15.8 28.9 23.7 10.5 10.5 2.6 2.6 5.3

Paediatrics 34.1 24.0 17.4 8.8 12.4 0.9 1.7 0.8

Palliative medicine(c) 10.7 32.1 21.4 25.0 7.1 3.6 0 0

Pathology 35.2 25.1 16.6 6.5 9.4 2.9 1.6 2.6

Pathology and RACP (jointly) 38.6 28.4 14.4 6.8 8.1 0.4 0 3.4

Psychiatry 36.1 31.1 17.5 4.8 7.2 2.2 0.2 1.0

Public health medicine 28.4 19.8 12.3 7.4 9.9 2.5 7.4 12.3

Radiation oncology 44.4 20.5 20.5 4.3 1.7 2.6 0.9 5.1

Radiodiagnosis 29.8 25.4 20.5 11.2 8.8 1.5 0 2.9

Rehabilitation medicine 45.0 25.2 16.8 6.9 2.5 2.5 0 1.0

Sexual health medicine 38.5 30.8 0 15.4 15.4 0 0 0

Sport and exercise medicine 41.5 36.6 17.1 0 4.9 0 0 0

Surgery 36.1 28.0 18.2 7.6 8.4 0.4 0.4 1.0

Total 32.9 24.7 20.6 7.6 9.4 2.1 1.6 1.2

Population proportion (%)(d) 32.0 24.8 20.1 7.2 11.0 2.2 1.0 1.7

(a) Figures are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. (b) Includes registrars on the Independent Pathway only. (c) Includes Chapter trainees only. (d) Population data from ABS. 3101.0 - Australian Demographics Statistics, March 2014, released 25/09/2014. (e) ACT data included in NSW figures for general practice, GPET.

Source: Medical colleges and GPET

Table 4.14: Proportion of advanced training positions/trainees by medical specialty and state/territory, 2014

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First-year Advanced Trainees In 2014, there were 3,556 first-year advanced vocational training positions/trainees (Table 4.15). The specialty with the most first-year advanced vocational training places was general practice (1,222), followed by adult medicine (677), paediatrics (315) and surgery (249).

Medical specialty NSW VIC QLD SA WA TAS NT ACT AUS

Addiction medicine(a) 3 1 0 1 1 1 0 0 7

Adult medicine(a) 214 198 118 57 58 12 5 15 677

Anaesthesia 46 45 49 8 18 3 3 2 174

Anaesthesia - pain medicine 10 5 6 2 2 3 0 0 28

Dermatology 8 13 4 5 2 0 0 0 32

Emergency medicine(b) 53 34 45 13 27 1 4 3 180

General practice

- GPET(c) 395 263 260 99 137 35 33 (f).. 1,222

- ACRRM(d) .. .. .. .. .. .. .. .. ..

Intensive care 11 15 15 0 3 0 1 3 48

Medical administration 13 2 10 1 3 2 2 0 33

Obstetrics and gynaecology 20 25 23 10 4 3 1 1 87

Occupational and environmental medicine 8 4 3 0 5 0 1 0 21

Ophthalmology 12 5 4 2 4 1 0 0 28

Oral and maxillofacial surgery 0 2 2 1 0 0 1 0 6

Paediatrics(a) 107 73 50 31 46 4 3 1 315

Palliative medicine(a),(e) 1 5 4 4 1 0 0 0 15

Pathology 17 11 10 7 6 1 2 3 57

Pathology and RACP (jointly) 22 21 8 4 7 0 0 3 65

Psychiatry 36 32 27 1 3 4 0 2 105

Public health medicine(a) 8 7 4 3 5 1 1 4 33

Radiation oncology 8 2 4 2 0 0 1 1 18

Radiodiagnosis 23 21 17 10 9 1 0 5 86

Rehabilitation medicine(a) 28 16 11 1 3 1 0 1 61

Sexual health medicine(a) 0 0 0 0 1 0 0 0 1

Sport and exercise medicine 4 2 2 0 0 0 0 0 8

Surgery 92 58 46 19 25 3 1 5 249

Total 1,139 860 722 281 370 76 59 49 3,556

(a) Includes all trainees who have undertaken less than 12 months certified units. (b) Both emergency medicine and paediatrics account for trainees undertaking paediatric emergency medicine. (c) Figures are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. (d) This applies to Independent Pathway registrars only, figures cannot be provided due to the individual training requirements

for these registrars following recognition of prior learning. (e) Includes Chapter trainees only. (f) ACT data included in NSW figures for general practice, GPET.

Source: Medical colleges and GPET

Table 4.15: First-year advanced positions/trainees by medical specialty and state/territory, 2014

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Female Trainees Half (6,733 or 52.6%) of all advanced vocational trainees were females (Table 4.16). This proportion was far higher in some specialties, with females comprising three-fifths or more of advanced vocational trainees in obstetrics and gynaecology (74.5%), paediatrics (72.8%), public health medicine (72.8%), sexual health medicine (69.2%), rehabilitation medicine (66.3%) and general practice (63.1%).

Medical specialty NSW VIC QLD SA WA TAS NT ACT AUS

Addiction medicine 3 1 2 2 1 1 0 0 10

Adult medicine 270 301 125 70 62 13 5 16 862

Anaesthesia 97 87 79 22 20 3 5 3 316

Anaesthesia - pain medicine 11 11 2 1 1 2 0 0 28

Dermatology 9 10 4 2 2 0 0 0 27

Emergency medicine(a) 153 136 135 32 68 6 13 6 549

General practice                  

- GPET(b) 961 571 584 207 316 93 69 (e).. 2,801

- ACRRM(c) 4 4 11 0 7 2 3 0 31

Intensive care 34 34 27 5 3 1 1 3 108

Medical administration 13 7 10 1 8 1 1 2 43

Obstetrics and gynaecology 34 34 31 10 8 4 1 1 123

Occupational and environmental medicine 9 4 6 1 6 0 1 2 29

Ophthalmology 18 7 4 4 4 0 1 0 38

Oral and maxillofacial surgery 0  1 2 0 1 0 0 0 4

Paediatrics 170 117 81 43 57 3 7 4 482

Palliative medicine(d) 2 6 3 3 1 1 0 0 16

Pathology 69 48 28 12 18 5 4 8 192

Pathology and RACP (jointly) 51 44 18 11 6 1 0 5 136

Psychiatry 77 68 33 11 18 3 0 2 212

Public health medicine 17 13 5 6 6 2 6 4 59

Radiation oncology 30 10 12 2 2 0 1 3 60

Radiodiagnosis 46 44 27 15 13 3 0 6 154

Rehabilitation medicine 58 39 24 10 1 2 0 0 134

Sexual health medicine 4 1 0 2 2 0 0 0 9

Sport and exercise medicine 3 5 1 0 0 0 0 0 9

Surgery 128 83 47 21 17 0 1 4 301

Total 2,271 1,686 1,301 493 648 146 119 69 6,733

(a) Both emergency medicine and paediatrics account for trainees undertaking paediatric emergency medicine. (b) Figures are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. (c) Includes registrars on the Independent Pathway only. (d) Includes Chapter trainees only. (e) ACT data included in NSW figures for general practice, GPET.

Source: Medical colleges and GPET

Table 4.16: Female advanced trainees by medical specialty and state/territory, 2014

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A few specialties had a relatively low proportion of female trainees, with females comprising less than forty percent of advanced vocational trainees in radiodiagnosis, medical administration, intensive care, occupational and environmental medicine, surgery, sport and exercise medicine, and oral and maxillofacial surgery.

Part-time Training Some colleges provide the opportunity for trainees to train part-time subject to approval by the employing authority, such as the hospital or laboratory.

In 2014, there were 2,075 part-time advanced trainees across specialties. This represents nearly one-sixth (16.2%) of all advanced trainees (Table 4.17).

Part-time training was most common in sexual health medicine (38.5%), addiction medicine (31.8%), general practice (30.5%) and public health medicine (28.4%) with over one-quarter of advanced vocational trainees undertaking part-time training.

A number of other specialties had relatively small numbers of trainees undertaking part-time training. It should be noted, that the availability of part-time training and interrupted training varies across specialties. Further information on this can be found in Appendix B.

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Medical specialty NSW VIC QLD SA WA TAS NT ACT AUS

Addiction medicine 3 1 1 0 1 1 0 0 7

Adult medicine 24 20 8 9 2 0 0 0 63

Anaesthesia 9 2 6 1 3 0 0 0 21

Anaesthesia - pain medicine 5 2 1 0 1 2 0 0 11

Dermatology 1 1 2 0 0 0 0 0 4

Emergency medicine(a) 91 72 69 31 26 3 0 3 295

General practice                  

- GPET(b) 526 232 308 94 103 57 48 (e).. 1,368

- ACRRM(c) 0 0 0 0 0 0 0 0 0

Intensive care 3 2 1 0 0 0 0 0 6

Medical administration 11 1 9 0 1 0 3 0 25

Obstetrics and gynaecology 3 2 1 1 1 0 0 0 8

Occupational and environmental medicine 0 0 0 0 0 0 0 0 0

Ophthalmology 0 1 1 0 0 0 0 0 2

Oral and maxillofacial surgery 0 0 0 0 0 0 0 0 0

Paediatrics 39 31 9 9 8 0 1 1 98

Palliative medicine(d) 2 1 1 2 0 0 0 0 6

Pathology 7 8 2 0 2 1 0 0 20

Pathology and RACP (jointly) 4 2 0 1 0 0 0 0 7

Psychiatry 18 19 7 6 6 2 0 0 58

Public health medicine 6 7 3 3 1 0 2 1 23

Radiation oncology 4 0 3 0 0 0 0 1 8

Radiodiagnosis 9 1 1 2 0 0 0 1 14

Rehabilitation medicine 9 5 3 0 0 0 0 0 17

Sexual health medicine 2 1 0 1 1 0 0 0 5

Sport and exercise medicine 2 0 1 0 0 0 0 0 3

Surgery 2 2 2 0 0 0 0 0 6

Total 780 413 439 160 156 66 54 7 2,075

(a) Both emergency medicine and paediatrics account for trainees undertaking paediatric emergency medicine. (b) Figures are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. (c) Includes registrars on the Independent Pathway only. (d) Includes Chapter trainees only. (e) ACT data included in NSW figures for general practice, GPET.

Source: Medical colleges and GPET

Discontinuation of Training Trainees may discontinue training for a variety of reasons, with either the trainee officially withdrawing from the training program, or the college or training provider terminating or dismissing a trainee in accordance with college regulations or employment conditions.

Table 4.17: Advanced trainees undertaking part-time training by medical specialty and state/territory, 2014

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In 2014, there were 366 advanced trainees who discontinued training (Table 4.18), the highest number of discontinuations for the period 2010-14.

  NSW VIC QLD SA WA TAS NT ACT AUS

2010 72 58 45 10 11 3 3 11 213

2011 42 31 22 8 6 3 3 0 115

2012 (a)39 21 21 12 6 0 0 4 (b)103

2013 (a)63 37 49 12 20 2 3 4 190

2014 (a)136 81 73 26 35 4 3 8 (c)366

(a) ACT data included in NSW figures for general practice. (b) Total advanced trainee discontinuations by state/territory, 2010-2012 (excluding one trainee from overseas). (c) GPET figures include both basic and advanced trainees together. Discontinuations include those registrars who withdrew from training in the 2014 training year and do not include those who withdrew before commencing in the

AGPT program.

Source: Medical colleges and GPET

Subspecialty Training

Obstetrics and Gynaecology Subspecialties

In 2014, there were 64 trainees undertaking additional advanced training in the subspecialty of obstetrics and gynaecology, with the most common subspecialties being maternal and fetal medicine (37.5%), and reproductive endocrinology and infertility (21.9%). Over two-thirds of obstetricians and gynaecologists training in a subspecialty were females (Table 4.19).

Subspecialty Positions Proportion (%) Females

Obstetrics and gynaecology ultrasound 9 14.1 8

Maternal and fetal medicine 24 37.5 18

Reproductive endocrinology and infertility 14 21.9 7

Gynaecological oncology 11 17.2 7

Urogynaecology 6 9.4 5

Total 64 100.0 45

Source: Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Pathology Subspecialties In 2014, there were 543 advanced trainees (Table 4.20) undertaking training with the Royal College of Pathologists of Australasia (RCPA). Nearly half of these (242 or 44.6%) were within the subspecialty of anatomical pathology and almost a third (174 or 32.0%) in haematology.

Table 4.18: Advanced trainee discontinuations by state/territory, 2010-2014

Table 4.19: Obstetrics and gynaecology advanced trainees: Total, proportion of total and females by subspecialty, 2014

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Subspecialty Positions Proportion (%) Females

Anatomical pathology 242 44.6 156

Chemical pathology 26 4.8 14

Forensic pathology 7 1.3 5

General pathology 9 1.7 5

Genetic pathology 7 1.3 1

Haematology 174 32.0 103

Immunopathology 23 4.2 11

Microbiology 55 10.1 33

Oral and maxillofacial pathology 0 0 0

Total 543 100.0 328

Source: Royal College of Pathologists of Australasia

Table 4.21 shows the number of training positions in the pathology subspecialties in each of the states and territories. New South Wales had the largest number of advanced trainees in 2014 (199) followed by Victoria (144).

Subspecialty NSW VIC QLD SA WA TAS NT ACT AUS

Anatomical pathology 87 60 41 16 23 5 3 7 242

Chemical pathology 6 7 5 1 5 1 0 1 26

Forensic pathology 3 3 0 0 1 0 0 0 7

General pathology 4 2 2 0 0 1 0 0 9

Genetic pathology 3 2 0 1 1 0 0 0 7

Haematology 66 52 24 14 10 2 1 5 174

Immunopathology 8 6 2 2 3 0 0 2 23

Microbiology 22 12 11 2 5 1 1 1 55

Oral and maxillofacial pathology 0 0 0 0 0 0 0 0 0

Total 199 144 85 36 48 10 5 16 543

Source: Royal College of Pathologists of Australasia

Physician Adult Medicine Subspecialties In 2014, there were 1,699 advanced physician trainees undertaking training with the Royal Australasian College of Physicians (RACP) in adult medicine (Table 4.22).

Of all the subspecialties, general medicine and geriatric medicine had the largest numbers of advanced trainees (487 and 224 respectively).

Table 4.20: Pathology advanced trainees: Total, proportion of total and females by subspecialty, 2014

Table 4.21: Pathology advanced trainees by subspecialty and state/territory, 2014

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Subspecialty Trainees(b) Proportion (%) Females

Cardiology 166 9.8 35

Clinical genetics 8 0.5 7

Clinical pharmacology 10 0.6 3

Endocrinology(a) 140 8.2 97

Gastroenterology 118 6.9 45

General medicine 487 28.7 218

Geriatric medicine 224 13.2 128

Haematology(b) 171 10.1 94

Immunology and allergy(c) 42 2.5 21

Infectious diseases(d) 124 7.3 74

Medical oncology 163 9.6 92

Nephrology 106 6.2 60

Neurology 88 5.2 47

Nuclear medicine 15 0.9 4

Palliative medicine(e) 71 4.2 47

Respiratory and sleep medicine 138 8.1 63

Rheumatology 40 2.4 28

Total(f) 1,699 100.0 862

(a) Includes trainees in either the Endocrinology or the joint Endocrinology/Chemical Pathology training program. (b) Includes trainees in either the Clinical Haematology or the joint Haematology training program. (c) Includes trainees in either the Clinical Immunology/Allergy or the joint Immunology/Allergy training program. (d) Includes trainees in either the Infectious Diseases or the joint Infectious Diseases/Microbiology training program. (e) Includes only divisional advanced trainees in palliative medicine, does not include Chapter trainees. (f) The totals are not cumulative sums of the figures above as some trainees are enrolled in multiple subspecialties

(i.e. dual trainees).

Source: Royal Australasian College of Physicians

Table 4.23 shows the numbers of advanced training positions in adult medicine subspecialties in each of the states and territories.

Table 4.22: Physician adult medicine advanced trainees: Total, proportion of total and females by subspecialty, 2014

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Subspecialty NSW VIC QLD SA WA TAS NT ACT AUS

Cardiology 65 43 31 11 9 3 1 3 166

Clinical genetics 5 1 2 0 0 0 0 0 8

Clinical pharmacology 2 1 3 4 0 0 0 0 10

Endocrinology(a) 48 47 28 7 7 1 1 1 140

Gastroenterology 43 36 18 12 8 0 0 1 118

General medicine 72 168 120 49 43 19 9 7 487

Geriatric medicine 60 74 36 20 26 4 1 3 224

Haematology(b) 62 50 25 13 9 4 0 8 171

Immunology and allergy(c) 16 9 4 6 7 0 0 0 42

Infectious diseases(d) 35 39 26 7 6 5 4 2 124

Medical oncology 61 51 26 11 7 1 0 6 163

Nephrology 35 35 17 7 7 1 2 2 106

Neurology 35 32 9 6 3 1 1 1 88

Nuclear medicine 8 3 2 0 1 0 0 1 15

Palliative medicine(e) 26 17 12 8 8 0 0 0 71

Respiratory and sleep medicine 44 37 25 15 9 1 2 5 138

Rheumatology 12 14 5 5 2 0 0 2 40

Total(f) 543 520 296 144 120 28 14 34 1,699

(a) Includes trainees in either the Endocrinology or the joint Endocrinology/Chemical Pathology training program. (b) Includes trainees in either the Clinical Haematology or the joint Haematology training program. (c) Includes trainees in either the Clinical Immunology/Allergy or the joint Immunology/Allergy training program. (d) Includes trainees in either the Infectious Diseases or the joint Infectious Diseases/Microbiology training program. (e) Includes only divisional advanced trainees in palliative medicine, does not include Chapter trainees. (f) The totals are not cumulative sums of the figures above as some trainees are enrolled in multiple subspecialties

(i.e. dual trainees).

Source: Royal Australasian College of Physicians

Physician Paediatric Subspecialties In 2014, there were 662 advanced paediatric and child health trainees with the RACP’s Paediatrics and Child Health Division (Table 4.24). Over two-thirds (482 or 72.8%) of these trainees were females.

The majority (545 or 82.3%) of all trainees were in general paediatrics.

Table 4.23: Physician adult medicine advanced trainees by subspecialty and state/territory, 2014

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Subspecialty Trainees Proportion (%) Females

Cardiology 17 2.6 5

Clinical genetics 15 2.3 10

Clinical pharmacology 3 0.5 2

Community child health 83 12.5 77

Endocrinology 25 3.8 18

Gastroenterology 11 1.7 7

General paediatrics 545 82.3 403

Haematology 13 2.0 10

Immunology and allergy(a) 23 3.5 19

Infectious diseases(b) 28 4.2 20

Medical oncology 20 3.0 17

Neonatal/perinatal medicine 94 14.2 48

Nephrology 9 1.4 6

Neurology 14 2.1 11

Nuclear medicine 0 0 0

Paediatric emergency medicine 54 8.2 34

Palliative medicine(c) 7 1.1 7

Respiratory and sleep medicine 22 3.3 16

Rheumatology 3 0.5 3

Total(d) 662 100.0 482

(a) Includes trainees in either the Clinical Immunology/Allergy or the joint Immunology/Allergy training program. (b) Includes trainees in either the Infectious Diseases or the joint Infectious Diseases/Microbiology training program. (c) Includes only divisional advanced trainees in palliative medicine, does not include Chapter trainees. (d) The totals are not cumulative sums of the figures above as some trainees are enrolled in multiple subspecialties

(i.e. dual trainees).

Source: Royal Australasian College of Physicians

Table 4.25 shows the numbers of training positions in paediatric subspecialties in each of the states and territories.

Table 4.24: Physician paediatric and child health advanced trainees: Total, proportion of total and females by subspecialty, 2014

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Subspecialty NSW VIC QLD SA WA TAS NT ACT AUS

Cardiology 3 5 3 2 4 0 0 0 17

Clinical genetics 6 5 0 3 1 0 0 0 15

Clinical pharmacology 0 2 1 0 0 0 0 0 3

Community child health 34 13 16 3 17 0 0 0 83

Endocrinology 7 5 5 3 5 0 0 0 25

Gastroenterology 2 3 4 0 2 0 0 0 11

General paediatrics 193 129 91 38 74 5 11 4 545

Haematology 6 3 2 2 0 0 0 0 13

Immunology and allergy(a) 5 4 3 6 4 0 0 1 23

Infectious diseases(b) 9 7 1 4 5 0 2 0 28

Medical oncology 7 2 4 5 2 0 0 0 20

Neonatal/perinatal medicine 26 20 21 11 10 2 1 3 94

Nephrology 3 4 1 0 1 0 0 0 9

Neurology 7 1 2 1 3 0 0 0 14

Nuclear medicine 0 0 0 0 0 0 0 0 0

Paediatric emergency medicine 17 13 14 5 3 0 2 0 54

Palliative medicine(c) 2 3 1 0 1 0 0 0 7

Respiratory and sleep medicine 9 5 3 2 2 1 0 0 22

Rheumatology 0 2 0 0 1 0 0 0 3

Total(d) 226 159 115 58 82 6 11 5 662

(a) Includes trainees in either the Clinical Immunology/Allergy or the joint Immunology/Allergy training program. (b) Includes trainees in either the Infectious Diseases or the joint Infectious Diseases/Microbiology training program. (c) Includes only divisional advanced trainees in palliative medicine, does not include Chapter trainees. (d) The totals are not cumulative sums of the figures above as some trainees are enrolled in multiple subspecialties

(i.e. dual trainees).

Source: Royal Australasian College of Physicians

Surgical Subspecialties In 2014, there were 1,094 advanced surgical trainees undertaking training with the RACS (Table 4.26). Of these, over one-quarter (301 or 27.5%) were females.

Of the nine subspecialties, general surgery and orthopaedic surgery had the highest numbers of trainees (444 and 225 respectively).

Table 4.25: Physician paediatric and child health advanced trainees by subspecialty and state/territory, 2014

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Subspecialty Trainees Proportion (%) Females

Cardiothoracic surgery 37 3.4 4

General surgery 444 40.6 160

Neurosurgery 57 5.2 15

Orthopaedic surgery 225 20.6 20

Otolaryngology, head and neck surgery 71 6.5 25

Paediatric surgery 28 2.6 16

Plastic and reconstructive surgery 78 7.1 24

Urology 114 10.4 28

Vascular surgery 40 3.7 9

Total 1,094 100.0 301

Source: Royal Australasian College of Surgeons

Table 4.27 shows the numbers of training positions in surgical subspecialties in each of the states and territories.

Subspecialty NSW VIC QLD SA WA TAS NT ACT AUS

Cardiothoracic surgery 14 13 5 3 1 1 0 0 37

General surgery 175 126 78 26 33 0 3 3 444

Neurosurgery 19 12 10 7 4 3 0 2 57

Orthopaedic surgery 81 51 44 20 27 0 0 2 225

Otolaryngology, head and neck surgery 23 20 10 8 7 0 0 3 71

Paediatric surgery 4 9 5 1 1 0 1 7 28

Plastic and reconstructive surgery 24 24 13 7 10 0 0 0 78

Urology 37 36 26 7 8 0 0 0 114

Vascular surgery 11 15 8 4 1 0 0 1 40

Total 388 306 199 83 92 4 4 18 1,094

Source: Royal Australasian College of Surgeons

Table 4.26: Surgical advanced trainees: Total, proportion of total and females by subspecialty, 2014

Table 4.27: Surgical advanced trainees by subspecialty and state/territory, 2014

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Trends in Advanced Training The total number of advanced training positions/trainees increased by over 35% between 2010 and 2014 (Table 4.28). The proportion of female advanced trainees increased slightly across the five years to its highest level of 52.6% in 2014. Similarly, the number and proportion of part-time advanced trainees reached its highest levels of 2,075 and 16.2% respectively.

 

Total college trainees

Advanced training positions/ trainees

Female advanced trainees

Proportion female (%)

Part-time advanced trainees

Proportion part-time (%)

2010 14,679 9,432 4,494 47.6 971 10.3

2011 15,478 10,214 5,116 50.1 1,416 13.9

2012 16,740 10,996 5,536 50.3 1,220 11.1

2013 17,888 11,832 6,160 52.1 1,576 13.3

2014 19,158 12,791 6,733 52.6 2,075 16.2

Change 2010-2014 (%) 30.5 35.6 49.8 10.6 113.7 57.5

Source: Medical colleges and GPET

Over the five years from 2010 to 2014, a number of medical colleges increased training numbers (Table 4.29). The ACRRM showed the largest increase of 144.3% between 2010 and 2014. This was followed by addiction medicine and ophthalmology, showing increases of 100% and 83.7% respectively. Palliative medicine and sexual health medicine were the only specialities that did not show an increase in total advanced trainees between 2010 and 2014.

Table 4.28: Vocational training positions/trainees: Total, advanced, female advanced and part-time advanced trainees, 2010-2014

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Medical specialty 2010 2011 2012 2013 2014

Change 2010-2014 (%)

Addiction medicine 11 13 18 24 22 100.0

Adult medicine 1,406 1,469 1,468 1,513 1,699 20.8

Anaesthesia 612 566 609 657 664 8.5

Anaesthesia - pain medicine 51 58 59 65 66 29.4

Dermatology 45 54 57 49 54 20.0

Emergency medicine(a) 881 1,090 1,204 1,339 1,355 53.8

General practice

- GPET 2,572 2,948 3,289 3,932 (q)4,315 67.8

- ACRRM(b) 70 6 (i)156 155 171 144.3

Intensive care 332 312 302 281 336 1.2

Medical administration 105 86 98 (m)107 (m)115 9.5

Obstetrics and gynaecology (d)123 143 (d)133 (d)159 (d)165 34.1

Occupational and environmental medicine 87 80 84 102 92 5.7

Ophthalmology (e)49 (f)86 (j)80 (n)90 (r)90 83.7

Oral and maxillofacial surgery .. .. 38 38 38 ..

Paediatrics(a) 583 640 593 556 662 13.6

Palliative medicine 58 71 24 80 (s)28 -51.7

Pathology 301 314 314 301 307 2.0

Pathology and RACP (jointly) 131 173 208 213 236 80.2

Psychiatry 350 (g)368 (k)417 (o)418 (t)418 19.4

Public health medicine 60 72 61 81 81 35.0

Radiation oncology 110 137 141 122 117 6.4

Radiodiagnosis 333 366 372 364 410 23.1

Rehabilitation medicine 143 162 177 191 202 41.3

Sexual health medicine 19 7 10 20 13 -31.6

Sport and exercise medicine .. 27 28 (p)30 41 ..

Surgery(c) 1,000 (h)966 (l)1,094 983 1,094 9.4

Total 9,432 10,214 11,034 11,870 12,791 35.6

(a) Emergency medicine and paediatrics both account for trainees undertaking paediatric emergency medicine. (b) Includes registrars on the Independent Pathway only. (c) RACS does not differentiate between basic and advanced surgical trainees as the surgical program is an integrated program (SET).

(d) Includes advanced Australian trainees who are undertaking FRANZCOG training only and not overseas trained specialists (referred to by the College as SIMG) who are also undertaking RANZCOG advanced training as a requirement to obtain college fellowship.

(e) Includes 3rd and 4th years only, not 5th year. (f) Includes 6 trainees who are completing their final year of training overseas. (g) Includes 170 fellows undertaking subspecialty training. (h) Total number of surgical trainees in 2011 was 1,167, including 966 Australian, 180 New Zealand and 21 overseas

trainees.

Table 4.29: Advanced training positions/trainees by medical specialty, 2010-2014

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(i) Excludes 4 trainees living overseas. The definition of what counted as advanced training changed in 2012, hence the significant change in the number of posts. (j) Includes 11 trainees who are completing their final year of training overseas. (k) Includes 229 fellows in subspecialty training. (l) Includes 183 New Zealand, 7 overseas accredited training posts and 7 New Zealand and 2 overseas SET trainees on

approved extended leave. (m) Excludes New Zealand and Hong Kong advanced trainees. (n) Includes 15 trainees who are currently completing their final year overseas. (o) Includes fellows completing advanced training certificates. (p) Excludes 9 trainees based overseas. (q) Figures for 2014 are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. (r) Includes 10 trainees who are completing their final year of training overseas. (s) Includes chapter trainees only. Excludes Clinical Diploma chapter trainees as the training program is not leading to

fellowship of RACP or AChPM. (t) Includes 215 fellows in subspecialty training.

Source: Medical colleges and GPET

Advanced vocational training activity increased in most states and territories from 2010 to 2014 (Table 4.30).

However, the Australian Capital Territory had a decrease 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 is distorted by the fact data for some specialties were previously reported within New South Wales data and general practice numbers continue to be reported together.

  NSW VIC QLD SA WA TAS NT ACT AUS(a)

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

2014 4,203 3,160 2,634 969 1,205 264 203 153 12,791

Change 2010-2014 (%) 38.6 29.1 48.0 30.9 72.1 55.3 15.3 -39.3 37.9

(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

Overall, the proportion of advanced vocational trainees who are females has shown small increases every year from 2010 to 2014. In 2014, over half (52.6%) of all advanced vocational trainees were females (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 were specialties that consistently had lower proportions of female trainees, such as oral and maxillofacial surgery, sport and exercise medicine, surgery, occupational and environmental medicine and intensive

Table 4.30: Advanced training positions/trainees by state/territory, 2010-2014

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care medicine. In contrast, obstetrics and gynaecology, paediatrics, public health medicine, rehabilitation medicine and general practice have maintained higher proportions of female advanced trainees, which were around three-fifths most years.

Medical specialty 2010 2011 2012 2013 2014

Change 2010-2014 (%)

Proportion female (%)

Addiction medicine 36.4 30.8 44.4 46.0 45.5 24.9

Adult medicine 42.3 43.0 45.6 48.0 50.7 19.9

Anaesthesia 39.9 43.1 44.0 44.9 47.6 19.3

Anaesthesia - pain medicine 29.4 27.6 38.9 52.3 42.4 44.3

Dermatology 55.6 61.1 73.7 63.3 50.0 -10.1

Emergency medicine 38.6 41.1 40.9 41.4 40.5 5.0

General practice 64.9 .. .. .. .. ..

- GPET .. 65.8 64.9 64.9 64.9 ..

- ACRRM .. 33.3 27.5 25.0 18.1 ..

Intensive care 27.1 26.9 30.5 32.7 32.1 18.6

Medical administration 27.6 41.9 39.8 40.2 37.4 35.5

Obstetrics and gynaecology 65.0 60.1 65.4 69.2 74.5 14.7

Occupational and environmental medicine 14.9 21.3 20.2 24.5 31.5 111.6

Ophthalmology 38.8 38.4 23.8 40.0 42.2 8.8

Oral and maxillofacial surgery na na 7.9 7.9 10.5 ..

Paediatrics 61.4 65.9 65.3 67.0 72.8 18.6

Palliative medicine 53.4 63.8 60.0 67.5 57.1 7.0

Pathology (a)80.1 59.2 64.3 58.8 62.5 ..

Pathology and RACP (jointly) .. 47.4 35.7 56.3 57.6 ..

Psychiatry 55.1 63.0 55.6 55.0 50.7 -8.0

Public health medicine 61.7 52.8 67.0 65.0 72.8 18.1

Radiation oncology 58.2 51.8 56.7 53.2 51.3 -11.9

Radiodiagnosis 31.8 31.4 46.5 34.0 37.6 18.2

Rehabilitation medicine 61.5 64.8 68.9 69.0 66.3 7.9

Sexual health medicine 52.6 28.6 80.0 70.0 69.2 31.6

Sport and exercise medicine .. 22.2 25.0 20.5 22.0 ..

Surgery 22.8 (b)23.8 25.5 28.1 27.5 20.7

Total (%) 47.6 49.9 50.4 52.0 52.6 10.6

Total female trainees 4,494 5,116 5,536 6,160 6,733 49.8

(a) In 2010 the proportion was calculated for pathology medical specialty only. The percentage for both pathology and RACP (jointly) was 53.4. (b) The total proportion of female surgical trainees including Australian, New Zealand and overseas was 24.4%.

Source: Medical colleges and GPET

Table 4.31: Proportion of female advanced trainees by medical specialty, 2010-2014

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The proportion of female advanced trainees (Table 4.32) 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).

  NSW VIC QLD SA WA TAS NT ACT AUS

Proportion female (%)

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

2014 54.0 53.4 49.4 50.9 53.8 55.3 58.6 45.1 52.6

Source: Medical colleges and GPET

The number of part-time advanced trainees increased by 31.7% between 2013 and 2014 (Table 4.33). It is difficult to distinguish any discernible trends in part-time training due to fluctuations in part-time advanced trainee numbers from year to year.

Table 4.32: Proportion of female advanced trainees by state/territory, 2010-2014

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Medical specialty 2010 2011 2012 2013 2014

Addiction medicine 5 3 4 5 7

Adult medicine 59 63 55 48 63

Anaesthesia 24 25 45 24 21

Anaesthesia - Pain medicine 6 6 8 10 11

Dermatology 5 2 7 6 4

Emergency medicine(a),(b) (e)23 44 105 193 295

General practice 631 .. .. .. ..

- GPET(c) .. 991 (f)715 1,020 (h)1,368

- ACRRM .. 0 0 0 0

Intensive care 1 3 5 4 6

Medical administration 1 5 4 (g)9 25

Obstetrics and gynaecology 3 7 6 8 8

Occupational and environmental medicine 0 0 0 0 0

Ophthalmology 1 0 3 4 2

Oral and maxillofacial surgery na na na na na

Paediatrics(a) 76 154 74 75 98

Palliative medicine 6 2 4 11 6

Pathology 11 18 28 15 20

Pathology and RACP (jointly) .. 1 5 9 7

Psychiatry 64 29 82 78 58

Public health medicine 11 17 16 7 23

Radiation oncology 4 2 5 5 8

Radiodiagnosis 7 13 8 11 14

Rehabilitation medicine 26 24 31 25 17

Sexual health medicine 11 4 5 7 5

Sport and exercise medicine 1 0 3 2 3

Surgery(d) 1 3 2 0 6

Total 977 1,416 1,220 1,576 2,075

(a) Emergency medicine and paediatrics data account for trainees undertaking paediatric emergency medicine. (b) Numbers reflect 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. (c) Registrars are part-time if their training time fell below 89% of a full-time equivalent registrar in either of the

semesters for that training year. (d) RACS does not differentiate between basic and advanced surgical trainees as the surgical program is an integrated program (SET). (e) 2010 data is year to date of posts credentialed. (f) Due to a different methodology being used to calculate part-time trainees in the 17th report this figure was changed

to 715 from 874 published in the 16th report. (g) Excludes the New Zealand and Hong Kong advanced trainees. (h) Figures for 2014 are for those enrolled in the 2014 training year and include those now withdrawn or fellowed.

Source: Medical colleges and GPET

General Practice General practitioners’ training under the AGPT program is provided through 17 regional training providers. Data from these providers are presented in Table 4.34. A total of 1,222 trainees or 28.3% were in their first year of a three or four year full-time program.

Table 4.33: Advanced trainees undertaking part-time training by medical specialty, 2010-2014

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Almost two-thirds (64.9%) of all general practice trainees were females.

Regional training provider Registrars

Proportion registrars (%) First-year

registrars Female registrars

Proportion female (%)

New South Wales and Australian Capital Territory

Beyond Medical Education (NSW)(c) 116 8.0 34 79 68.1

CoastCityCountry Training Inc(d) 308 21.4 86 197 64.0

General Practice Training - Valley to Coast 218 15.1 55 152 69.7

GP Synergy 426 29.6 128 284 66.7

North Coast NSW General Practice Training Ltd 167 11.6 37 103 61.7

WentWest Ltd 206 14.3 55 146 70.9

Total NSW and ACT 1,441 395 961 66.7

Victoria

Beyond Medical Education (VIC)(c) 161 17.9 45 105 65.2

Bogong Regional Training Network 113 12.6 36 62 54.9

Southern GP Training Ltd 237 26.4 71 151 63.7

Victorian Metropolitan Alliance 388 43.2 111 253 65.2

Total VIC 899 263 571 63.5

Queensland

General Practice Training Queensland 504 53.2 140 323 64.1

Queensland Rural Medical Education 214 22.6 54 118 55.1

Tropical Medical Training 230 24.3 66 143 62.2

Total QLD 948 260 584 61.6

South Australia

Adelaide to Outback Training Program 169 50.8 51 108 63.9

Sturt Fleurieu General Practice Education and Training 164 49.2 48 99 60.4

Total SA 333 99 207 62.2

Western Australia

WAGPET Ltd 447 100.0 137 316 70.7

Total WA 447 137 316 70.7

Tasmania

General Practice Training Tasmania 134 100.0 35 93 69.4

Total TAS 134 35 93 69.4

Northern Territory

Northern Territory General Practice Education Ltd 113 100.0 33 69 61.1

Total NT 113 33 69 61.1

Australia 4,315 1,222 2,801 64.9

(a) Registrars may train within more than one regional training provider or state. The totals may not sum to the state totals and the state totals may not sum to the national total. (b) Figures are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. (c) Beyond Medical Education serves an area that crosses over part of New South Wales and part of Victoria. (d) All training in ACT is included in the totals for CoastCityCountry Training Inc.

Source: GPET

Table 4.34: General practice trainees: Registrars, first-year registrars and female registrars by state/territory and training consortium, 2014(a),(b)

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Rural Pathway

In 2014, there were 2,137 registrars undertaking general practice training through the rural pathway.

The number of rural pathway registrars for each state and territory is shown in Table 4.35. The table also shows the percentage of all rural pathway registrars training in each jurisdiction. In 2014, a total of 26.1% of rural pathway registrars were trained in Queensland, 25.6% in New South Wales/ Australian Capital Territory and 22.2% in Victoria.

 NSW/ACT VIC QLD SA WA TAS NT AUS(b)

Number 547 475 558 173 180 125 79 2,137

Proportion of total (%) 25.6 22.2 26.1 8.1 8.4 5.8 3.7 100.0

(a) Figures are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. (b) Includes both basic and advanced trainees together.

Source: GPET

Medical College Examinations This section provides information on the number of Australian vocational trainees who sat college or faculty examinations in 2013 and the number of trainees who successfully passed.

Current Data Table 4.36 presents data on the number of trainees sitting their final or fellowship examinations and highlights the considerable variation in the pass rate across medical specialties and even for different examinations required by colleges for a particular specialty.

Further information on the requirements of each college is provided under the heading ‘Training Assessment’ in Appendix B.

Medical specialty Examination

Trainees sitting Trainees passing

Proportion passing (%)

Addiction Medicine .. na na na

Adult medicine .. na na na

Anaesthesia Fellowship 260 212 81.5

Anaesthesia - pain medicine Fellowship 33 27 81.8

Dermatology Fellowship Written 34 30 88.2

Fellowship Clinical 29 25 86.2

Emergency medicine   275 131 47.6

Table 4.35: General practice rural pathway trainees by state/territory, 2014(a)

Table 4.36: Vocational trainees sitting a final or fellowship examination: Trainees sitting and proportion passing by medical specialty, 2013

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Medical specialty Examination

Trainees sitting Trainees passing

Proportion passing (%)

General practice RACGP Fellowship Exam

AKT 880 743 84.4

KFP 869 725 83.4

OSCE 813 754 92.7

ACRRM Fellowship Exam MSF 89 84 94.4

MiniCEX 111 97 87.4

MCQ 95 71 74.7

StAMPS 106 64 60.4

Intensive care General Fellowship exam 98 41 41.8

Paediatric Fellowship exam 4 2 50.0

Medical administration Oral Examination 16 12 75.0

Obstetrics and gynaecology Written 148 118 79.7

Oral 174 117 67.2

Occupational and environmental Written 17 10 58.8

medicine Practical 17 14 82.4

Ophthalmology RANZCO Advanced Clinical Exam

(Written) 30 19 63.3

RANZCO Advanced Clinical Exam (Clinical) 30 26 86.7

Oral and maxillofacial surgery OMS Final Examination 12 11 91.7

Paediatrics .. na na na

Palliative medicine .. na na na

Pathology Part II Examinations 107 93 86.9

Psychiatry .. na na na

Public health medicine Final Program Assessment 20 15 75.0

Radiation oncology Part II Written and Clinical Vivas 24 16 66.7

Radiodiagnosis Part II FRANZCR Examination

Written and Vivas 87 58 66.7

Rehabilitation medicine

 

Written Short-Answer 33 28 84.8

Written MCQ 33 22 66.7

Clinical 50 20 40.0

Sexual health medicine Exit Assessment Interview 0 0 0

Sport and exercise medicine

 

Written 21 8 38.1

Clinical 4 4 100.0

Surgery Fellowship 335 (a)221 66.0

Total   4,854 3,818 78.7

(a) Includes 32 New Zealand trainees and 1 overseas trainee who also passed final or fellowship examination.

Source: Medical colleges

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Table 4.37 presents the examination outcomes for the additional examinations that are required as part of some college training programs. The data covers Australian trainees only.

Medical specialty Examination Time held

Trainees sitting Trainees passing

Proportion passing (%)

Addiction medicine .. .. .. .. ..

Adult medicine Written February 760 529 69.6

Clinical July 732 516 70.5

Anaesthesia (a)Part I Pharmacology written February/

May and July/

September 111

   

(a) Part I Pharmacology oral 102 95 85.6

(a) Physiology written 25

(a) Physiology oral 19 14 56.0

New Format Primary Written 179

New Format Primary Oral   111 100 55.9

Dermatology (b)Clinical sciences May .. .. ..

Pharmacology May 18 17 94.4

(b) Clinical sciences November .. .. ..

Pharmacology November 2 2 100.0

Emergency medicine Primary - Anatomy   457 144 31.5

Primary - Pathology 430 216 50.2

Primary - Physiology 443 142 32.1

Primary - Pharmacology   445 191 42.9

General practice          

- RACGP 0 0 0 0 0

- ACRRM .. .. .. .. ..

Intensive care

Part I

May and November 48 25 52.1

Medical administration .. .. .. .. ..

Obstetrics and gynaecology na na na na na

Occupational and environmental medicine .. .. .. .. ..

Table 4.37: Vocational trainees undertaking additional examinations: Numbers and proportions passing by medical specialty, 2013

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Medical specialty Examination Time held

Trainees sitting Trainees passing

Proportion passing (%)

Ophthalmology

 

(c) Ophthalmic sciences 2 45 43 95.6

Ophthalmic Basic

Competencies and

Knowledge (OBCK) 2 30 27 90.0

Ophthalmic pathology 2 22 22 100.0

Oral and maxillofacial surgery The Surgical Sciences and Training (SST) Examination May 14 11 78.6

Paediatrics Written February 239 173 72.4

Clinical July 245 164 66.9

Palliative medicine .. .. .. .. ..

Pathology Basic pathology sciences April 51 47 92.2

Part 1

May/ August 135 101 74.8

Psychiatry Case Histories   282 227 80.5

Basic training Written 206 143 69.4

(d) Clinical (OSCE only) 150 123 82.0

Public health medicine Part 1   (e)na (e)na (e)na

Radiation oncology Part 1 Once 31 25 80.6

Radiodiagnosis

Part 1

Twice Yearly 107 94 87.9

Rehabilitation medicine .. .. .. .. ..

Sexual health medicine .. .. 0 0 ..

Sport and exercise

.. medicine na na 0 0

Surgery

 

Clinical Exam May and September 293 264 90.1

Surgical Science Exam (Generic) May and September 341 257 75.4

Surgical Science (Specialty Specific) May and September 429 244 56.9

(a) This format for the primary exam was replaced in 2013 with a new consolidated primary exam format. Both exams were run at the first exam sitting in 2013. This was the last sitting of the previous primary exam format. (b) Please note that Clinical sciences are no longer run as an exam. It is now online modules that must be completed satisfactorily within one year. (c) Trainees passing are those who sat at least one of the five Ophthalmic sciences exams in 2013 and passed. (d) A changed exam format was introduced by RANZCP in 2012 and these results reflect the Observed Structured Clinical

Examination (OSCE) pass rates only. (e) Public health medicine no longer has a Part 1 Exam.

Source: Medical colleges

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Trends

Tables 4.38 and 4.39 provide data on the numbers passing their final or fellowship examinations and how these vary as a proportion of the total sitting each year from 2009 to 2013. Some specialties show considerable variation from one year to the next in the numbers and proportions passing each year.

This data should be interpreted cautiously, due to various college training requirements and changes to these across the years, and also due to relatively small numbers sitting examinations in some specialties.

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Medical specialty Examination 2009 2010 2011 2012 2013

Anaesthesia Fellowship 189 169 176 229 212

Anaesthesia - Pain medicine Fellowship 20 15 23 22 27

Dermatology Fellowship Written 20 18 20 17 30

Fellowship Clinical 20 16 19 17 25

Emergency medicine   73 76 83 116 131

General practice (b)RACGP Fellowship Exam 407 439 553 .. ..

AKT .. .. .. 672 743

KFP .. .. .. 664 725

OSCE .. .. .. 651 754

ACRRM Fellowship Exam .. .. .. .. 0

MSF 36 54 55 54 84

MiniCEX 37 34 57 77 97

MCQ 22 44 74 70 71

StAMPS 11 47 35 63 64

Intensive care General Fellowship exam 64 62 61 51 41

Paediatric Fellowship exam 5 7 5 11 2

Medical administration Oral Examination 8 25 8 16 12

Obstetrics and gynaecology Written 84 95 61 129 118

Oral 69 77 77 78 117

Occupational and environmental Written 4 3 5 10 10

medicine Practical 5 5 5 8 14

Ophthalmology RANZCO Advanced Clinical

Exam 34 17 30 (d)23 (e)19

Oral and maxillofacial surgery OMS Final Examination 9 7 4 8 11

Pathology Part II Examinations 98 87 93 92 93

Public health medicine Final Program Assessment 16 9 7 7 15

Radiation oncology Part II Written and Clinical Vivas 19 22 19 19 16

Radiodiagnosis Part II FRANZCR Examination

Written and Vivas 70 61 64 58 58

Rehabilitation medicine Written 16 21 15 36 na

Written Short-Answer .. .. .. .. 28

Written MCQ .. .. .. .. 22

Clinical 16 20 20 19 20

Sexual health medicine   .. .. 2 0 0

Sport and exercise medicine   1 4 4 4 4

Surgery(a) Fellowship 197 (c)165 178 190 (f)188

(a) Excludes international medical graduates. (b) These figures were for the Training Program route only. (c) In addition there were 27 New Zealand trainees and 1 overseas trainee who also passed final or fellowship examination. (d) There are two components to this examination and both must be passed to progress. The figure of 23 represents those

that passed both components. (e) There are two components to this examination and both must be passed to progress. This figure represents those that passed both components within the 2013 calendar year. (f) In addition, there were 32 New Zealand trainees and 1 overseas trainee who also passed final or fellowship examination.

Source: Medical colleges

Table 4.38: Vocational trainees who passed final or fellowship examination by medical specialty, 2009-2013

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Medical specialty Examination 2009 2010 2011 2012 2013

Proportion passing (%)

Adult medicine(a)

 

Written 66.8 68.2 68.7 69.9 69.6

Clinical 76.9 69.7 70.4 69.5 70.5

Anaesthesia   78.4 84.9 76.9 81.8 81.5

Anaesthesia - pain medicine   83.3 78.9 82.0 78.6 81.8

Dermatology Written 83.3 85.7 83.3 81.0 88.2

Clinical 95.2 88.9 95.0 94.4 86.2

Emergency medicine 65.8 66.1 62.9 60.7 47.6

General practice   .. .. .. .. ..

(c) RACGP Fellowship Exam 87.9 92.6 87.2 .. ..

AKT .. .. .. 90.0 84.4

KFP .. .. .. 89.5 83.4

OSCE .. .. .. 92.5 92.7

ACRRM Fellowship Exam .. .. .. .. ..

MSF 80.0 80.6 62.5 100.0 94.4

MiniCEX 97.4 77.3 87.6 92.0 87.4

MCQ 64.7 62.9 77.0 81.0 74.7

StAMPS 64.7 78.3 43.2 58.0 60.4

Intensive care General 55.0 56.4 56.0 60.7 41.8

Paediatric 83.0 53.8 50.0 84.6 50.0

Medical administration 70.0 86.2 36.0 61.5 75.0

Obstetrics and gynaecology Written 64.1 64.2 44.5 78.2 79.7

Oral 82.1 86.5 76.2 74.3 67.2

Occupational and environmental medicine

Written 40.0 33.3 38.5 76.9 58.8

Practical 45.6 55.6 45.5 72.7 82.4

Ophthalmology Written .. 84.0 78.9 76.5 63.3

Clinical 70.0 76.0 81.6 82.4 86.7

Oral and maxillofacial surgery OMS Final Examination 100.0 87.5 66.6 72.7 91.7

Paediatrics(a) Written 69.8 65.0 71.2 70.3 72.3

Clinical 72.2 67.3 67.5 65.8 66.9

Pathology   97.0 89.7 90.0 89.3 86.9

Psychiatry   na na na na na

Public health medicine   70.0 69.2 54.0 63.6 75.0

Radiation oncology   76.0 78.6 76.0 63.3 66.7

Radiodiagnosis   76.0 67.0 76.2 63.7 66.7

Table 4.39: Proportion of vocational trainees sitting a final or fellowship examination who passed by medical specialty, 2009-2013

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Medical specialty Examination 2009 2010 2011 2012 2013

Rehabilitation medicine Written 66.6 72.4 58.0 92.3 na

Written Short-Answer na na na na 84.8

Written MCQ na na na na 66.7

Clinical 62.5 66.7 69.0 47.5 40.0

Sexual health medicine   .. 2.0 66.0 na na

Sport and exercise medicine Written 100.0 44.4 66.7 80.0 38.1

Clinical 100.0 100.0 100.0 100.0 100.0

Surgery(b)   91.6 80.9 65.7 61.1 66.0

(a) Exam results for adult and paediatric medicine refer to the basic training written and clinical exams. (b) Excludes international medical graduates. (c) These figures are for the Training Program route only.

Source: Medical colleges

New College Fellows

Current Data There were 2,954 new fellows of medical colleges in 2013. Of these, 1,341 or 45.4% were females (Table 4.40). Nearly one-quarter (710 or 24%) were overseas trained specialists who were assessed as having qualifications substantially comparable with specialists trained by the medical college in Australia and awarded fellowship of that college.

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Medical specialty Total

Proportion all new fellows (%) Female

Proportion female (%)

Overseas trained specialists

Proportion overseas trained (%)

Addiction medicine 3 0.1 1 33.3 0 0

Adult medicine 438 14.8 187 42.7 59 13.5

Anaesthesia 256 8.7 108 42.2 56 21.9

Anaesthesia - pain medicine 14 0.5 5 35.7 0 0

Dermatology 23 0.8 12 52.2 6 26.1

Emergency medicine 115 3.9 44 38.3 23 20.0

General practice  

- RACGP (b)1,096 37.1 (f)576 52.6 361 32.9

- ACRRM 85 2.9 28 32.9 12 14.1

Intensive care (c)52 1.8 (g)16 30.8 5 9.6

Medical administration 13 0.4 6 46.2 0 0

Obstetrics and gynaecology 68 2.3 41 60.3 19 27.9

Occupational and environmental medicine 8 0.3 0 0 1 12.5

Ophthalmology (d)36 1.2 (h)11 30.6 12 33.3

Oral and maxillofacial surgery 11 0.4 0 0 0 0

Paediatrics 134 4.5 76 56.7 24 17.9

Palliative medicine 15 0.5 13 86.7 1 6.7

Pathology 55 1.9 28 50.9 10 18.2

Pathology and RACP (jointly) 43 1.5 19 44.2 0 0

Psychiatry 141 4.8 64 45.4 56 39.7

Public health medicine 7 0.2 5 71.4 1 14.3

Radiation oncology 23 0.8 15 65.2 3 13.0

Radiodiagnosis 100 3.4 32 32.0 17 17.0

Rehabilitation medicine 20 0.7 14 70.0 2 10.0

Sexual health medicine 3 0.1 1 33.3 1 33.3

Sport and exercise medicine (e)2 0.1 2 100.0 0 0

Surgery(a) 193 6.5 37 19.2 41 21.2

Total 2,954 100.0 1,341 45.4 710 24.0

(a) Includes new fellows through SET program and overseas trained specialists that have been awarded fellowship. (b) Excludes 99 new fellows who live overseas. (c) Excludes 17 new fellows who live overseas. (d) Excludes 6 new fellows who live overseas. (e) Excludes 1 New Zealand new fellow. (f) Excludes 38 female new fellows who live overseas. (g) Excludes 9 new fellows who live overseas. (h) Excludes 1 female new fellow who lives overseas.

Source: Medical colleges

Table 4.40: New fellows: Total, females and overseas trained specialists by medical specialty, 2013

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Data on the state or territory in which new fellows resided are shown in Table 4.41.

Medical specialty NSW VIC QLD SA WA TAS NT ACT AUS 

Addiction medicine 0 0 0 1 1 0 1 0 3

Adult medicine 125 148 79 37 37 3 4 5 438

Anaesthesia 71 63 50 15 40 4 8 5 256

Anaesthesia - pain medicine 6 5 2 1 0 0 0 0 14

Dermatology 5 9 4 1 4 0 0 0 23

Emergency medicine 24 25 37 8 16 3 1 1 115

General practice - RACGP 331 225 247 82 152 31 9 19 (a)1,096

- ACRRM 12 9 43 4 9 1 7 0 85

Intensive care 13 16 12 2 6 0 1 2 52

Medical administration 1 3 5 1 2 0 0 1 13

Obstetrics and gynaecology 19 23 13 2 6 3 1 1 68

Occupational and environmental medicine 1 2 4 0 1 0 0 0 8

Ophthalmology 12 8 11 1 2 1 1 0 (b)36

Oral and maxillofacial surgery 1 1 3 1 3 1 1 0 11

Paediatrics 43 36 25 6 19 2 3 0 134

Palliative medicine 5 7 1 2 0 0 0 0 15

Pathology 14 13 14 5 8 0 1 0 55

Pathology and RACP (jointly) 18 9 9 1 4 1 0 1 43

Psychiatry 38 36 32 10 18 5 1 1 141

Public health medicine 0 1 0 2 1 1 0 2 7

Radiation oncology 9 4 6 1 1 0 1 1 23

Radiodiagnosis 22 35 19 4 15 3 0 2 100

Rehabilitation medicine 6 3 4 4 3 0 0 0 20

Sexual health medicine 2 0 0 1 0 0 0 0 3

Sport and exercise medicine 0 0 0 0 1 0 0 1 2

Surgery 54 66 40 12 15 2 4 0 193

Total 832 747 660 204 364 61 44 42 2,954

(a) Excludes 99 new fellows who live overseas. (b) Excludes 6 new fellows who live overseas.

Source: Medical colleges

Table 4.41: New fellows by medical specialty and state/territory, 2013

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The distribution across states and territories of female new fellows followed a similar pattern to the distribution of all new fellows (Table 4.42).

Medical specialty NSW VIC QLD SA WA TAS NT ACT AUS

Addiction medicine 0 0 0 0 0 0 1 0 1

Adult medicine 68 63 24 13 17 1 0 1 187

Anaesthesia 33 26 14 9 19 3 2 2 108

Anaesthesia - pain medicine 2 3 0 0 0 0 0 0 5

Dermatology 3 7 1 0 1 0 0 0 12

Emergency medicine 8 10 8 6 9 2 1 0 44

General practice

- RACGP(a) 183 116 132 42 70 17 8 8 576

- ACRRM 4 3 17 0 1 1 2 28

Intensive care 6 5 3 0 1 0 1 0 16

Medical administration 0 1 4 1 0 0 0 0 6

Obstetrics and gynaecology 11 16 6 2 4 1 1 0 41

Occupational and environmental medicine 0 0 0 0 0 0 0 0 0

Ophthalmology 2 4 2 1 1 0 1 0 (b)11

Oral and maxillofacial surgery 0 0 0 0 0 0 0 0 0

Paediatrics 23 22 13 6 10 1 1 0 76

Palliative medicine 5 6 0 2 0 0 0 0 13

Pathology 8 5 7 2 5 0 1 0 28

Pathology and RACP (jointly) 8 4 3 0 2 1 0 1 19

Psychiatry 18 20 16 5 5 0 0 0 64

Public health medicine 0 1 0 1 1 0 0 2 5

Radiation oncology 8 2 3 0 0 0 1 1 15

Radiodiagnosis 7 13 3 2 4 1 0 2 32

Rehabilitation medicine 4 3 1 4 2 0 0 0 14

Sexual health medicine 0 0 0 1 0 0 0 0 1

Sport and exercise medicine 0 0 0 0 1 0 0 1 2

Surgery 10 14 9 2 2 0 0 0 37

Total 411 344 266 99 155 28 20 18 1,341

(a) Excludes 38 female new fellows who live overseas. (b) Excludes 1 female new fellow who lives overseas.

Source: Medical colleges

Table 4.42: Female new fellows by medical specialty and state/territory, 2013

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Trends Table 4.43 shows that the number of new fellows increased by 23.3% between 2009 (2,396) and 2013 (2,954). The number of new fellows reported in 2013 slightly decreased from 2012, as new fellows who live overseas have been excluded from the total.

General practice had the largest increase in terms of absolute number over the five years, with 213 more new fellows in 2013 than 2009. In terms of proportional increases, the number of new fellows in ophthalmology was over three times (227.3%) higher than in 2009.

Medical specialty 2009 2010 2011 2012 2013

Change 2009-2013 (%)

Addiction medicine 6 3 1 4 3 -50.0

Adult medicine 397 346 362 456 438 10.3

Anaesthesia 197 243 223 229 256 29.9

Anaesthesia - pain medicine 9 17 12 19 14 55.6

Dermatology 11 26 21 20 23 109.1

Emergency medicine 82 77 78 135 115 40.2

General practice

- RACGP 928 (b)835 (c)1,037 (h)1,216 (j)1,096 18.1

- ACRRM 40 28 (d)38 63 85 112.5

Intensive care 63 60 50 63 (k)52 -17.5

Medical administration 9 18 (e)14 19 13 44.4

Obstetrics and gynaecology 56 82 90 81 68 21.4

Occupational and environmental medicine 11 5 2 4 8 -27.3

Ophthalmology 11 26 (f)29 (i)38 (l)36 227.3

Oral and maxillofacial surgery na na 4 8 11 ..

Paediatrics 116 91 102 146 134 15.5

Palliative medicine 8 6 7 16 15 87.5

Pathology 64 94 88 99 (m)98 53.1

Psychiatry 125 154 131 136 141 12.8

Public health medicine 12 15 4 7 7 -41.7

Radiation oncology 18 13 22 20 23 27.8

Radiodiagnosis 44 54 77 115 100 127.3

Rehabilitation medicine 13 22 23 26 20 53.8

Sexual health medicine 1 0 3 3 3 200.0

Sport and exercise medicine 1 1 3 2 (n)2 100.0

Surgery(a) 174 184 212 217 193 10.9

Total 2,396 2,400 (g)2,633 (g)3,142 2,954 23.3

Table 4.43: New fellows by medical specialty, 2009-2013

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(a) Includes new fellows through SET program and overseas trained specialists that have been awarded fellowship. (b) An additional 151 new fellows who live overseas joined the college in 2010. (c) Excludes 96 new fellows awarded fellowship who live overseas. (d) Excludes 2 new fellows who live overseas. (e) Includes 5 New Zealand and Hong Kong new fellows. (f) Includes 10 new fellows trained overseas. (g) Oral and maxillofacial surgery was a new medical specialty added in 2014. The numbers of new fellows for 2012 and

2013 have been amended accordingly. (h) Excludes 107 new fellows awarded fellowship but living overseas. (i) Includes 13 overseas trained specialists. (j) Excludes 99 new fellows who live overseas. (k) Excludes 17 new fellows who live overseas. (l) Excludes 6 new fellows who live overseas. (m) Includes new fellows from pathology, and pathology and RACP (jointly). (n) Excludes 1 New Zealand new fellow.

Source: Medical colleges

Table 4.44 shows the states and territories in which new fellows resided.

  NSW VIC QLD SA WA TAS NT ACT AUS(a)

2009 620 548 471 196 225 47 25 41 2,285

2010 734 603 479 179 272 52 29 40 2,388

2011 744 713 603 198 242 45 31 41 2,617

2012 863 759 702 241 328 89 43 64 3,103

2013 832 747 660 204 364 61 44 42 2,954

Change 2009-2013 (%) 34.2 36.3 40.1 4.1 61.8 29.8 76.0 2.4 29.3

(a) Australian totals for 2009 and 2012 differ from the sum of state/territory numbers due to the inclusion of new fellows who completed their training overseas.

Source: Medical colleges

Table 4.45 shows that occupational and environmental medicine, surgery, intensive care, ophthalmology, medical administration, ophthalmology and radiodiagnosis generally have a lower proportion of female new fellows each year.

Between 2009 and 2013 the proportion of female new fellows varied year to year, particularly with smaller specialties.

Table 4.44: New fellows by state/territory, 2009-2013

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Medical specialty 2009 2010 2011 2012 2013

Proportion female (%)

Addiction medicine 50.0 33.3 .. 25.0 33.3

Adult medicine 35.8 37.6 37.0 39.9 42.7

Anaesthesia 29.4 32.5 31.8 41.5 42.2

Anaesthesia - pain medicine 33.3 29.4 33.3 15.8 35.7

Dermatology 90.9 53.8 57.1 65.0 52.2

Emergency medicine 36.6 44.2 34.6 45.2 38.3

General practice          

- RACGP 43.3 56.0 52.6 50.8 52.6

- ACRRM 27.5 39.3 23.7 31.7 32.9

Intensive care 23.8 23.3 24.0 11.1 30.8

Medical administration 11.1 27.8 7.1 42.1 46.2

Obstetrics and gynaecology 62.5 56.6 63.3 54.3 60.3

Occupational and environmental medicine 9.1 20.0 0 50.0 0

Ophthalmology 36.4 30.8 10.3 28.9 30.6

Oral and maxillofacial surgery na na na na 0

Paediatrics 47.4 57.1 63.7 64.4 56.7

Palliative medicine 62.5 66.7 85.7 56.3 86.7

Pathology 46.9 47.6 59.3 55.7 50.9

Pathology and RACP (jointly) .. 48.4 37.9 51.7 44.2

Psychiatry 42.4 46.8 45.0 52.9 45.4

Public health medicine 58.3 53.3 75.0 57.1 71.4

Radiation oncology 44.4 53.8 50.0 45.0 65.2

Radiodiagnosis 40.9 24.1 29.9 31.3 32.0

Rehabilitation medicine 69.2 59.1 60.9 57.7 70.0

Sexual health medicine 100.0 0 100.0 33.3 33.3

Sport and exercise medicine .. 0 33.3 50.0 100.0

Surgery 19.5 14.1 15.1 19.4 19.2

Total 39.0 44.0 43.7 44.7 45.4

Female new fellows 935 1,057 1,149 1,402 1,341

Source: Medical colleges

While the proportion of female new fellows remained relatively stable over the period 2009 to 2013, the picture varied more at the state/territory level (Table 4.46). Most of this variation is due to fluctuations in relatively smaller numbers seen in some jurisdictions. The proportion of female new fellows for NSW increased every year over the five year period and in 2013 reached its highest level of 49.4%.

Table 4.45: Proportion of female new fellows by medical specialty, 2009-2013

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  NSW VIC QLD SA WA TAS NT ACT AUS

Proportion female (%)

2009 41.3 42.7 37.8 42.3 40.0 61.7 44.0 34.1 39.2

2010 42.9 47.9 42.0 36.9 44.5 46.2 65.5 42.5 44.1

2011 44.4 47.7 41.1 41.9 35.5 60.0 29.0 53.7 43.8

2012 45.8 46.2 42.2 42.7 45.1 42.7 44.2 54.7 44.8

2013 49.4 46.1 40.3 48.5 42.6 45.9 45.5 42.9 45.4

Source: Medical colleges

New Fellows by Subspecialty - Selected Colleges A number of the larger medical colleges have also provided data on new fellows, detailed by subspecialty. Obstetrics and gynaecology, pathology, physician (adult and paediatrics and child health) and surgical subspecialties are presented in Table 4.47 to Table 4.51.

Obstetrics and Gynaecology Subspecialties

Subspecialty New fellows(a)

Female new fellows

Proportion female (%)

Obstetrics and gynaecology ultrasound 2 2 100.0

Maternal and fetal medicine 5 5 100.0

Reproductive endocrinology and infertility 3 3 100.0

Gynaecological oncology 2 1 50.0

Urogynaecology 1 1 100.0

Total 13 12 92.3

(a) Does not include new fellows who are still training in the subspecialty, see Table 4.19. Includes only those that completed their subspecialty training in 2013.

Source: Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Table 4.46: Proportion of female new fellows by state/territory, 2009-2013

Table 4.47: Obstetrics and gynaecology subspecialties: New fellows, females and proportion of females by subspecialty, 2013

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Pathology Subspecialties

Subspecialty New fellows

Female new fellows

Proportion female (%)

Anatomical pathology 45 24 53.3

Chemical pathology 2 0 0

Forensic pathology 2 2 100.0

Genetics pathology 0 0 0

Haematology 33 13 39.4

Immunopathology 6 3 50.0

Microbiology 10 5 50.0

Total 98 47 48.0

Source: Royal College of Pathologists of Australasia

Table 4.48: Pathology subspecialties: New fellows, females and proportion of females by subspecialty, 2013

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Physician Adult Medicine Subspecialties

Subspecialty New fellows(b)

Female new fellows(b)

Proportion female (%)

Cardiology 54 8 14.8

Clinical genetics 0 0 0

Clinical Haematology 1 1 100.0

Clinical Immunology and Allergy 1 0 0

Clinical pharmacology 2 2 100.0

Endocrinology 29 21 72.4

Endocrinology and chemical pathology 0 0 0

Gastroenterology 39 15 38.5

General medicine 67 19 28.4

Geriatric medicine 40 17 42.5

Haematology 19 8 42.1

Immunology and allergy 5 2 40.0

Infectious diseases 19 5 26.3

Infectious diseases and microbiology 9 7 77.8

Intensive care medicine 0 0 0

Medical oncology 54 28 51.9

Nephrology 36 20 55.6

Neurology 27 14 51.9

Nuclear medicine 2 0 0

Palliative medicine 11 9 81.8

Respiratory and sleep medicine(c) 45 15 33.3

Rheumatology 8 6 75.0

Total(d) 438 187 42.7

(a) Numbers reflect fellows within a sub-specialty. Due to fellows holding multiple sub-specialties this is not a one-to-one relationship. (b) Includes those that were admitted as an overseas trained physician. (c) Includes fellows who completed training in thoracic medicine and thoracic and sleep medicine, Sleep I and II. (d) The totals listed are not cumulative totals of the numbers presented above, as the list of specialties is not exhaustive.

Source: Royal Australasian College of Physicians

Table 4.49: Physician adult medicine subspecialties: New fellows, females and proportion of females by subspecialty(a), 2013

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Physician Paediatric Subspecialties

Subspecialty New fellows(b)

Female new fellows(b)

Proportion female (%)

Cardiology 1 0 0

Clinical genetics 4 4 100.0

Clinical pharmacology 0 0 0

Community child health 7 5 71.4

Endocrinology 3 2 66.7

Endocrinology and chemical pathology 0 0 0

Gastroenterology 1 1 100.0

General paediatrics 72 43 59.7

Haematology 1 1 100.0

Immunology and allergy 0 0 0

Infectious diseases 4 2 50.0

Intensive care medicine 0 0 0

Medical oncology 3 1 33.3

Neonatal/perinatal medicine 28 12 42.9

Nephrology 1 1 100.0

Neurology 3 1 33.3

Nuclear medicine 0 0 0

Paediatric emergency medicine 6 3 50.0

Palliative medicine 0 0 0

Respiratory and sleep medicine(c) 4 1 25.0

Rheumatology 0 0 0

Total(d) 134 76 56.7

(a) Numbers reflect fellows within a sub-specialty. Due to fellows holding multiple sub-specialties, this is not a one-to-one relationship. (b) Includes those that were admitted as an overseas trained physician. (c) Includes fellows who completed training in thoracic medicine and thoracic and sleep medicine, Sleep I and II. (d) The totals listed are not cumulative totals of the numbers presented above, as the list of specialties is not exhaustive.

Source: Royal Australasian College of Physicians

Table 4.50: Physician paediatric and child health subspecialties: New fellows, females and proportion of females by subspecialty(a), 2013

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Surgical Subspecialties

Subspecialty New fellows

Female new fellows

Proportion female (%)

Cardiothoracic surgery 13 0 0

General surgery 60 15 25.0

Neurosurgery 8 3 37.5

Orthopaedic surgery 50 3 6.0

Otolaryngology, head and neck surgery 17 6 35.3

Paediatric surgery 3 1 33.3

Plastic and reconstructive surgery 14 3 21.4

Urology 22 4 18.2

Vascular surgery 6 2 33.3

Total 193 37 19.2

Source: Royal Australasian College of Surgeons  

College Fellows In 2013, there were 50,704 medical practitioners who were fellows of medical colleges (Table 4.52). Just over one-third (17,783 or 35.1%) were females.

Overall, new fellows represented 5.8% of all college fellows. This proportion varied across specialties, with the largest proportions of new fellows in pathology and RACP (jointly) (8.6%), emergency medicine (7.9%) and intensive care (7.3%).

Table 4.51: Surgical subspecialties: New fellows, females and proportion of females by subspecialty, 2013

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Medical specialty Fellow Female

Proportion female (%)

New fellow 2013

New fellows as a

proportion of all fellows (%)

Addiction medicine (a)155 (a)40 25.8 3 1.9

Adult medicine (a)6,823 (a)2,034 29.8 438 6.4

Anaesthesia 4,043 1,126 27.9 256 6.3

Anaesthesia - pain medicine 252 54 21.4 14 5.6

Dermatology (b)495 (f)200 40.4 23 4.6

Emergency medicine 1,453 455 31.3 115 7.9

General practice - RACGP (c)17,261 (g)8,068 46.7 (k)1,096 6.3

- ACRRM (d)1,459 (h)311 21.3 85 5.8

Intensive care (e)713 (i)120 16.8 (l)52 7.3

Medical administration 411 111 27.0 13 3.2

Obstetrics and gynaecology 1,586 632 39.8 68 4.3

Occupational and environmental medicine (a)240 (a)46 19.2 8 3.3

Ophthalmology 827 161 19.5 (m)36 4.4

Oral and maxillofacial surgery 172 16 9.3 11 6.4

Paediatrics (a)1,984 (a)937 47.2 134 6.8

Palliative medicine (a)220 (a)114 51.8 15 6.8

Pathology 1,241 518 41.7 55 4.4

Pathology and RACP (jointly) 501 185 36.9 43 8.6

Psychiatry 3,154 1,185 37.6 141 4.5

Public health medicine (a)402 (a)169 42.0 7 1.7

Radiation oncology 327 135 41.3 23 7.0

Radiodiagnosis 1,786 457 25.6 100 5.6

Rehabilitation medicine 400 176 44.0 20 5.0

Sexual health medicine (a)111 (a)60 54.1 3 2.7

Sport and exercise medicine 70 (j)26 37.1 (n)2 2.9

Surgery 4,618 447 9.7 (o)193 4.2

Total 50,704 17,783 35.1 2,954 5.8

(a) Numbers are down from 2012 due mainly to the inclusion in 2012 of ‘Retired’ and ‘Life’ fellows (i.e. fellows aged 70+). These fellows have been excluded from the count in 2013.

(b) Excludes 17 fellows who live overseas. (c) Excludes 1,729 fellows who live overseas. (d) Excludes 19 fellows who live overseas. (e) Excludes 197 fellows who live overseas. (f) Excludes 5 female fellows who live overseas.

(g) Excludes 703 female fellows who live overseas. (h) Excludes 2 female fellows who live overseas. (i) Excludes 52 fellows who live overseas. (j) Excludes 5 female fellows who live overseas. (k) Excludes 99 fellows who live overseas. (l) Excludes 17 new fellows who live overseas. (m) Excludes 6 new fellows who live overseas. (n) Excludes 1 New Zealand new fellow. (o) Includes new fellows through SET program and overseas

trained specialists that have been awarded fellowship.

Source: Medical colleges

Table 4.52: Fellows: Total, number and proportion of females, and new fellows and proportion of all fellows by medical specialty, 2013

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Overall, the distribution of fellows across states and territories was proportionate to the population as a whole (Table 4.53).

Medical specialty NSW VIC QLD SA WA TAS NT ACT AUS 

Addiction medicine(a) 65 28 25 14 13 7 2 1 155

Adult medicine(a) 2,213 2,008 1,148 558 570 138 53 135 6,823

Anaesthesia 1,248 999 830 336 422 107 34 65 (c)4,043

Anaesthesia - pain medicine 88 50 47 30 28 8 0 1 252

Dermatology 194 132 85 39 45 0 0 0 495

Emergency medicine 370 392 332 98 176 39 20 26 1,453

General practice - RACGP 5,026 4,205 3,828 1,405 1,826 469 175 327 17,261

- ACRRM 411 233 425 183 120 34 31 22 1,459

Intensive care 221 165 162 58 66 15 7 19 713

Medical administration 117 97 99 26 33 7 6 26 411

Obstetrics and gynaecology 497 443 311 116 146 34 13 26 1,586

Occupational and environmental medicine(a) 74 55 34 25 32 7 0 13 240

Ophthalmology 320 207 140 63 66 16 4 11 827

Oral and maxillofacial surgery 39 54 38 12 19 2 2 6 172

Paediatrics(a) 664 519 346 148 223 31 23 30 1,984

Palliative medicine(a) 84 50 38 17 16 11 1 3 220

Pathology 427 268 241 104 139 29 5 28 1,241

Pathology and RACP (jointly) 193 112 82 35 53 9 2 15 501

Psychiatry 966 910 585 279 289 57 14 54 3,154

Public health medicine(a) 130 71 66 29 37 13 22 34 402

Radiation oncology 119 82 66 20 22 7 2 9 327

Radiodiagnosis 547 478 336 142 202 42 4 35 1,786

Rehabilitation medicine(a) 194 111 43 28 12 5 3 4 400

Sexual health medicine(a) 53 23 16 7 5 1 1 5 111

Sport and exercise medicine 28 21 6 3 4 1 0 7 70

Surgery 1,528 1,235 859 395 407 89 30 75 4,618

Total 15,816 12,948 10,188 4,170 4,971 1,178 454 977 50,704

Proportion of total (%) 31.2 25.5 20.1 8.2 9.8 2.3 0.9 1.9 100.0

Population proportion (%)(b) 32.0 24.8 20.1 7.2 11.0 2.2 1.0 1.7 100.0

(a) Numbers are down from 2012 due mainly to the inclusion in 2012 of ‘Retired’ and ‘Life’ fellows (i.e. fellows aged 70+). These fellows have been excluded from the count in 2013. In addition, as a result of data cleansing exercises some fellows’ status have changed from ‘Active’ to ‘Retired’ which also affects the statistics reported.

(b) Population data from ABS. 3101.0 - Australian Demographics Statistics, March 2014, released 25/09/2014. (c) No state/territory data available for 2 fellows.

Source: Medical colleges

Table 4.53: Fellows by medical specialty and state/territory, 2013

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The distribution of female fellows by states and territories followed a similar pattern to the distribution of all fellows (Table 4.54).

Medical specialty NSW VIC QLD SA WA TAS NT ACT AUS

Addiction medicine 20 4 7 2 4 1 2 0 40

Adult medicine 675 657 311 150 143 38 16 44 2,034

Anaesthesia 345 280 229 84 129 30 9 20 1,126

Anaesthesia - pain medicine 22 12 8 6 4 2 0 0 54

Dermatology 83 57 31 19 10 0 0 0 200

Emergency medicine 119 127 94 33 51 16 9 6 455

General practice - RACGP 2,362 1,986 1,732 619 836 243 110 180 8,068

- ACRRM 77 44 102 41 20 10 12 5 311

Intensive care 47 30 21 4 10 1 3 4 120

Medical administration 37 26 20 7 6 1 4 10 111

Obstetrics and gynaecology 181 199 114 48 57 13 9 11 632

Occupational and environmental medicine

20 14 4 2 5 1 0 0 46

Ophthalmology 64 54 17 14 8 1 1 2 161

Oral and maxillofacial surgery 2 6 4 0 4 0 0 0 16

Paediatrics 304 270 152 63 111 10 12 15 937

Palliative medicine 51 22 16 11 8 5 1 0 114

Pathology 197 103 93 42 55 13 1 14 518

Pathology and RACP (jointly) 76 45 24 9 17 5 1 8 185

Psychiatry 348 342 219 111 111 19 9 26 1,185

Public health medicine 50 30 29 10 19 3 12 16 169

Radiation oncology 56 31 29 5 6 2 1 5 135

Radiodiagnosis 138 126 75 45 54 11 2 6 457

Rehabilitation medicine 85 51 18 12 8 2 0 0 176

Sexual health medicine 26 14 7 4 4 1 0 4 60

Sport and exercise medicine 11 7 2 1 3 0 0 2 26

Surgery 138 143 77 40 36 7 1 5 447

Total 5,534 4,680 3,435 1,382 1,719 435 215 383 17,783

Proportion of female fellows (%) 31.1 26.3 19.3 7.8 9.7 2.4 1.2 2.2 100.0

Source: Medical colleges

Table 4.54: Female fellows by medical specialty and state/territory, 2013

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Fellows by Subspecialty - Selected Colleges Data on fellows for pathology, physician (adult medicine and paediatric and child health) and surgical subspecialties are presented in Table 4.55 to Table 4.58.

Pathology Subspecialties

Subspecialty Fellow Female fellow

Proportion female (%)

Anatomical pathology 772 356 46.1

Chemical pathology 77 25 32.5

Forensic pathology 43 17 39.5

General pathology 81 16 19.8

Genetic pathology 17 6 35.3

Haematology 448 171 38.2

Immunopathology 102 31 30.4

Microbiology 196 80 40.8

Oral and maxillofacial pathology 6 1 16.7

Total 1,742 703 40.4

Source: Royal College of Pathologists of Australasia

Table 4.55: Pathology fellows: Total, females and proportion of females by subspecialty, 2013

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Physician Adult Medicine Subspecialties

Subspecialty Fellow Female fellow

Proportion female (%)

Cardiology 935 139 14.9

Clinical genetics 9 6 66.7

Clinical haematology 8 3 37.5

Clinical immunology and allergy 16 5 31.3

Clinical pharmacology 50 12 24.0

Endocrinology 452 242 53.5

Endocrinology/Chemical pathology 5 5 100.0

Gastroenterology 593 139 23.4

General medicine 713 164 23.0

Geriatric medicine 494 236 47.8

Haematology 337 119 35.3

Immunology and allergy 72 25 34.7

Infectious diseases 271 112 41.3

Infectious diseases and microbiology 35 18 51.4

Intensive care medicine 68 9 13.2

Medical oncology 483 218 45.1

Nephrology 389 130 33.4

Neurology 378 100 26.5

Nuclear medicine 167 44 26.3

Palliative medicine 80 58 72.5

Respiratory and sleep medicine(b) 824 211 25.6

Rheumatology 252 110 43.7

Total(c) 6,823 2,034 29.8

(a) Numbers reflect fellows within a sub-specialty. Due to fellows holding multiple sub-specialties, this is not a one-to-one relationship. (b) Includes fellows who completed training in thoracic medicine and thoracic and sleep medicine, Sleep I and II. (c) The totals listed are not cumulative totals of the numbers presented above, as the list of specialties is not exhaustive, and

there are several fellows who were admitted to fellowship when record-keeping practices did not denote a specialty.

Source: Royal Australasian College of Physicians

Table 4.56: Physician adult medicine fellows: Total, females and proportion of females by subspecialty(a), 2013

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Physician Paediatric Subspecialties

Subspecialty Fellow Female fellow

Proportion female (%)

Cardiology 27 3 11.1

Clinical genetics 55 31 56.4

Clinical haematology 2 0 0

Clinical immunology and allergy 8 5 62.5

Clinical pharmacology 3 2 66.7

Community child health 80 69 86.3

Endocrinology 40 26 65.0

Endocrinology/Chemical pathology 0 0 0

General paediatrics 696 379 54.5

Gastroenterology 21 7 33.3

Haematology 18 10 55.6

Immunology and allergy 12 6 50.0

Infectious diseases 22 12 54.5

Infectious diseases and microbiology 3 0 0

Intensive care medicine 8 1 12.5

Medical oncology 40 17 42.5

Neonatal/Perinatal medicine 157 73 46.5

Nephrology 18 7 38.9

Neurology 45 19 42.2

Nuclear medicine 14 3 21.4

Paediatric child and adolescent psychiatry 6 4 66.7

Paediatric emergency medicine 81 47 58.0

Palliative medicine 4 3 75.0

Respiratory and sleep medicine(b) 87 42 48.3

Rheumatology 15 5 33.3

Total(c) 1,984 937 47.2

(a) Numbers reflect fellows within a sub-specialty. Due to fellows holding multiple sub-specialties, this is not a one-to-one relationship. (b) Includes fellows who completed training in thoracic medicine and thoracic and sleep medicine, Sleep I and II. (c) The totals listed are not cumulative totals of the numbers presented above, as the list of specialties is not exhaustive,

and there are several fellows who were admitted to fellowship when record-keeping practices did not denote a specialty.

Source: Royal Australasian College of Physicians

Table 4.57: Physician paediatrics and child health fellows: Total, females and proportion of females by subspecialty(a), 2013

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Surgical Subspecialties

Subspecialty Fellow Female fellow

Proportion female (%)

Cardiothoracic surgery 175 10 5.7

General surgery 1,539 204 13.3

Neurosurgery 218 25 11.5

Orthopaedic surgery 1,211 40 3.3

Otolaryngology, head and neck surgery 429 48 11.2

Paediatric surgery 89 22 24.7

Plastic and reconstructive surgery 402 50 12.4

Urology 378 31 8.2

Vascular surgery 177 17 9.6

Total 4,618 447 9.7

 Source: Royal Australasian College of Surgeons

Table 4.58: Surgical fellows: Total, females and proportion of females by subspecialty, 2013

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Chapter 5 INTERNATIONAL SUPPLY Overseas trained doctors are a key part of the medical workforce, not only in rural and remote areas, but metropolitan and regional areas as well. They may work in Australia on a temporary basis and many will go on to become permanent residents of Australia.

This chapter brings together the available data on medical practitioners who have trained overseas - their assessment by the Australian Medical Council and those with approved working visas issued by the Australian Government Department of Immigration and Border Protection.

International medical graduates must first apply to the Australian Government Department of Immigration and Border Protection for a visa under which they may work or continue their training in Australia. They are usually overseas when applying, but others who have already entered Australia can also apply. Applicants are then assessed by the Australian Medical Council as to whether they are eligible to seek registration to practise medicine in Australia. Prior to July 2010, they then had to apply to the relevant medical board to register to practise in a given state or territory. From July 2010, applicants must apply through the Australian Health Practitioner Regulation Agency (AHPRA) to be registered to practise nationally.

As part of their Medicare Provider Number applications to the Australian Government Department of Human Services - Medicare, overseas trained doctors must apply for an exemption under section 19AB of the Act in order to access Medicare benefits for the services they provide.

Further information is available at:

www.doctorconnect.gov.au

More details on these processes and the numbers entering Australia and being assessed are provided in this chapter.

Australian Government Department of Immigration and Border Protection Entry Processes There are a number of visa classes and processes through which non-Australians can apply to work in Australia. Temporary visas range in duration from one day up to four years.

Until 30 June 2010, there were three subclasses of visas under which most medical practitioners entered Australia, namely subclasses 457, 422 and 442.

Temporary Work (Skilled) visa (subclass 457) The Temporary Work (Skilled) visa (subclass 457) is the most commonly used program for employers to sponsor overseas workers to work on a temporary basis in Australia.

Recipients may remain in Australia for up to four years and can bring eligible family members with them. They can work full time, but only for their sponsor or, in some circumstances, an associated entity of the sponsor. Doctors are able to work for multiple and/or unrelated entities, but their sponsor retains obligations in relation to them.

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Applicants must comply with the following conditions:

- be sponsored by an approved employer; - have skills, qualifications, experience and an employment background that match those required for the position; - have a job with their approved sponsor; - meet the English language requirement unless eligible for a waiver; - be eligible to hold a licence or registration for the position (if required); and - be paid the rate of guaranteed salary specified in the relevant nomination, based on the

market salary rate for the position.

Further information is available at:

http://www.immi.gov.au/Visas/Pages/457.aspx

Medical Practitioner (Temporary) visa (subclass 422) Following the creation of flexible working arrangements for international medical graduates under the subclass 457 visa, the subclass 422 visa has not been available for new primary visa applicants since 1 July 2010.

These arrangements do not mean that all subclass 422 visas expired on 1 July 2010. All international medical graduates holding a subclass 422 visa on or after 1 July 2010 are able to remain on that visa until:

- the end of the visa validity period; - they change their employer sponsor; or - they are granted a new visa subclass.

The Medical Practitioner (Temporary) visa (subclass 422) was only open to medical practitioners and permitted them to work in Australia for a sponsoring employer for a period of three months to four years. Applicants worked in Australia for their sponsoring employer, as an independent contractor or for multiple unrelated employers. There were special arrangements available if applicants wanted to work in rural or regional Australia. Applicants could bring eligible family members with them to Australia, who were able to work and study.

Applicants were to comply with the following conditions:

- be eligible for at least conditional registration through the medical board to practise as a medical practitioner in the state or territory where they were to be employed; - have an offer of full-time employment with an Australian employer, such as a hospital, medical practice or area health service; - salary may include fees charged and Medicare rebates; - comply with the required health examinations for their family; - have police clearances, for themselves and any family members over 16 years, if their stay

exceeded 12 months; and - ensure that they and their family held adequate private medical and hospital health insurance cover for the entire time they were in Australia.

Further information is available at:

http://www.immi.gov.au/Visas/Pages/422.aspx

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Occupational Trainee visa (subclass 442) From 24 November 2012 the Occupational Trainee visa (subclass 442) was no longer open to new applicants. After this date people who wanted to come to Australia on a temporary basis to undertake work based training, research activities or a professional development program were required to apply for the new Training and Research visa (subclass 402).

The Occupational Trainee visa (subclass 442) allowed people to complete workplace-based training in Australia on a temporary basis in an approved training program. The training must have provided the visa holder with additional or enhanced skills in the nominated occupations, tertiary studies or fields of expertise. This visa was valid for up to two years (subject to the length of the approved training program).

People may have been nominated for this visa if the proposed occupational training was one of the following:

- training or practical experience in the workplace required for the person to obtain registration for employment in their occupation in Australia or in their home country;

- a structured workplace training program to enhance the person’s existing skills in an eligible occupation; or

- structured workplace training to enhance the person’s skills and promote capacity building overseas.

Further information is available at:

http://www.immi.gov.au/Visas/Pages/442.aspx

Training and Research visa (subclass 402) The Training and Research visa (subclass 402) is for people who want to come to Australia on a temporary basis to participate in occupational training, observe or participate in research as a visiting academic, or participate in a professional development program. There are three streams in the Training and Research visa (subclass 402):

- Occupational Trainee stream;

- Research stream; and

- Professional Development stream.

The Occupational Trainee stream is for people who require structured workplace-based training to enhance their skills in their current occupation, area of tertiary study, or field of expertise.

The Research stream enables professional academics to visit Australia on a temporary basis, to observe or participate in an Australian research project at an Australian tertiary or research institution.

The Professional Development stream is for professionals, managers or government officials invited to participate in a professional development training program in Australia that has been arranged by an employer outside Australia and which usually lasts up to 18 months.

Further information is available at:

http://www.immi.gov.au/Visas/Pages/402.aspx

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Current Data In 2013-14, there were 2,650 visas granted to medical practitioners across the main subclasses - 457, 422 and 442/402 (Table 5.1).

The overall number of visas granted to medical practitioners in 2013-14 dropped to the lowest level for the past decade. The overall number of visas was 16.9% less than in 2009-10 (3,190), just five years earlier.

The trend in the types of visas issued over this period has altered dramatically. The bulk of those (2,440 or 92.1%) being granted are now under subclass 457. This reflects the phasing out of visa subclass 422, with the numbers decreasing to zero from 2011-12 from a high of 1,380 visas issued in 2005-06.

Visa subclass 2009-10 2010-11 2011-12 2012-13 2013-14

2013-14 Proportion of total (%)

Change 2012-13 to 2013-14 (%)

Change 2009-10 to 2013-14 (%)

457 2,670 2,930 3,300 2,860 2,440 92.1 -14.5 -8.7

422(c) 260 40 0 0 0 na na na

442/402 250 260 260 230 210 7.9 -10.7 -17.1

Total 3,190 3,220 3,560 3,090 2,650 100.0 -14.2 -16.9

(a) Figures are rounded to the nearest 10. (b) For Subclass 442/402 and 457, nominated occupations include Australian Standard Classification of Occupations 231 Medical Practitioner. (c) Subclass 422 is not available for new primary visa applicants from 1 July 2010.

Source: Australian Government Department of Immigration and Border Protection administrative data, 2014

As in previous years, in 2013-14 primary visa applications were granted to medical practitioners from all over the world (Table 5.2).

Many of those who applied to work in Australia came from countries, namely the United Kingdom, Republic of Ireland and Canada, which have very similar medical training and have been major sources of medical practitioners immigrating to Australia for decades. Almost half (44.1%) of visas under the three main classes were granted to applicants from the United Kingdom and Republic of Ireland. Just 5.1% and 2.2% of the medical practitioners granted visas came from Canada and the United States of America respectively.

More recently, larger numbers of international recruits have come from a number of Asian countries. In 2013-14 almost a third (28.5%) of all applications were granted to medical practitioners from Malaysia, India, Sri Lanka, Singapore, Iran and Pakistan (8.2%, 6.9%, 4.6%, 3.2%, 3.2% and 2.4% respectively of all visas under subclasses 457 and 442/402).

Medical practitioners from New Zealand do not require any of these visas to work in Australia.

Table 5.1: Major classes of primary visa granted to medical practitioners(a),(b), 2009-2010 to 2013-2014

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Citizenship country

Visa subclass

Total

Proportion of total (%) 457 442/402

United Kingdom 960 30 990 37.3

Malaysia 200 20 220 8.2

India 160 20 180 6.9

Ireland, Republic of 180 < 5 180 6.8

Canada 130 10 130 5.1

Sri Lanka 110 20 120 4.6

Singapore 70 20 90 3.2

Iran 80 0 80 3.2

Pakistan 60 0 60 2.4

United States of America 50 10 60 2.2

Other countries 440 90 530 20.1

Total 2,440 210 2,650 100.0

(a) Figures are rounded to the nearest 10.

(b) Subclass 457 and 442/402, nominated occupations include Australian Standard Classification of Occupations 231 Medical Practitioners.

Source: Australian Government Department of Immigration and Border Protection administrative data, 2014

Table 5.3 shows the total number of medical practitioners who held each of the main subclasses of visa at the end of the 2012-13 and 2013-14 financial years, with 4,300 medical practitioners holding visas in these subclasses at 30 June 2014. There was a decrease of 10.7% on the 4,810 visa holders in the previous year. This suggests continuation of the downward trend in migration.

Visa type

Visa holders at 30/06/2013

Visa holders at 30/06/2014

Change

2012-13 to 2013-14 (%)

457 4,600 4,140 -10.0

422 40 <5 -94.3

442/402 180 160 -13.3

Total 4,810 4,300 -10.7

(a) Figures are rounded to the nearest 10.

Source: Australian Government Department of Immigration and Border Protection administrative data, 2014

Table 5.2: Primary visa applications granted to medical practitioners by visa subclass: Top 10 citizenship countries(a),(b), 2013-14

Table 5.3: Primary visa holders where the occupation is medical practitioner by visa subclass(a), 2012-13 and 2013-14

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Requirements for Practicing Medicine in Australia Although national examinations for non-specialist international medical graduates have existed in Australia since 1978, states and territories had adopted different approaches to the assessment of some categories of Area of Need practitioners and specialists.

In July 2006 the Council of Australian Governments (COAG) agreed to the introduction of a nationally consistent assessment process for international medical graduates and overseas trained specialists. COAG gave Health Ministers the responsibility for implementation of this decision, and a model for a national process was developed and submitted to Health Ministers on 12 December 2006. The final report on the agreed pathways was presented to the Australian Health Ministers’ Advisory Committee (AHMAC) in October 2008.

This model outlines three main assessment pathways:

- Competent Authority Pathway;

- Standard Pathway (including the current Australian Medical Council examination and a workplacebased assessment pathway); and

- Specialist pathways for all specialties, including general practice:

• Standard specialist assessment;

• Area of Need assessment; and

• Overseas trained specialist in specified training position.

The Competent Authority Pathway was implemented from 1 July 2007 and the first stage of the Standard Pathway (workplace-based assessment) for general practitioners and non-specialist hospital doctors was implemented the following year, from 1 July 2008.

The Australian Medical Council (AMC) is an independent national standards body which is responsible for processing all initial inquiries regarding assessment of international medical graduates and overseas trained specialists. It was established by Australian Health Ministers as a legal entity in 1985 and became a Company Limited by Guarantee in 2008.

With implementation of the National Registration and Accreditation Scheme (NRAS) in July 2010, the AMC responsibilities were expanded to cover the following:

- acting as an external accreditation entity for the purposes of the Health Practitioner Regulation National Law;

- developing accreditation standards, policies and procedures for medical programs of study based predominantly in Australia and New Zealand and for assessment of international medical graduates for registration in Australia;

- assessing, using the approved accreditation standards, medical programs and the institutions that provide them - both those leading to general registration and those leading to specialist registration of the graduates to practice medicine in Australia;

- assessing other countries’ examining and accrediting authorities to decide whether persons who successfully complete the examinations or programs of study conducted or accredited by those authorities have the knowledge, clinical skills and professional attributes to practice medicine in Australia;

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- assessing the knowledge, clinical skills and professional attributes of overseas qualified medical practitioners seeking registration to practice medicine in Australia; and

- assessing the case for recognition of medical specialties.

Further details on assessment requirements that are common to each of the pathways and the specific requirements of each are provided below.

Common Assessment Requirements Each of the pathways includes some (or all) of the following steps:

- assessment of English language proficiency at a nationally agreed level;

- primary source verification of qualifications;

- assessment against a position description with the level of assessment according to level of risk (for Area of Need positions);

- orientation within three months of starting employment and evidence of satisfactory completion of this submitted to the relevant medical board with the supervisor’s three-month report; and

- access to continuing professional development.

Competent Authority Pathway Competent Authorities are designated overseas accredited medical training and licensing examination authorities that have been reviewed and approved against criteria developed by the AMC as competent to undertake a basic assessment of medical knowledge and clinical skills for the purposes of registration in Australia. One of the criteria used to recognise a Competent Authority is the extent to which the clinical context of the country in which it operates is consistent with the Australian context of health care. This is defined in terms of the pattern of disease, level of medical technology, delivery of medical education and professional ethics. The AMC has approved four examination authorities in:

- the United Kingdom (PLAB examination or for graduates of GMC-accredited medical courses);

- the United States of America (the USMLE examination);

- Canada (the MCC Licensing Examination); and

- New Zealand (the NZREX examination).

Graduates of medical courses in Ireland are accredited by the Medical Council of Ireland.

International medical graduates undergo a pre-employment assessment of suitability for a position if required by the Medical Board of Australia (MBA). Where the board determines a Pre-Employment Structured Clinical Interview (PESCI) is required, it is carried out by an AMC-accredited provider against the position description. This may be carried out if required for more senior hospital-based positions and is included as a matter of course for general practice positions.

Doctors eligible for the Competent Authority Pathway are granted advanced standing towards the AMC Certificate and undergo up to 12 months workplace-based assessment to ensure satisfactory adjustment to the Australian health care system before they are eligible to receive the AMC Certificate and apply for general registration.

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Table 5.4 shows that a total of 1,123 applicants were assessed through this pathway in 2013. Of these, 1,054 applicants qualified for advanced standing. While these are primarily applicants who applied in 2013, the figures also include a number of 2012 applicants who were required to submit additional documentation to confirm their eligibility.

In 2013, a total of 662 AMC Certificates were granted, making the applicants eligible to apply for general registration. This is a 27.3% increase from 520 Certificates granted in 2012.

Two-thirds of those granted advanced standing in 2013 were international medical graduates from the United Kingdom.

Almost one-fifth of certificates were issued to international medical graduates from Ireland. A total of 30 certificates were issued to international medical graduates from India. Six certificates were received by international medical graduates from each of the United States of America and Canada.

Country of training PLAB(c) MCC(d) USMLE(e) NZREX(f) GMCUK(g) MCI(h) Total

Advanced standing Issued Certificate

issued

Canada 0 24 0 0 0 0 25 22 6

India 33 3 4 4 1 0 54 51 30

Ireland 0 0 0 0 0 111 125 114 102

South Africa 1 1 0 0 0 0 3 4 3

United Kingdom 0 0 0 0 677 0 757 729 461

United States of America 0 0 15 0 0 0 20 17 6

Other(b) 37 48 14 6 1 0 139 117 54

Total 71 76 33 10 679 111 1,123 1,054 662

(a) Data covers the period 1 January 2013 to 31 December 2013. (b) Other includes: Afghanistan, Albania, Algeria, Antigua and Barbuda, Argentina, Armenia, Austria, Bahrain, Bangladesh, Belarus, Belize, Bolivia, Bulgaria, Chile, China, Colombia, Croatia, Czech Republic, Democratic Republic of the Congo, Dominica, Dominican Republic, Egypt, Ethiopia, Fiji, France, Georgia, Germany, Ghana, Greece, Grenada, Guyana, Hong

Kong, Hungary, Indonesia, Iran, Iraq, Israel, Italy, Jamaica, Jordan, Kenya, Kuwait, Latvia, Lebanon, Libya, Lithuania, Macedonia, Malaysia, Mexico, Moldova, Myanmar, Nepal, Netherlands Antilles, Netherlands, Nigeria, Oman, Pakistan, Peru, Philippines, Poland, Romania, Russia, Saba, Saint Kitts and Nevis, Saint Lucia, Samoa, Saudi Arabia, Serbia, Sierra Leone, Singapore, Sint Eustatius, Sint Maarten, Slovakia, Somalia, South Korea, Spain, Sri Lanka, Sudan, Sweden, Syria, Tanzania, Thailand, Trinidad and Tobago, Turkey, Uganda, Ukraine, United Arab Emirates, Uzbekistan, Venezuela, Vietnam, Yemen, Zambia and Zimbabwe. (c) Professional Linguistic Assessments Board Exam. (d) Medical Council of Canada Exam. (e) United States Medical Licensing Exam. (f) New Zealand Registration Exam. (g) General Medical Council of the United Kingdom Accreditation. (h) Medical Council of Ireland Accreditation.

Source: Australian Medical Council administrative data, 2014

Table 5.4: International medical graduates: Applications assessment through Competent Authority Pathway, 2013(a)

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Standard Pathway Doctors who are not eligible for either the Competent Authority or Specialist pathways are assessed through the Standard Pathway. The Standard Pathway has two alternative processes leading to the Australian Medical Council (AMC) Certificate.

- Standard Pathway (AMC examinations). Assessment is by examination only - the AMC Multiple Choice Questionnaire (MCQ) and the AMC clinical examination; and

- Standard Pathway (workplace-based assessment). Assessment is by examination and workplace-based assessment - the AMC MCQ examination and workplace-based assessment of clinical skills and knowledge by an AMC-accredited authority.

A Pre-Employment Structured Clinical Interview (PESCI) is also required for all international medical graduates applying for general practice positions and for some international medical graduates in hospital positions.

Successful completion of the assessment requirements leads to the awarding of the AMC Certificate.

In 2013, there were 1,508 international medical graduates (Table 5.5) who passed the MCQ (52.9% of attempts), a decrease from 57.5% in 2012.

The number of international medical graduates who passed the clinical examinations increased from 964 in 2012 to 1,055 in 2013. This was 40.5% of attempts.

Country of training

MCQ exam attempts

MCQ exam passes Clinical exam attempts

Clinical exam passes

Bangladesh 207 104 204 72

China 128 38 113 48

Colombia 26 11 22 11

Egypt 129 59 63 29

Fiji 17 6 12 5

India 448 233 508 202

Indonesia 20 7 23 9

Iran 217 131 133 54

Iraq 66 39 64 30

Jordan 30 24 17 7

Malaysia 45 29 43 22

Myanmar 112 75 196 86

Nepal 45 21 33 17

Nigeria 121 59 57 20

Pakistan 279 153 272 111

Papua New Guinea 5 3 13 2

Table 5.5: International medical graduates: Applications assessed through Standard Pathway AMC examination, 2013(a)

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Country of training

MCQ exam attempts

MCQ exam passes Clinical exam attempts

Clinical exam passes

Philippines 137 41 151 39

Romania 10 1 12 2

Russia 98 42 84 29

Saudi Arabia 4 4 9 2

South Africa 33 24 36 23

Sri Lanka 245 190 195 98

Ukraine 45 18 40 16

Vietnam 10 5 10 2

Zimbabwe 12 8 16 9

Other(b),(c) 360 183 281 110

Total 2,849 1,508 2,607 1,055

(a) Data covers the period 1 January 2013 to 31 December 2013.

(b) Other in MCQ Exam includes: Afghanistan, Albania, Argentina, Armenia, Austria, Bahrain, Barbados, Belarus, Belgium, Bolivia, Bosnia and Herzegovina, Brazil, Bulgaria, Canada, Cayman Islands, Chile, Cuba, Czech Republic, Democratic Republic Of The Congo, Denmark, Dominica, Dominican Republic, Ecuador, Ethiopia, Finland, France, Georgia, Germany, Ghana, Greece, Grenada, Hungary, Ireland, Israel, Italy, Jamaica, Japan, Kazakhstan, Kenya, Kosovo, Kyrgyzstan, Laos, Latvia, Lebanon, Libya, Lithuania, Macedonia, Malawi, Mauritius, Mexico, Moldova, Mozambique, Netherlands, Norway, Oman, Palestinian Authority, Peru, Poland, Rwanda, Saba, Saint Kitts and Nevis, Saint Lucia, Samoa, Serbia, Seychelles, Singapore, Sint Maarten, Slovakia, South Korea, Sudan, Sweden, Switzerland, Syria, Taiwan, Tajikistan, Tanzania, Thailand, Trinidad and Tobago, Turkey, Uganda, United Arab Emirates, United Kingdom, United States of America, Uzbekistan, Venezuela, Yemen and Zambia.

(c) Other in Clinical Exam includes: Afghanistan, Algeria, Argentina, Armenia, Austria, Azerbaijan, Belarus, Belgium, Bolivia, Bosnia and Herzegovina, Brazil, Bulgaria, Canada, Croatia, Cuba, Czech Republic, Democratic Republic Of The Congo, Ecuador, El Salvador, Ethiopia, Finland, France, Germany, Ghana, Greece, Grenada, Hungary, Ireland, Jamaica, Japan, Kazakhstan, Kenya, Kosovo, Kyrgyzstan, Latvia, Lebanon, Libya, Lithuania, Macedonia, Malta, Mauritius, Mexico, Moldova, Netherlands, Norway, Oman, Palestinian Authority, Paraguay, Peru, Poland, Rwanda, Saint Kitts and Nevis, Samoa, Serbia, Seychelles, Singapore, Slovakia, Slovenia, South Korea, Spain, Sudan, Switzerland, Syria, Taiwan, Tanzania, Thailand, Trinidad And Tobago, Turkey, Uganda, United Arab Emirates, United Kingdom, United States of America, Union of Soviet Socialist Republics, Uzbekistan, Venezuela, Yemen and Zambia.

Source: Australian Medical Council administrative data, 2014

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Table 5.6 presents information on workplace-based assessment through the Standard Pathway.

Authority

Country of training

Workplace-based assessment attempts

Workplace-based assessment passes

Australian College of Rural and Remote Medicine Argentina 1 1

Bangladesh 2 1

Serbia 1 1

Sri Lanka 2 1

Zimbabwe 1 0

Total Australian College of Rural and Remote Medicine 7 4

Hunter New England Area Health Services Bangladesh 1 0

China 1 1

Fiji 2 2

India 7 7

Indonesia 1 1

Iran 3 3

Jordan 1 1

Pakistan 6 5

Sudan 1 1

Ukraine 1 1

Total Hunter New England Area Health Services 24 22

Launceston General Hospital Germany 1 1

India 5 3

Iran 1 1

Iceland 1 1

Myanmar 1 0

Nepal 3 2

Pakistan 5 4

Russia 1 1

Sri Lanka 1 0

Uzbekistan 1 1

Total Launceston General Hospital 20 14

Rural and Outer Metro United Alliance Guatemala 1 0

Nigeria 2 2

Pakistan 3 3

Romania 1 1

Total Rural and Outer Metro United Alliance 7 6

Southern Health Colombia 1 0

Egypt 1 1

India 4 1

Iran 1 1

Pakistan 3 3

Philippines 3 1

Russia 2 2

Total Southern Health 15 9

Table 5.6: International medical graduates: Workplace-based assessment through Standard Pathway, 2013

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Authority

Country of training

Workplace-based assessment attempts

Workplace-based assessment passes

WA Health Bangladesh 1 1

Colombia 1 1

Germany 1 1

India 3 2

Iran 2 2

Nepal 1 1

Pakistan 10 10

Philippines 2 2

South Africa 1 1

Total WA Health 22 21

Total 95 76

Source: Australian Medical Council administrative data, 2014

Assessment of Overseas Trained Specialists Prior to 1990, all overseas trained specialists seeking registration in Australia who did not hold a recognised primary medical qualification were obliged to pass the AMC examination and obtain general registration before they could be registered to practise as a specialist. In addition, before 1990 only two states (Queensland and South Australia) had separate specialist registers.

In 1991, the Australian Health Ministers’ Conference (AHMC), in anticipation of the implementation of the mutual recognition scheme, approved a process for overseas trained specialists to be assessed by the relevant specialist medical college in Australia against the standards for an Australian trained specialist in the same field of specialist practice. If the qualifications and relevant experience of the applicant were assessed as substantially comparable to an Australian trained specialist, he/she could apply for registration limited to the field of specialty.

In consultation with the former state and territory medical boards and colleges, it was subsequently agreed that the specialist assessment process should not be seen as a backdoor to specialist training in Australia. For this reason it was resolved that any overseas trained specialist who required more than two years of further supervised training to meet the required standard for substantial comparability (equivalence to an Australian trained specialist) would be assessed as ‘not comparable’ and would be required to sit the AMC examination and obtain general registration.

A national assessment process for Area of Need specialists was not resolved until 2002, when agreement was reached on a separate pathway for the assessment and registration of overseas trained specialists in Area of Need positions. This involves an assessment against a position description that defines the levels of clinical responsibility, supervision and specific clinical skills required for a particular position. The relevant specialist college assesses the individual against the position description, rather than against the standards required by the medical college for a (fully recognised) specialist.

A number of colleges have agreed to combine their Area of Need and full comparability assessments, so that the applicant (and the Medical Board of Australia) can be advised of the additional steps required to achieve substantial comparability at the same time as he or she is being assessed for the Area of Need position. To date some nine colleges (RANZCOG, RACP,

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RCPA, ACD, RACS, RANZCO, RANZCP, ACRRM and RANZCR) have agreed to undertake the combined assessments of overseas trained specialists.

All specialist applications are administered through the AMC and assessment of comparability to Australian standards is carried out by the relevant specialist college. Applicants who do not meet the requirements for specialist assessment are required to undergo assessment through one of the non-specialist pathways.

Standard Specialist Assessment Overseas trained specialists applying for comparability to an Australian trained specialist must have completed all training requirements and be recognised as a specialist in their country of training before applying under the specialist pathway for assessment of comparability.

There are three possible outcomes of assessment:

- substantially comparable;

- partially comparable, requiring up to two years up skilling to reach comparability; and

- not comparable.

The majority of medical colleges will allow applicants who are considered substantially comparable to Australian trained specialists to gain fellowship without requiring an additional examination, although most require a period of practice under oversight.

International medical graduates with specialist qualifications or specialists-in-training are eligible to apply for general registration under the Competent Authority Pathway (if eligible), in addition to applying for specialist registration through the Specialist Pathway.

In total, there were 2,234 overseas trained specialists whose applications to be recognised as a specialist in Australia were being processed in 2013. While these are primarily applicants who applied the previous year, this figure also includes a number of applicants who were required to submit additional documentation or undergo further training to confirm their eligibility.

Table 5.7 shows that 349 overseas trained specialists had their applications approved (that is, they were deemed to be substantially comparable) and a further 335 were deemed as requiring further training and/or examinations (that is, partially comparable).

Total number of overseas trained specialists with approved applications has slightly decreased from 2,346 in 2012 to 2,234 in 2013 (4.8%).

Table 5.8 presents data on the countries in which approved applicants were trained. More than half (179 or 51.3%) of all overseas trained specialists, who have had their applications approved in 2013, were trained in the United Kingdom and Ireland. The next largest number of specialists in 2013 came from India (50 or 14.3% of all approved applicants). Two other cohorts of overseas trained specialists with qualifications substantially comparable to Australia came from South Africa and the United States of America (25 or 7.1% each).

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Medical specialty

Initial

processing

College processing

Substantially comparable

Partially comparable

Not

comparable

Withdrawn

Total

Proportion of

total (%)

Adult medicine

102

29

69

65

15

58

338

15.1

Anaesthesia

33

44

44

30

13

22

186

8.3

Dermatology

8

6

1

1

1

1

18

0.8

Emergency medicine

14

3

21

16

6

13

73

3.3

General practice

451

60

11

33

8

15

578

25.9

Intensive care

5

10

8

4

4

3

34

1.5

Medical administration

0

0

1

0

0

1

2

0.1

Obstetrics and gynaecology

59

3

34

12

11

7

126

5.6

Occupational and environmental medicine

1

0

2

2

0

0

5

0.2

Ophthalmology

27

5

8

12

7

4

63

2.8

Oral and maxillofacial surgery

0

0

0

1

0

0

1

0

Paediatrics and child health

60

7

17

36

4

29

153

6.8

Pain medicine

4

1

0

0

0

1

6

0.3

Palliative medicine

0

0

1

1

0

2

4

0.2

Pathology

40

5

15

22

3

8

93

4.2

Psychiatry

33

9

43

22

3

0

110

4.9

Public health medicine

5

0

2

0

0

0

7

0.3

Radiology

35

6

37

40

2

2

122

5.5

Rehabilitation medicine

1

0

2

4

1

0

8

0.4

Sexual health medicine

3

0

0

1

0

0

4

0.2

Sport and exercise medicine

1

0

0

0

0

0

1

0

Surgery

62

116

33

33

19

39

302

13.5

Total

944

304

349

335

97

205

2,234

100.0

Source: Australian Medical Council administrative data, 2014 Table 5.7: Specialist assessment process by medical specialty, 2013

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Medical specialty Canada India

New

Zealand South Africa

United Kingdom and Ireland

United States of America Other(a) Total

Proportion of total (%)

Adult medicine 0 6 0 3 41 3 16 69 19.8

Anaesthesia 0 10 0 1 25 1 7 44 12.6

Dermatology 0 0 0 1 0 0 0 1 0.3

Emergency medicine 1 0 0 0 11 9 0 21 6.0

General practice 0 0 1 4 2 4 0 11 3.2

Intensive care 0 0 0 1 2 1 4 8 2.3

Medical administration 0 0 0 1 0 0 0 1 0.3

Obstetrics and gynaecology 1 3 0 1 19 1 9 34 9.7

Occupational and environmental medicine 0 0 0 0 2 0 0 2 0.6

Ophthalmology 0 0 0 1 7 0 0 8 2.3

Paediatrics and child health 3 3 0 1 9 0 1 17 4.9

Palliative medicine 0 0 0 0 1 0 0 1 0.3

Pathology 0 4 0 2 5 1 3 15 4.3

Psychiatry 0 10 0 2 21 2 8 43 12.3

Public health medicine 0 0 0 1 1 0 0 2 0.6

Radiology 0 8 0 2 18 1 8 37 10.6

Rehabilitation medicine 0 0 0 0 0 1 1 2 0.6

Surgery 1 6 0 4 15 1 6 33 9.5

Total 6 50 1 25 179 25 63 349 100.0

(a) Other includes: Austria, Belgium, Brazil, Egypt, Germany, Hong Kong, Hungary, Iran, Israel, Italy, Jordan, Kenya, Nepal, Netherlands, Pakistan, Singapore, Spain, Sri Lanka, Sweden, Switzerland and Zimbabwe.

Source: Australian Medical Council administrative data, 2014

Area of Need Specialist Assessment Overseas trained specialists applying for an Area of Need assessment must also have completed all training requirements and be recognised as a specialist in their country of training. When assessing applicants for suitability for Area of Need positions, medical colleges will determine at the same time (or soon thereafter) what is required to meet standards for fellowship.

Table 5.8: Substantially comparable specialist applications by country of training and medical speciality, 2013

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An Area of Need applicant is always assessed against a position description. This allows an overseas trained specialist to work in a designated specialty position, provided conditions imposed by the Medical Board of Australia are met. The position description together with the qualifications, training and experience of the applicant will determine the level of risk and the level of supervision or further assessment required.

Specified Specialist Training Applicants who wish to enter Australia for specified specialist training will require registration by the Medical Board of Australia (through the medical boards in each state and territory) following advice from the relevant specialist medical college. This limited registration allows applicants to undertake training or to obtain experience in Australia not available in their country of training for a short period (normally up to one year), but can in exceptional circumstances be extended to three years.

Medicare Provider Number Restrictions In 1996, the Australian Government introduced Medicare provider number restrictions to improve the quality of Australia’s medical workforce over the longer term and to address growing concerns about the maldistribution of the medical workforce. Since 1997, doctors who obtained their primary medical qualification overseas have been required to gain an exemption under section 19AB of the Act in order to access Medicare benefits for the services they provide. Exemptions under the Act are generally only granted if the medical practitioner works in a recognised area of workforce shortage, as defined by the Australian Government.

Restrictions of Practice Section 19AB of the Act restricts access to Medicare provider numbers and requires overseas trained doctors and ‘foreign graduates of an accredited medical school’ (FGAMS) from April 2010 to work in a District of Workforce Shortage (DWS) for a period of generally ten years in order to access the Medicare benefits arrangements. This is referred to as the ‘ten year moratorium’.

A DWS is an area in which the general population’s need for health care is considered not to be met. These areas are identified as those that have less access to medical services than the national average. They are determined on the basis of a full-time equivalent measure, which takes into account latest Medicare billing in the area, irrespective of whether or not local doctors are working in a part-time or a full-time capacity. Districts are defined on a quarterly basis for general practice and annually for the other medical specialties.

The DWS status of each area in Australia for the specialty of General Practice is available on the Doctor Connect map located at:

www.doctorconnect.gov.au

On 1 July 2010 the Australian Government introduced the scaling initiative as part of the Rural Health Workforce Strategy (RHWS). The scaling initiative allows overseas trained doctors and FGAMS to receive significant reductions in their restriction period under the ten year moratorium if they practice privately within an eligible regional, rural or remote area. The greatest discounts are available to medical practitioners who practise within the most remote locations in Australia. Further advice regarding the scaling initiative is available from the Doctor Connect website.

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Table 5.9 shows the cumulative number of overseas trained doctors granted exemptions under Section 19AB of the Act. As at 30 June 2014 there were a total of 11,138 exemptions issued to overseas trained doctors.

  2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 (a)

Total 1,303 1,722 2,290 2,878 3,634 4,476 5,483 5,914 6,892 7,785 9,053 10,459 11,138

(a) 2014 figure calculated to 30 June 2014.

Source: Australian Government Department of Health administrative data, 2014

Current Distribution of Overseas Trained Doctors The intake of overseas trained doctors by all states and territories increased from 2013.

Table 5.10 shows which jurisdictions were relatively more reliant on overseas trained doctors to provide services in 2014. The largest number of overseas trained doctors (3,189) was in Queensland, followed by New South Wales (2,997) and Victoria (2,861).

 

General

practitioners(a) Specialists(a) Total

New South Wales 1,792 1,216 2,997

Victoria 1,930 923 2,861

Queensland 1,909 1,289 3,189

South Australia 600 369 959

Western Australia 1,003 550 1,543

Tasmania 211 197 406

Northern Territory 179 100 273

Australian Capital Territory 96 115 212

Australia(b) 7,130 4,056 11,138

 (a) General practitioners include section 3GA (under the Health Insurance Act 1973) placements and Specialists include assistant specialists. (b) Overseas trained doctors may work in more than one location across different states/territories.

Source: Australian Government Department of Health administrative data as at 30 June 2014

There is marked variation in the reliance on overseas trained doctors across jurisdictions and by remoteness.

The following figures show the distribution of overseas trained doctors across states and territories and by remoteness (Figure 5.1 to Figure 5.4). These figures highlight the variation between jurisdictions in the overall and relative number of overseas trained doctors, as well as where they are working.

Table 5.9: Overseas trained doctors with Section 19AB exemptions, 2014

Table 5.10: Overseas trained doctors by state/territory, 2014

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Although overseas trained doctors constitute a far higher proportion of the medical workforce in more remote areas of Australia, the majority work in Major cities and Inner regional areas. More specifically, nearly half of overseas trained general practitioners and overseas trained specialists worked in Major cities (Figure 5.1), where just over two-thirds of the population reside. More than one-third of both overseas trained general practitioners and specialists worked in Inner regional areas (Figure 5.2), where one-fifth of the population resides.

Queensland has relatively high numbers of overseas trained doctors across all Remoteness Areas, while Western Australia stands out for the relatively higher numbers in Remote and Very remote areas (Figure 5.4).

NSW VIC QLD SA WA ACT

State/Territory

Overseas trained doctors

General practitioners Specialists

0

100 200

300 400

500 600

700 800

900 1,000

1,100 1,200

Source: Medicare data, Australian Government Department of Health administrative data, 2014

NSW VIC QLD SA WA TAS

State/Territory

Overseas trained doctors

0

200 100

400 300

600 500

800 700

900 1,000

1,100

General practitioners Specialists

Source: Medicare data, Australian Government Department of Health administrative data, 2014

Figure 5.1: Overseas trained doctors in Major cities by state/territory, 2014

Figure 5.2: Overseas trained doctors in Inner regional areas by state/territory, 2014

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NSW VIC QLD SA WA TA S N T

State/Territory

Overseas trained doctors

0

50

100

150

200

250

300

350

400

450

500

General practitioners Specialists

Source: Medicare data, Australian Government Department of Health administrative data, 2014

NSW VIC QLD SA WA TA S N T

State/Territory

Overseas trained doctors

0

50

100

150

200

250

300

350

400

450

500

General practitioners Specialists

(a) Data for Remote, Very Remote and Migratory classes have been combined.

Source: Medicare data, Australian Government Department of Health administrative data, 2014

Figure 5.3 Overseas trained doctors in Outer regional areas by state/territory, 2014

Figure 5.4: Overseas trained doctors in Remote and Very remote areas by state/territory(a), 2014

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Chapter 6 SPECIAL PURPOSE TRAINING PROGRAMS This chapter reports on the Special Purpose Training Programs established under section 3GA of the Act. Section 3GA programs target particular workforce requirements. These include vocational training, vocational recognition and other training needs.

Special Purpose Training Programs also provide for those doctors seeking vocational recognition, but who are not involved in a specialist training program. Many of the Special Purpose Training Programs offer a range of incentives to doctors. The two most common incentives are access to a Medicare provider number and access to the higher A1 Medicare rebate. Other incentives may involve access to an alternative vocational training pathway, the opportunity to broaden the range of clinical experience within an existing training pathway or special support in achieving vocational recognition.

Some of these programs specifically cover doctors who have trained overseas to assist with their integration into the Australian workforce and to promote them working in areas of workforce shortage.

Background Section 19AA of the Act was introduced in 1996 to recognise and support general practice as a vocational specialty, as well as to provide a framework for achieving long term improvements in the quality of doctors working in Australia.

Section 19AA of the Act applies to all medical practitioners who:

- held medical registration by an Australian Medical Board on or after 1 November 1996;

- are Australian permanent residents or Australian citizens; and

- do not hold continued recognition by the RACGP or the ACRRM and/or recognition from a specialist medical college.

The Medicare provider number restrictions introduced in 1996 in section 19AA of the Act apply to doctors who were first recognised as Australian medical practitioners on or after 1  November 1996 and who are neither vocationally recognised nor hold fellowship of a recognised medical college. Section 19AA of the Act restricts the accessing of Medicare benefits to doctors who are:

- Australian citizens or permanent residents; or

- temporary residents who have completed their commitment under section 19AB of the Act.

Section 19AA of the Act ensures that all doctors receiving medical education and training in Australia possess the appropriate qualifications to practise medicine. These qualifications require Australian-trained doctors, as well as permanent residents and Australian citizens who trained overseas, to complete a program of postgraduate vocational medical training before being eligible to receive a Medicare provider number with access to the Medicare benefits arrangements.

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There are exemptions from section 19AA restrictions for certain training and workforce programs. Section 3GA of the Act allows medical practitioners undertaking postgraduate education or training placements on approved workforce training programs to provide professional medical services that are eligible to attract Medicare benefits. Exemptions to section 19AA of the Act apply to most medical college training and workforce programs, including the Australian General Practice Training (AGPT) Program and the Rural Locum Relief Program (RLRP).

3GA Programs Providers Table 6.1 summarises the number of providers, as a headcount, on workforce programs and some specialised training programs under section 3GA of the Act from 2004-05 to 2013-14. Providers are identified where they have rendered a service on a fee-for-service basis for which claims were processed by the Australian Government Department of Human Services - Medicare. Those only providing services to public patients in hospitals and through other publicly funded programs within the specified periods are not covered.

Further information on each of the programs is provided below.

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Program

2004-05

2005-06

2006-07

2007-08

(c)

2008-09

2009-10

2010-11

2011-12

2012-13

2013-14

194 - Approved Medical Deputising Services Program

108

141

165

206

215

272

363

446

586

830

197 - Approved Private Emergency Department Program

8

6

19

14

18

21

15

34

51

61

187 - Approved Placements for Sports Physicians Program (discontinued)

(d),(e)

8

8

7

8

14

13

13

-

-

-

414 - Sports Physician Trainees Program

-

16

22

21

27

21

29

28

35

38

617 - Metropolitan Workforce Support Program (discontinued)

8

8

4

1

-

-

-

-

-

-

178 - Prevocational General Practice Placement Program

21

56

81

134

182

238

400

647

779

765

177 - Queensland Country Relieving Doctors Program

161

260

301

293

340

368

354

403

393

357

190 - Rural Locum Relief Program

660

554

551

583

657

767

890

999

1,127

1,340

179 - Special Approved Placement Program

7

13

14

37

49

90

159

217

265

359

198 - Temporary Resident Other Medical Practitioners Program

(d),(f)

70

84

98

106

105

109

109

119

118

115

176 - Remote Vocational Training Scheme

10

10

13

16

26

30

36

40

46

70

AGPT - Australian General Practice Training Program

(g)

na

na

na

na

na

na

na

na

na

3,670

(a) Providers have claimed through Medicare for at least one service on a valid date for the program in question. (b) Providers may be counted against multiple programs and therefore programs are not additive, apart from within the AGP grouping referred to. (c) Statistics for 2007-08 had regard to claims processed up to the end of September. Statistics for all other financial years had regard to claims processed up to the end of October. (d) The Temporary Resident Other Medical Practitioner Program (198) and the Approved Placements for Sports Physician Trainees Program (187) were not location specific. All other programs were location specific. (e) Based on advice from Medicare Australia, providers on Approved Placements for Sports Physicians Program (187) were only counted if they had an end date of 30 June 2011. Also Medicare Australia used code 187 for 3GA and non-3GA providers.

(f) The number of providers registered against the Temporary Resident Other Medical Practitioner Program who provided at least one service during 2010-11 has been revised from 93 as in the MTRP 15th report to 109. (g) AGPT groups programs 134, 430, 431, 432, 433, 434, 435, 436, 437, 438, 439, 440, 441, 442, 443, 444, 445, 446, 447, 448, 449, 450, 451, 452, 453, 454, 455 and 456. Providers registered against more than one of these GPET/GPTRAINEE programs in the financial year shown are only counted once. Provider counts on the basis referred to in note (b) are not available for years before 2013-14.

Source: Australian Government Department of Health administrative data, 2014 Table 6.1: Providers on approved 3GA programs placements

(a),(b)

, 2004-05 to 2013-14

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Section 3GA Programs

Approved Medical Deputising Services Program The purpose of the Approved Medical Deputising Services Program (AMDSP) is to expand the pool of available medical practitioners who may work for after-hours deputising services. This program allows otherwise ineligible medical practitioners to provide a range of restricted professional services, for which Medicare benefits will be payable, where the medical practitioner works for an approved medical deputising service.

The AMDSP was established under section 3GA of the Act in 1999 in response to concerns about the shortage of medical practitioners providing after-hours home visit services in metropolitan areas. The Australian Government Department of Health administers the program.

Approved Private Emergency Department Program The Approved Private Emergency Department Program (APEDP) allows advanced specialist trainees undertaking emergency medicine training to work under supervision in accredited private hospital emergency departments. The program was established to enhance public access to private emergency departments by expanding the pool of doctors able to work in private hospital emergency departments.

Approved Placements for Sports Physicians Program The Approved Placements for Sports Physicians Program (APSPP) was introduced in April 2004. At the time, sports medicine was not recognised as a medical specialty.

This 3GA program was specified in Schedule 5 of the Health Insurance Regulations as an interim measure to allow medical practitioners who gained fellowship of the Australasian College of Sports Physicians (ACSP) after 1 January 2004, and who were subject to the provisions of section 19AA of the Act, to gain access to a Medicare provider number. Once the placement has been approved, the Australian Government Department of Human Services - Medicare registers the placements using specification code 187. Providers are then able to access attendance items from Group A2 of the Medicare Benefits Schedule (MBS), as well as from relevant procedural items, for the nominated period of the placement.

‘Sports and exercise medicine’ was recognised as a specialty under the Act in November 2009. In 2012, the APSPP was discontinued as all sports medicine physicians are now recognised specialists and can access the relevant Medicare item numbers without requiring a 3GA program.

Sports Physician Trainees Program Practitioners in the Sports Physician Trainees program are eligible to be registered under section 3GA of the Act as an ACSP Trainee for specific practice locations using specification code 414. These placements entitle the practitioner to access Group A2 attendance items in the Medicare Benefits Schedule, including relevant procedural items for the period of registration and at approved locations. The Australian Government Department of Human Services - Medicare receives advice on placements directly from the ACSP and registers the placements for Medicare purposes.

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Australian General Practice Training Program The Australian General Practice Training (AGPT) program is a postgraduate vocational training program for medical graduates wishing to pursue a career in general practice. The program provides training towards fellowship of the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM) offered through 17 Regional Training Providers (RTPs) across Australia. Training places are available in all locations; however, there is a requirement that 50% of training activity is undertaken in rural and remote areas classified using the ASGC-RA index as Remoteness Areas (RA) 2 to 5.

The AGPT program commenced in January 2002 with 450 places available. There has been a gradual increase of training placements since this time. In 2004, the number of places was increased to 600 and further increased in 2009 to 675, and 700 in 2010. A greater expansion of the program commenced in 2011 with 900 training places, 1,000 in 2012, 1,108 in 2013 and 1,192 in 2014.

In the 2014-15 Federal Budget, the Australian Government announced additional training places to meet the significant demand for places under the AGPT program in recent years. From 2015, a total of 1,500 AGPT annual commencing training places will be funded.

Prevocational General Practice Placements Program The Prevocational General Practice Placements Program (PGPPP) encouraged junior doctors at all levels to take up general practice as a career and enhanced their understanding of the integration between primary and secondary care.

Placements were available in all locations, however, there was a requirement that 50% of placements occur in rural and remote areas classified using the ASGC-RA index as Remoteness Areas (RA) 2 to 5. Placements were generally for a period of 12 weeks.

General practice placements in this program commenced in January 2005. The number of completed supervised placements has increased each year from 111 in 2005-06, 173 in 2006-07, 248 in 2007-08 and then to 338 in 2008-09. After 2008-09, data on the number of completed supervised general practice placements was collected on a calendar year basis. In 2009, there were 353 placements. A total of 400 completed the 12-week placements in 2010.

The number of placements available increased from 380 in 2010, to 910 in 2011, and 975 placements in 2012 onwards. For the 2011 training year, 692 of the 910 available were filled.

In 2012, 918 out of 975 placements were filled. The shortfalls in 2011 and 2012 were predominantly due to the significant growth in the number of placements (from 380 in 2010 up to 975 in 2012).

In order to fund intern places in private hospitals in 2013, the target for the 2013 training year was reduced to 961. The target remained 975 placements for 2014.

The Prevocational General Practice Placements Program was ceased on 31 December 2014, as announced in the 2014-15 Federal Budget.

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Queensland Country Relieving Doctors Program The Queensland Country Relieving Doctors (QCRD) program provides relieving services to Queensland Health’s rural medical practitioners by drawing on a pool of junior medical staff employed within the state’s public hospitals. The role of these junior doctors is limited to that of a junior doctor without vocational qualification.

The 3GA exemptions are only necessary for practitioners relieving in medical superintendent or medical officer positions with rights to private practice. The exceptions, however, are where a hospital based position attracts Medicare benefits in which case a 3GA exemption is still required.  Therefore, not all practitioners in the program require the 3GA exemptions. These positions with rights to private practice are specific to Queensland and do not exist in other jurisdictions. These positions are generally in small rural locations, where the hospital doctor also fulfils a general practitioner role. The 3GA component of the QCRD program enables medical practitioners to provide services that attract Medicare benefits.

The QCRD program currently provides relief to over 100 rural medical practitioners throughout Queensland. Many of these are solo medical practitioners, who would have limited opportunities for relief if they were reliant upon the recruitment of private locums. The QCRD program contributes towards maintaining a medical service to rural and remote communities in the absence of the community’s permanent doctor.

Rural Locum Relief Program The Rural Locum Relief Program (RLRP) was introduced in 1998. It enables doctors who are not otherwise eligible to access the Medicare Benefits Schedule to have temporary access when providing services through approved placements in rural areas.

Rural Health Workforce Australia through the Rural Workforce Agencies (RWAs) in each state and the Northern Territory administer the program on behalf of the Australian Government. Doctors without postgraduate qualifications who fall within the scope of the restrictions under section 19AA of the Act are eligible to make an application to their respective state or territory RWAs for a placement on the program. For overseas trained doctors who are subject to the restrictions under section 19AB of the Act, practice locations must be within a DWS.

Locations eligible to receive approved placements through the program are:

- rural and remote areas, Rural, Remote and Metropolitan Areas (RRMAs) 3-7;

- Areas of Consideration, as determined by the Australian Government Minister for Health; and/or

- all Aboriginal medical services, including those in RRMA 1 and 2 locations.

Doctors who are registered to practise in a particular state or territory and have been assessed as having suitable experience and skills to practise in the particular location may fill these placements.

Special Approved Placements Program The Special Approved Placements Program (SAPP) was established under section 3GA of the Act in December 2003. The program allows medical practitioners to access Medicare benefits in metropolitan areas if they can demonstrate exceptional circumstances that make them unable to participate on any other workforce or training program under Section 3GA of the Act.

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Exceptional circumstances that would normally be considered are:

- where it can be demonstrated that there is substantial hardship, due to a particular family circumstance, resulting in the medical practitioner not being able to access the Medicare benefits in other suitable locations under section 3GA of the Act;

- where serious illness relating to the medical practitioner, or his or her immediate family members can be demonstrated, including where the treatment for the condition is limited to a particular location(s); or

- other exceptional circumstances peculiar to the individual case.

Temporary Resident Other Medical Practitioners Program The Temporary Resident Other Medical Practitioners (TROMPs) program was established in 2001. The program was introduced to overcome an unintended consequence of amendments to the 1996 Medicare provider number legislation, which would have resulted in a number of long-term temporary resident medical practitioners losing access to Medicare benefits. This affected temporary resident medical practitioners who had entered medical practice in Australia prior to 1 January 1997 and who were not vocationally recognised.

The TROMPs program provides access to Medicare benefits at the A2 rate for these eligible medical practitioners.

Remote Vocational Training Scheme The Remote Vocational Training Scheme (RVTS) was introduced in 1999 to address health service needs in Australia’s remote communities. The Scheme allows registrars to remain in one location for the period of their training, supported by distance education and remote supervision. The RVTS provides an alternative route to vocational recognition for remote practitioners who are in solo doctor towns or where their departure would otherwise have a detrimental impact on the local community. RVTS registrars are eligible to sit for fellowship of the RACGP and/or the ACRRM.

Up until 28 February 2007, the RVTS was a 3GA program under the auspices of the RACGP. Since 1 March 2007, legislative changes and the incorporation of the RVTS have enabled the Scheme to be recognised as a 3GA program in its own right.

The Australian Government announced an increase in the annual intake of RVTS registrars from 15 to 22, which commenced from 2011. Since the inception of the pilot program in 1999, a total of 80 registrars have completed the RVTS. As at 30 June 2013, 79 registrars are training on the RVTS.

In August 2013, the Australian Government approved the annual intake of an additional 10 RVTS registrars to train in Aboriginal and Community Controlled Health Services (ACCHSs). The first cohort of registrars under the new scheme commenced in 2014, taking the total annual intake to 32.

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APPENDICES APPENDIX A: MEDICAL TRAINING REVIEW PANEL ROLE AND MEMBERSHIP

APPENDIX B: MEDICAL COLLEGE TRAINING REQUIREMENTS

APPENDIX C: GLOSSARY OF TERMS

APPENDIX D: EXTENDED DATA TREND TABLES

APPENDIX E: DATA SPECIFICATIONS

APPENDIX F: TRAINING PROGRAM TERMINOLOGY

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Appendix A: MEDICAL TRAINING REVIEW PANEL ROLE AND MEMBERSHIP Under section 3GC of the Act, the MTRP is required to examine the demand for and supply of medical training opportunities and to monitor the effect of the Medicare provider number arrangements. These arrangements generally require medical practitioners to complete a recognised postgraduate training program, in either general practice or another specialty, before they are eligible to provide services that attract Medicare benefits.

Role of the Medical Training Review Panel The MTRP was established to monitor the demand for and supply of medical training opportunities and to monitor the implementation of particular measures in the Health Insurance Amendment Act (no 2) 1996.

Medical Training Review Panel Membership Members of the MTRP must be endorsed by the Commonwealth Minister for Health and comprise of representatives of each member organisation listed below.

Chair

Australian Government Department of Health

State and Territory Health Departments

ACT Health

Department of Health and Families, Northern Territory

Department of Health, South Australia

Department of Health and Human Services, Tasmania

Department of Health, Western Australia

Department of Health, Victoria

NSW Ministry of Health

Queensland Health

Medical Colleges

Australasian College of Dermatologists

Australasian College for Emergency Medicine

Australian College of Rural and Remote Medicine

Australian and New Zealand College of Anaesthetists

Royal Australasian College of Medical Administrators

Royal Australasian College of Physicians

Royal Australasian College of Surgeons

Royal Australian College of General Practitioners

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Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Royal Australian and New Zealand College of Ophthalmologists

Royal Australian and New Zealand College of Psychiatrists

Royal Australian and New Zealand College of Radiologists

Royal College of Pathologists of Australasia

Other Organisations

Australian General Practice Network

Australian Medical Association

Australian Medical Council

Australian Medical Association Council of Doctors-in-Training

Australian Salaried Medical Officers’ Federation

Australian Medical Students’ Association

Confederation of Postgraduate Medical Education Councils

General Practice Education and Training Ltd

Medical Deans Australia and New Zealand Inc.

Rural Doctors Association of Australia

Observers

Australian Indigenous Doctors’ Association

Australasian College of Sports Physicians

Australian Private Hospital Association

Catholic Health Australia

Medical Training Review Panel Subcommittee Memberships The 2014 membership of the MTRP Clinical Training Subcommittee was:

Dr Andrew Singer (Chair) Australian Government Department of Health

Dr Will Milford Australian Medical Association Council of Doctors-in-Training

Dr Nick Buckmaster Australian Salaried Medical Officers’ Federation

Professor Simon Willcock Confederation of Postgraduate Medical Education Councils

Professor Frank Bowden ACT Health

Associate Professor Alison Jones SA Health

Dr Craig White Department of Health and Human Services, Tasmania

Ms Jessica Dean Australian Medical Students’ Association

Professor Nick Glasgow Medical Deans Australia and New Zealand Inc.

Dr Kim Hill Royal Australasian College of Medical Administrators

Dr Marie-Louise Stokes Royal Australasian College of Physicians

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The 2014 membership of the MTRP Data Subcommittee was:

Dr Nick Buckmaster (Chair) Australian Salaried Medical Officers’ Federation

Dr William Milford Australian Medical Association Council of Doctors-in-Training

Professor Nicholas Glasgow Medical Deans Australia and New Zealand Inc.

Dr Andrew Gosbell Australasian College for Emergency Medicine

Dr Linda MacPherson NSW Ministry of Health

Dr Dennis Pashen Australian General Practice Network

Ms Lesley Chisholm Department of Health, Victoria

Ms Maureen McCarty Australian Government Department of Health

Ms Mila Nastachevskaia Australian Government Department of Health

The 2014 membership of the MTRP Rural Subcommittee was:

Dr Dennis Pashen (Chair) Australian General Practice Network

Dr Dinesh Arya NT Health

Dr George Cerchez Department of Human Services, Tasmania

Dr Nick Buckmaster Australian Salaried Medical Officers’ Federation

Dr Ross Roberts-Thomson Australian Medical Association Council of Doctors-in-Training

Dr William Milford Australian Medical Association Council of Doctors-in-Training (alternate)

Dr Linda MacPherson NSW Ministry of Health

Ms Jenny Johnson Rural Doctors Association of Australia (alternate)

Dr Jeff Ayton Australian College of Rural and Remote Medicine

Professor Richard Murray Australian College of Rural and Remote Medicine/ James Cook University

Ms Jessica Dean Australian Medical Students’ Association

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Appendix B: MEDICAL COLLEGE TRAINING REQUIREMENTS Appendix B provides summary information about each medical college’s training requirements.

The training requirements for vocational trainees vary between colleges. Tables B1 to B3 provide a consolidated summary of the length of vocational training and training program entry requirements, as well as the guidelines for part-time training and interrupted training.

Every effort has been made to ensure that the information contained in this appendix is correct at the time of publication and relevant for the data period that the report covers. However, these requirements change over time, and information should be checked with the relevant college or training organisation if current information is required. Website contact details for each college or training organisation are provided in the summaries for the colleges below.

In order to improve general understanding of medical college training requirements, the MTRP has decided to use common language in describing each college training program. Accordingly, the descriptors used in this summary may vary from the information provided by the individual college, faculty or vocational training organisation.

Consolidated Summary Tables

College/Faculty/Training organisation Training requirements

Australian and New Zealand College of Anaesthetists (ANZCA) 5 years full-time (0.5 years introductory training, 1.5 years basic, 2 years advanced and one year provisional fellowship)

Australian and New Zealand College of Anaesthetists

- Faculty of Pain Medicine (ANZCA-FPM)

1-3 years full-time, depending on prior specialist training and experience

1-2 years of structured training in Faculty Accredited Unit full-time equivalent

1 elective year full-time equivalent

Can enter during specialty training

Royal Australasian College of Dental Surgeons 4 years full-time and assessments (including SST and Final Examinations)

Entry following the Surgery in General (SIG) year

Australasian College of Dermatologists (ACD) 4 years full-time - trainees who do not pass both written and clinical fellowship examinations and satisfy all other training

requirements in their fourth year may be invited to undertake a fifth year of training

This will be dependent upon the availability of a Fellow to oversee the trainee in a non-accredited training position and at the discretion of the National Training Committee

Can enter after completing PGY1 and PGY2

Table B1: Summary of specialty training requirements and entry time, 2013

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College/Faculty/Training organisation Training requirements

Australasian College for Emergency Medicine (ACEM) 2 years basic training full-time (which comprise PGY1 and PGY2) NB: From 20 June 2014 ACEM no longer processed

registrations for basic training

From 1 January 2016, PGY1 and PGY2 will no longer be part of the ACEM Training Programme structure

1 year provisional training full-time equivalent

4 years advanced training full-time equivalent

Royal Australian College of General Practitioners (RACGP) 3 years full-time Optional 4th year for Advanced Skills training and for academic

post

May apply in PGY1 and can enter after completing PGY2

College of Intensive Care Medicine of Australia and New Zealand (CICM) 3 years basic training full-time 3 years advanced training full-time

Can enter after completing PGY1

1st January 2014 onwards: 6 months of Foundation Training (undertaken prior to selection into the training program)

24 months core intensive care training

12 months clinical anaesthesia training

12 months clinical medicine training

Approximately 12 months elective training (amount dependent on assessment by the College)

12 months of Transition Year training

Royal Australasian College of Medical Administrators (RACMA) 3 years full-time Can enter after 3 years clinical experience

Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG)

6 years full-time

Years 1-4 in the Core Training Program (as at 1 December 2013)

Years 5-6 in the Advanced Training Program (as at 1 December 2013)

Can enter after completing PGY2

Royal Australian and New Zealand College of Ophthalmologists (RANZCO) 5 years full-time 2 years Basic Training

2 years Advanced Training

1 final year (fellowship year)

Can enter after completing PGY2

Royal College of Pathologists of Australasia (RCPA) 5 years full-time Can enter after completing PGY1

Royal Australasian College of Physicians

- Adult Medicine (RACP-AM)

3 years basic training full-time and assessments (including Written and Clinical Examinations)

3 or more years advanced training full-time equivalent

Can enter after completing PGY1

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College/Faculty/Training organisation Training requirements

Royal Australasian College of Physicians

- Paediatrics and Child Health (RACP-PCH)

3 years basic training full-time and assessments (including Written and Clinical Examinations)

3 or more years advanced training full-time equivalent

Can enter after completing PGY1

Royal Australasian College of Physicians

- Australasian Faculty of Occupational and Environmental Medicine (RACP-AFOEM)

4 years full-time (approximately)

Can enter after completing 2 full-time years of general clinical experience

Can enter in PGY3

Royal Australasian College of Physicians

- Australasian Faculty of Public Health Medicine (RACP-AFPHM)

3 years full-time equivalent

Can enter after completing at least 3 years of postgraduate medical experience and completion of, or enrolment in, a Masters of Public Health Medicine (or comparable degree), which includes the faculty’s core discipline areas

Royal Australasian College of Physicians

- Australasian Faculty of Rehabilitation Medicine (RACP-AFRM)

Adult Rehabilitation Medicine

4 years full-time equivalent

Can enter after completing PGY2

Paediatric Rehabilitation Medicine

3 years basic training full-time (with the RACP PCH)

3 years advanced training full-time equivalent

Can enter after completing PGY1

Royal Australasian College of Physicians

- Chapter of Palliative Medicine (RACP-AChPM)

3 years full-time equivalent

Can enter with fellowship of a faculty or college approved by the Chapter or completion of RACP basic training, including written and clinical examinations

Royal Australasian College of Physicians

- Chapter of Addiction Medicine (RACP-AChAM)

3 years full-time equivalent

Can enter with fellowship of a faculty or college approved by the Chapter or completion of RACP basic training, including written and clinical examinations

Royal Australasian College of Physicians

- Chapter of Sexual Health Medicine

3 years full-time equivalent

Can enter with fellowship of a faculty or college approved by the Chapter or completion of RACP basic training, including written and clinical examinations

Royal Australian and New Zealand College of Psychiatrists (RANZCP) 2003 Fellowship Program: 5 years full-time, which comprises 3 years basic training and 2 years advanced training

2012 Fellowship Program: 5 years full-time which comprises 1 year in Stage 1, 2 years in Stage 2 and 2 years in Stage 3

Optional additional advanced training certificate programs in addiction, adult, child and adolescent, consultation-liaison, old age, psychotherapy and forensic psychiatry

Can enter after completing PGY1

Royal Australian and New Zealand College of Radiologists (RANZCR)

- Clinical Radiology (Radiodiagnosis)

5 years full-time

Can enter after completing PGY1 and PGY2 years

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College/Faculty/Training organisation Training requirements

Royal Australian and New Zealand College of Radiologists (RANZCR)

- Radiation Oncology

5 years full-time

Can enter after completing PGY1 and PGY2 years

Australian College of Rural and Remote Medicine (ACRRM) 4 years full-time Can enter after completing PGY1

Training consists of 1 year Core Clinical Training, 2 years Primary Rural and Remote Training, and 1 year Advanced Specialised Training

Australasian College of Sports Physicians (ACSP) 3 years basic training full-time (PGY1, PGY2, PGY3 to be completed prior to entering the College program)

4 years advanced training full-time equivalent

Royal Australasian College of Surgeons (RACS) 4 - 7 years full-time Can apply from PGY2 to commence in PGY3

Surgical Education and Training (SET) occurs in nine specialty areas:

- Cardiothoracic surgery - 6 years full-time

- General surgery - 4 to 5 years full-time

- Neurosurgery - 6 years full-time including 1 year of full-time research

- Orthopaedic surgery - 5 years full-time

- Otolaryngology Head and Neck surgery - 5 years full-time

- Paediatric surgery - up to 7 years full-time

- Plastic and Reconstructive surgery - 5 years fulltime

- Urology - 5 years full-time

- Vascular surgery - 5 years full-time

Source: Medical colleges and GPET

College/Faculty/Training organisation Requirements for part-time training

Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine

Minimum 50% of full-time commitment

Must result in FTE time

Royal Australasian College of Dental Surgeons Minimum 50% of full-time commitment Training must be completed within six years

Australasian College of Dermatologists Minimum 50% of full-time commitment; must be for two consecutive years and may only be undertaken once during the registrar’s Training Program

Must result in FTE time

Cannot be taken in 4th year

Australasian College for Emergency Medicine Minimum 50% of full-time commitment Must result in FTE time

Table B2: Summary of specialty part-time training requirements, 2013

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College/Faculty/Training organisation Requirements for part-time training

Royal Australian College of General Practitioners Approval on a case-by-case basis Approval provided by regional training providers

College of Intensive Care Medicine of Australia and New Zealand Minimum 20% of full-time commitment Must result in FTE time

Royal Australasian College of Medical Administrators Must result in FTE time Complete program within 8 years

Royal Australian and New Zealand College of Obstetricians and Gynaecologists Minimum 50% of full-time commitment First year of training must be full-time

Royal Australian and New Zealand College of Ophthalmologists Part-time training is possible, provided Basic and Advanced Training are completed within the required time limit as stated

in the flexible training policy

Royal College of Pathologists of Australasia Minimum 8 hours per week/20% of full-time commitment

Royal Australasian College of Physicians

- Adult Medicine Division

Part-time training is possible, provided Basic Training and Advanced Training are completed within the time limit specified in the flexible training policy

Minimum load of 40% in most cases. The minimum load may be less than 40% for some training programs

Royal Australasian College of Physicians

- Paediatrics and Child Health

Part-time training is possible, provided Basic Training and Advanced Training are completed within the time limit specified in the flexible training policy

Minimum load of 40% in most cases. The minimum load may be less than 40% for some training programs

Royal Australasian College of Physicians

- Australasian Faculty of Occupational and Environmental Medicine

Minimum 10 hours per week

Training must be completed within 10 years

Royal Australasian College of Physicians

- Australasian Faculty of Public Health Medicine

Minimum load of 40% in most cases may be less than 40% in exceptional circumstances

Training must be completed within 8 years

Royal Australasian College of Physicians

- Australasian Faculty of Rehabilitation Medicine

Minimum 40% of full-time commitment

Adult Rehabilitation Medicine

Training must be completed within 10 years

Paediatric Rehabilitation Medicine

Training must be completed within 8 years

Royal Australasian College of Physicians

- Chapter of Palliative Medicine

Minimum load of 40% in most cases; may be less than 40% in exceptional circumstances

Training must be completed within 8 years

Royal Australasian College of Physicians

- Chapter of Addiction Medicine

Minimum load of 40% in most cases; may be less than 40% in exceptional circumstances

Training must be completed within 8 years

Royal Australasian College of Physicians

- Chapter of Sexual Health Medicine

Minimum load of 40% in most cases; may be less than 40% in exceptional circumstances

Training must be completed within 8 years

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College/Faculty/Training organisation Requirements for part-time training

Royal Australian and New Zealand College of Psychiatrists Minimum 50% of full-time commitment, although in rare instances part-time training at less than 50% of full-time

commitment may be approved for Advanced Training post-Fellowship

Must result in FTE time

Royal Australian and New Zealand College of Radiologists

- Radiodiagnosis

Minimum 50% of full-time commitment

Must result in minimum of .5 FTE time

Royal Australian and New Zealand College of Radiologists

- Faculty of Radiation Oncology

Minimum 50% of full-time commitment

Must result in minimum of .5 FTE time

Australian College of Rural and Remote Medicine Minimum 50% of full-time commitment Approval provided by training providers

Australasian College of Sports Physicians Considered on an individual basis

Must result in FTE time

Completion must be within 10 years of commencement

Royal Australasian College of Surgeons Trainees on a SET Program who wish to apply for part-time training must apply to the relevant Specialty Board at least 6 months prior to the proposed commencement of the part-time training

The overall duration of the training program must not exceed the published expected minimum duration of training plus 4 years

Source: Medical colleges and GPET

College/Faculty/Training organisation Requirements for interrupted training

Australian and New Zealand College of Anaesthetists

- Faculty of Pain Medicine

Allowed, details available from the ANZCA Handbook on Training and Accreditation at: www.anzca.edu.au/ training/2013-training-program/pdfs/training-accreditation-handbook

Royal Australasian College of Dental Surgeons Allowed For a maximum of two years without penalty

A trainee interrupting for more than two years will be required to undertake a period of additional training

Australasian College of Dermatologists Considered on an individual basis within the policy guidelines

Australasian College for Emergency Medicine Allowed up to 2 years and possibly beyond this, depending upon circumstances

General Practice Education and Training

- Royal Australian College of General Practitioners

- Australian College of Rural and Remote Medicine

Allowed up to a maximum of 2 years

Table B3: Summary of specialty interrupted training requirements, 2013

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College/Faculty/Training organisation Requirements for interrupted training

College of Intensive Care Medicine of Australia and New Zealand Allowed Advanced training must include at least 2 years interrupted only

by normal holiday or short term (e.g. study, conference) leave

If training is interrupted for between 1 and 2 years, there must be a minimum of 1 core advanced training year as part of subsequent training

If training is interrupted for between 2 and 4 years, 2 advanced training years, including one core year must be completed as part of subsequent training

If training is interrupted for 4 years or more, 2 core training years must be completed as part of subsequent training

Royal Australasian College of Medical Administrators Allowed

Royal Australian and New Zealand College of Obstetricians and Gynaecologists Allowed up to 2 years without loss of credit for previous training The FRANZCOG (i.e. Fellowship of the RANZCOG) specialist

training program comprises Core Training (the initial four years) and Advanced training (the final two years). The RANZCOG allows fractional training (ie between 0.5 - 1.0 FTE). Trainees have a maximum of 6 years to complete Core Training and 3 years to complete Advanced Training - dated from commencement of the training program

Royal Australian and New Zealand College of Ophthalmologists Training must be completed within 12 years. If training is interrupted for a period of 3 months or more reskilling may be

required on return to work

Royal College of Pathologists of Australasia Allowed - no limit is placed on the time taken to complete training, but if the final Part II examination has not been passed

within 5 years of passing the Part I examination then the Part I examination must be sat and passed again

Royal Australasian College of Physicians

- Adult Medicine Division

Interruption allowed, but training program must be completed within time limit. Interruptions of more than 12 continuous months may require additional assessments (determined on a case-by-case basis). Interruptions of more than 24 continuous months may require additional training time and/or assessments (determined on a case-by-case basis)

A maximum period of 24 months of full-time parental leave across each training program can be excluded from the time limit to complete training

Royal Australasian College of Physicians

- Paediatrics and Child Health

Interruption allowed, but training program must be completed within time limit. Interruptions of more than 12 continuous months may require additional assessments (determined on a case-by-case basis)

Interruptions of more than 24 continuous months may require additional training time and/or assessments (determined on a case-by-case basis)

A maximum period of 24 months of full-time parental leave across each training program can be excluded from the time limit to complete training

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College/Faculty/Training organisation Requirements for interrupted training

Royal Australasian College of Physicians

- Australasian Faculty of Occupational and Environmental Medicine

Interruption allowed, but training program must be completed within time limit. Interruptions of more than 12 continuous months may require additional assessments (determined on a case-by-case basis)

Interruptions of more than 24 continuous months may require additional training time and/or assessments (determined on a case-by-case basis)

A maximum period of 24 months of full-time parental leave can be excluded from the time limit to complete training

Royal Australasian College of Physicians

- Australasian Faculty of Public Health Medicine

Interruption allowed, but training program must be completed within time limit. Interruptions of more than 12 continuous months may require additional assessments (determined on a case-by-case basis)

Interruptions of more than 24 continuous months may require additional training time and/or assessments (determined on a case-by-case basis)

A maximum period of 24 months of full-time parental leave can be excluded from the time limit to complete training

Royal Australasian College of Physicians

- Australasian Faculty of Rehabilitation Medicine

Interruption allowed, but training program must be completed within time limit. Interruptions of more than 12 continuous months may require additional assessments (determined on a case-by-case basis)

Interruptions of more than 24 continuous months may require additional training time and/or assessments (determined on a case-by-case basis)

A maximum period of 24 months of full-time parental leave can be excluded from the time limit to complete training

Royal Australasian College of Physicians

- Chapter of Palliative Medicine

Interruption allowed, but training program must be completed within time limit. Interruptions of more than 12 continuous months may require additional assessments (determined on a case-by-case basis)

Interruptions of more than 24 continuous months may require additional training time and/or assessments (determined on a case-by-case basis)

A maximum period of 24 months of full-time parental leave can be excluded from the time limit to complete training

Royal Australasian College of Physicians

- Chapter of Addiction Medicine

Interruption allowed, but training program must be completed within time limit. Interruptions of more than 12 continuous months may require additional assessments (determined on a case-by-case basis)

Interruptions of more than 24 continuous months may require additional training time and/or assessments (determined on a case-by-case basis)

A maximum period of 24 months of full-time parental leave can be excluded from the time limit to complete training

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College/Faculty/Training organisation Requirements for interrupted training

Royal Australasian College of Physicians

- Chapter of Sexual Health Medicine

Interruption allowed, but training program must be completed within time limit. Interruptions of more than 12 continuous months may require additional assessments (determined on a case-by-case basis)

Interruptions of more than 24 continuous months may require additional training time and/or assessments (determined on a case-by-case basis)

A maximum period of 24 months of full-time parental leave can be excluded from the time limit to complete training

Royal Australian and New Zealand College of Psychiatrists Allowed Basic Training must be completed within 8 years or may need

to repeat or complete the training experiences lapsed

Advanced Training must be completed within 6 years or may result in review of overall training and assessment

Royal Australian and New Zealand College of Radiologists

- Radiodiagnosis

Allowed

Royal Australian and New Zealand College of Radiologists

- Faculty of Radiation Oncology

Allowed

Australasian College of Sports Physicians Considered on an individual basis

Royal Australasian College of Surgeons With the exception of leave for medical or family reasons, trainees cannot apply for leave in the first 6 months of their training program

Trainees on a SET Program who wish to interrupt their training must apply to the relevant Specialty Board at least 6 months prior to the proposed commencement of the training year in which the interruption will commence

Trainees applying for interruption due to medical reasons may do so at any time if supported by medical evidence

Source: Medical colleges and GPET

Training Program Information The series of brief summaries of the training requirements and processes for each of the specialist colleges is provided below. Each summary provides descriptions of the following:

- training programs;

- trainee selection processes and criteria;

- trainees assessment methods;

- fellowship examination;

- overseas trained specialist assessment processes; and

- accreditation processes where relevant.

Any further information or clarification should be sought directly from the relevant college.

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AUSTRALIAN AND NEW ZEALAND COLLEGE OF ANAESTHETISTS

Training Program The Australian and New Zealand College of Anaesthetists (ANZCA) approved training sequence encompasses an initial two-year prevocational medical education and training period and the five-year period of ANZCA approved training, which consists of half a year of introductory training, a year and a half of basic training, two years advanced training and one year of provisional fellowship training. In the course of ANZCA approved training, trainees are required to:

- Maintain their training portfolio system records, ensuring they are accurate and up-to-date.

- Set learning goals for each clinical placement.

- Actively seek clinical experience to meet volume of practice requirements.

- Ensure adequate preparation for the primary and final examinations.

- Actively participate in self-assessment.

- Participate in feedback sessions and reviews, reflect on feedback received and strive to improve their performance in line with training requirements.

The training program provides for part-time training. The minimum trainee commitment must be 50% of that of a full-time trainee. There is provision for interrupted training. Some overseas training may be recognised during both basic and advanced training, subject to prior approval by the college assessor.

Trainee Selection ANZCA’s Training and Accreditation Handbook outlines the principles that should be used in selecting trainees for appointment to hospitals approved for training for fellowship of ANZCA.

Trainees are trained and educated in approved hospital departments, which must be part of an approved rotation, according to the ANZCA guidelines and policies, and under the supervision of the ANZCA. It should be noted that the hospital is the employing authority, not ANZCA, and the hospital makes the appointments using a process as outlined by these guidelines. However, the selection committee should include at least one ANZCA representative approved by the relevant regional/national committee. Trainees are not reselected into advanced training by ANZCA.

Trainee Assessment In-Training Assessment (ITA) is carried out at least every 6 months, and is comprised of clinical placement reviews, core unit reviews and a provisional fellowship review. The trainee and the supervisor of training carry out a regular process of evaluation, recording goals set and areas identified for improvement. Each trainee must maintain a learning portfolio, which should include formal documents relating to training, including the ITA forms, the trainee’s self-evaluation of performance forms, as well as an online logbook maintained using the training portfolio system. Workplace based assessments are an essential requirement of the revised curriculum.

The primary examination was changed in 2013 to a single examination encompassing physiology, including clinical measurement, pharmacology, and statistics. Trainees progress to the oral section when they have attained a satisfactory score in the written section. The final examination consists of written and oral sections, and may be taken after three years of approved training.

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Admission to fellowship is available to trainees who have successfully completed five years of training, passed both examinations, and completed all other training requirements.

International Medical Graduate Specialists The international medical graduate specialist assessment process is conducted by ANZCA to assess and make a determination regarding the comparability of the international medical graduate specialist to a fellow of ANZCA.

The ANZCA international medical graduate specialist assessment process commences with application directly to the college (as of 1 July 2014) and proceeds to a paperbased assessment to establish qualifications, training, clinical experience, recency of practice, health systems worked in, and participation in continuing professional development (CPD). Area of Need applicants are also assessed for comparability, as required.

If eligible to proceed, the assessment then includes:

- a face-to-face assessment interview;

- a clinical practice assessment period; and

- either a workplace-based assessment or the choice of the international medical graduate specialist performance assessment or the final examination.

International medical graduate specialist applicants need to provide evidence of their specialist anaesthesia training in relation to duration, structure, content, curriculum, sub-specialty experience, supervision and assessment. The ANZCA international medical graduate specialist assessment process will take into account the college’s training requirements at the time the applicant attained his/her initial post-graduate specialist qualification in anaesthesia.

In relation to the specialist qualification, consideration will be given to the curriculum vitae, references, and details of practice as a specialist anaesthetist. Experience and qualifications must be substantiated by statements and original or certified copies of diplomas from relevant bodies.

Assessment of the specialist’s experience takes into account case mix, use of equipment and drugs and compliance with standards of anaesthesia practice as promoted in the college professional documents. Evidence of participation in CPD is sought, comparable to the college’s continuing CPD program. Continuous involvement in recent years is particularly important.

Accreditation Accredited hospitals are reviewed according to a seven-year cycle. Where possible, an entire rotation or training scheme is reviewed at the same time. Sometimes it is necessary to visit individual hospitals in between the seven-year rotational reviews. This is usually a result of major staffing or structural changes within the hospital, or a particular concern raised by the hospital, the trainees, the regional/national committee or other parties.

The College approves departments as a whole as being suitable for training; it does not approve a particular number of posts. The number of trainees is decided by the hospital.

Hospitals are normally approved for both basic and advanced training. That is, they may take trainees in any of the 5 years of training. Under very rare circumstances, a hospital may be approved for advanced training only.

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Hospitals may also be approved for the potential to offer a provisional fellowship program. This is normally in addition to approval for basic and advanced training, but some hospitals may be deemed suitable for provisional fellowship training only.

Further Information www.anzca.edu.au

AUSTRALIAN AND NEW ZEALAND COLLEGE OF ANAESTHETISTS - FACULTY OF PAIN MEDICINE

Training Program Fellowship of the Faculty of Pain Medicine - FFPMANZCA is a post fellowship qualification. Those wishing to obtain this qualification are required to hold, or be training toward, a specialist qualification acceptable to the board (initially anaesthesia, medicine, surgery, psychiatry, rehabilitation medicine and more recently general practice, obstetrics and gynaecology and occupational medicine). The ANZCA-FPM training requirements vary from one to three years, depending on the primary specialist qualification and previous experience and exposure to pain medicine. Training may commence during, and may be concurrent with, training programs for the diploma of fellowship of the five participating bodies, including ANZCA, RACS, RACP, RANZCP and AFRM-RACP as well as RACGP, RACRRM, RANZCOG and AChPM-RACP.

A new curriculum, to be introduced in 2015, stipulates two years of supervised training in pain medicine for all candidates for Fellowship.

Trainees must undertake a prospectively approved structured training period of one or two years in a Faculty accredited pain medicine program. One further year of additional approved experience of direct relevance to pain medicine is required. There is some provision for retrospective approval by the Assessor of prior experience and training.

The training program provides for part-time training. The minimum trainee commitment must be 0.5 full-time equivalent (FTE). There is provision for interrupted training.

It is a requirement of the training program that all trainees receive training and experience in the broad areas of acute, chronic and cancer pain. Trainees are provided with a trainee support kit that includes the objectives of training and focused resources. The objectives of training set out in detail the aims of education and training. The objectives divide into four main sections: socio-biology of pain and neurobiology of pain as ‘basic’ knowledge; principles of pain medicine and practice of pain medicine as ‘clinical’ knowledge.

Trainee Selection Employers place advertisements for positions in pain medicine training units accredited by the FPM. Interview, selection and appointment processes are determined by the employing jurisdictions, with representation from the FPM.

Trainee Assessment Formative assessment includes the logbook that documents workload and experience recorded over a period of six months. This acts as a tool for supervisors of training to direct trainees to rectify any gaps in exposure to the required areas. Quarterly In-Training Assessments (ITAs) require the trainee and the supervisor of training to carry out regular evaluation, with a recording

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of goals being met and areas identified for improvement. Summative assessment includes the final ITA, a case report and an examination.

The Faculty examination format comprises a written paper, an observed clinical long case, short cases and a viva voce. Candidates must achieve a mark of at least 50%. Trainees may present for the annual examination during or after the mandatory structured training period in a Faculty accredited unit.

Admission to fellowship is available to candidates who are fellows of ANZCA, RACP, RACS, RANZCP, AFRM-RACP, RACGP, RNZCGP, RANZCOG, or who hold a specialist qualification acceptable to the Board, and who have successfully completed the training period prescribed by the Assessor, passed the examination and completed all other training requirements.

International Medical Graduate Specialists In 2013, the Faculty Board approved the Regulation for the recognition as a specialist in pain medicine for overseas trained specialists and admission to Fellowship by assessment for overseas trained specialists. The FPM overseas trained specialists assessment process commences with application directly to the faculty (as of 1 July 2014) and proceeds to a paper-based assessment to establish qualifications, training, clinical experience, recency of practice, health systems worked in, and participation in continuing professional development (CPD).

If eligible to proceed, the assessment then includes:

- a face-to-face assessment interview;

- a clinical practice assessment period; and

- either a workplace-based assessment or the examination.

Accreditation The Faculty accredits multidisciplinary pain medicine units that include practitioners from at least three relevant medical specialties and from relevant allied health professions. Comprehensive policies and criteria have been developed by the Faculty requiring a specified standard for facilities and adequate supervision by pain medicine specialists. Units seeking accreditation are required to complete a detailed questionnaire and undergo an accreditation visit. During the accreditation process, significant weighting is given to the feedback provided during structured interviews with the trainees who are based at the unit.

Further Information www.fpm.anzca.edu.au

ROYAL AUSTRALASIAN COLLEGE OF DENTAL SURGEONS

Training Program The Oral and Maxillofacial Surgery (OMS) program of the Royal Australasian College of Dental Surgeons (RACDS) requires four years of specialist surgical training in the area of OMS.

The college training program is undertaken in under the apprenticeship model and is designed to provide supervised training and experience in all aspects of clinical assessment, decision making and patient management.

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The program is delivered over four years, with six monthly assessments to gauge trainee’s progression and culminates with a Final Examination before being awarded Fellowship FRACDS (OMS).

Trainee Selection Trainees are selected directly into one of the six trainee centres within Australia and New Zealand. Any prospective trainee wishing to enter the program must satisfy the following criteria:

- a Dental degree and full registration in either Australia or New Zealand;

- a Medical degree and full registration in either Australia or New Zealand;

- a full year of surgery in general (SIG) whilst occupying a post in a hospital that is approved for surgical training by the Trainee Advisory Committee, or be expected to complete this year prior to the commencement of OMS training. Surgical rotations during this year should be undertaken in related surgical disciplines (e.g. ENT surgery, plastic surgery, orthopaedic surgery, neurosurgery, ophthalmology, general surgery) for a minimum of nine months. Consideration is given for relevant rotations in Intensive Care and Emergency Medicine.

Once a prospective trainee has fulfilled these requirements, application is made to the College for assessment. Once approved, a prospective trainee must present to the College for a formal interview process, where the following areas are assessed:

Curriculum Vitae 20%

Professional Performance Appraisal 35%

Interview 45%

Total 100%

Prospective trainees that are deemed Successful in this process will be offered a place in the program.

Trainee Assessment Trainees are assessed throughout the four years of training, including six monthly Formative Assessments, Assessment of Operative procedures and Case Presentations.

Trainees must also pass two examinations; SST (Surgical Science and Training) and the Final Examination. Both examinations consist of a written paper and a clinical examination. Trainees must pass both examinations to obtain Fellowship.

Overseas Trained Specialists The processes for assessing the suitability of overseas trained doctors for practice as surgeons in Australia are in accordance with the principles outlined in the:

- AMC application procedures and requirements for specialist assessment;

- AMC/Committee of Presidents of Medical Colleges (CPMC)/state and territory medical boards/Australian Government Department of Health/state and territory health departments’ Assessment Process for Area of Need specialists: User’s Guide; and

- AMC/CPMC Joint Standing Committee on Overseas Trained Specialists Assessment of Overseas Trained Specialists: Template for Colleges.

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Overseas Trained Oral and Maxillofacial Surgeons are referred to as OTOMS. An OTOMS is any specialist Oral and Maxillofacial Surgeon who has gained their specialist qualification external to Australia and/or New Zealand.

The pathway for independent specialist surgical practice in the specialty of OMS culminates in obtaining Fellowship of the College by completing the OMS Training Program and the FRACDS (OMS) Final Examination. Under these circumstances the Australian and New Zealand jurisdictions and public can be assured both of the quality of training and the standards of the exit examination as all aspects are under the aegis of the College.

There are three possible outcomes to the specialist assessment process:

- Not Comparable.

- Partially Comparable.

- Substantially Comparable.

Accreditation Accreditation of training settings is undertaken by position, as part of a training centre (network model). There is a Director of Training (DoT) in each centre, responsible for preparing for an accreditation visit.

Each position and training centre is assessed against the SCOMS (Accreditation Standards and Criteria for Oral and Maxillofacial Surgery). The SCOMS are divided into 8 standards for assessment:

1. Education and Training.

2. Clinical Experience.

3. Equipment and Support Services.

4. Resources to support education and training.

5. Supervision.

6. Organisational Support for Trainees.

7. Institutional Responsibilities.

8. Quality and Safety.

Each criterion is set and divided into two categories: Must (mandatory) and Should (desirable).

Once an accreditation assessment is finalised the position within the training centre is afforded one of the following three levels of accreditation:

- Full Accreditation:

Full accreditation will be granted to a post when all mandatory requirements have been met and the accreditation team is satisfied that the core requirements for accreditation have been achieved. Posts that receive full accreditation will be subject to periodic review every five years.

- Conditional Accreditation:

Conditional accreditation will be granted to a post when the mandatory criteria have not all been met but the accreditation team is satisfied that there is the potential for significant

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progress to be made in that area within the next twelve months. The training institution would be required to report progress within twelve months of the visit.

- Suspended Accreditation:

Suspended accreditation may be applied if there is a substantial change to the post, for example, if the post is unoccupied or if the Supervisor of Training resigns without an appropriate replacement being appointed.

Further Information www.racds.org

AUSTRALASIAN COLLEGE OF DERMATOLOGISTS

Training Program The Australasian College of Dermatologists (ACD) supervises a four-year vocational training program, which consists of supervised clinics in all aspects of dermatology including dermatological medicine and procedural dermatology. In the trainees’ fourth year they also complete part of the TAE40110 Certificate IV Training and Assessment as part of a basic teacher training course in preparation for becoming supervisors in the future.

Trainees pass through two defined stages during their training. These stages are designed to facilitate the progressive and cumulative acquisition of knowledge and skills. Basic training must be completed satisfactorily before the trainee can move to advanced training.

Basic Training

The purpose of basic training (years one and two) is to build on existing skills so that trainees acquire broad knowledge of the theory and practice of dermatological medicine and the basic sciences underpinning them. It is designed to give the trainee a sound base from which to further develop their skills in later years of the program.

Advanced Training

During advanced training (years three and four) trainees acquire skills in the treatment of more complex dermatological conditions and are given increased responsibility for patient management.

As of commencement of training in 2014, trainees are required to prepare and have published 1 major quality publication or 3 minor publications in one or more of the approved journals as listed on the ACD Website. Trainees who commenced prior to 2014 are only required to prepare and publish two papers of a significant nature on a dermatological subject. At least one of these papers must be published in the Australasian Journal of Dermatology (AJD) and the other may be published in another peer-reviewed journal. Trainees must also prepare and present 2 presentations. These may be 2 oral presentations or 1 oral and 1 poster presentation. The presentations must be presented at the ACD Annual Scientific Meeting or the Australasian Dermatopathology Society conference or the Australasian Society of Dermatology Research meeting or another meeting of similar stature that has been approved in advance by the National Examinations Committee.

Trainee Selection Entry into the training program requires completion of PGY1 and PGY2 and be/likely to be a permanent resident. Applicants must complete the on-line form, accompanied by payment.

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Shortlisted applicants are considered for interview dependent on the projected number of vacancies.

Trainee Assessment Trainees pass through two defined stages in their training. These stages are designed to facilitate the progressive and cumulative acquisition of knowledge and skills. Basic training must be completed satisfactorily before the trainee can progress to advanced training.

Basic Training

To be eligible to proceed to advanced training trainees must pass the clinical sciences self-paced online modules and the pharmacology examination within the first 12 months of training and perform satisfactorily in the workplace.

Advanced Training

Trainees are eligible to apply to sit the fellowship examinations in their fourth year of training. These examinations consist of the following:

- written papers in dermatological medicine, procedural dermatology and clinical pharmacology;

- objective structured clinical examinations in procedural dermatology and laboratory dermatology; and

- clinical vivas in dermatological medicine.

Trainees who do not satisfy all the requirements of the training program, including passing both the written and clinical fellowship examinations in their fourth year of training, may be invited to complete an additional year of training. This will be dependent upon the availability of a Fellow to oversee the trainee in a non-accredited training position and at the discretion of the National Training Committee.

In addition to the examinations described above, trainees undertake throughout their four years of training a number of work-based assessments: ProDAs (Procedural Dermatology Assessments), DermCEXs (Dermatology Clinical Evaluation Exercises) and CbDs (Case-based Discussions). They have regular summative in-training assessments (SITAs). All these assessments must be passed. Through these assessment methods, along with the College’s formal examinations, trainees must be assessed as competent to independently perform all essential procedures and treatment modalities as described in the Training Program Handbook.

International Medical Graduates International medical graduate applicants are assessed against the standards expected of recently trained Australian dermatologists, making allowance for the number of years since graduation in determining comparability.

Applicants must submit all application material to the ACD. The college assesses applications on behalf of the MBA. The ACD International Medical Graduate Assessment Committee undertakes an initial assessment of the applicant based on their submitted documentation.

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There are three potential initial assessment outcomes:

- Applicant is not comparable: the applicant is not substantially comparable to an Australian-trained dermatologist and could not obtain equivalence with further supervised clinical training in Australia within a maximum period of two years.

- Applicant is partially comparable: the applicant is not substantially comparable to an Australian-trained dermatologist but may be able to obtain substantial comparability with further specific supervised clinical training in Australia within a maximum period of two years.

- Applicant is substantially comparable: the applicant is substantially comparable to an Australian-trained dermatologist and is recommended for acceptance to practise as a dermatologist in Australia.

An interview may be required to confirm the assessment. The committee undertakes structured interviews four times per year that include resume-specific questions, clinical scenario questions and competency-based questions. The interview allows the committee to make a final assessment recommendation including the specific nature of any additional training and or assessment required. Full details of assessment criteria and processes are available on the college website.

Accreditation The college does not accredit training facilities; instead individual training positions are accredited. All positions are regularly inspected to ensure that they continue to meet the college’s accreditation requirements. These requirements are available on the college website.

Further Information www.dermcoll.asn.au

AUSTRALASIAN COLLEGE FOR EMERGENCY MEDICINE

Training Program

Basic and Provisional

Basic training of the Australasian College of Emergency Medicine (ACEM) comprises PGY1 and PGY2. The aim is to gain a broad range of experience and the acquisition of basic skills in medicine through a variety of hospital and associated posts.

Provisional training becomes more specified to emergency medicine skills. Requirements include:

- Six-months of compulsory time and experience in emergency medicine;

- a further six months in either emergency medicine or another discipline;

- completion of the primary examination; and

- the provision of three structured references.

Basic training is in the process of being removed from the ACEM Training Program. From 20 June 2014 ACEM is no longer processing registrations for basic training. From 1 January 2016, PGY1 and PGY2 will no longer be part of the ACEM Training Program structure.

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Advanced

The advanced training program is of four years duration with a requirement of 30 months spent in emergency medicine over a minimum of two sites, one of which must be designated as major referral and one as urban district or rural/regional.

During advanced training, trainees acquire and demonstrate the knowledge, skills and attitudes that are outlined in the fellowship curriculum as being required for good clinical practice in emergency medicine. The balance is non-emergency department training, where trainees learn and experience more detailed aspects of related disciplines. The curriculum is described under Emergency Medicine Training on the ACEM website.

Trainee Selection There is no selection process for trainees entering either basic or provisional training. The program is open to any registered medical practitioner.

Trainees undergo a selection process for advanced training although there is no quota applied. Selection to advanced training requires successful completion of 12 months provisional training, a pass in the primary examination and satisfactory structured references. Trainees satisfying all these requirements will move into advanced training.

Trainee Assessment

Provisional Training

Assessment of this training component is via the completion of In-Training Assessments (ITAs) that record the trainee’s performance in various domains of learning and assessment as related to aspects of the fellowship curriculum. Domains include: knowledge and basic skills; clinical judgment; practical skills; professional relationships and communication; ability to perform under stress and different workloads; sense of responsibility and work ethic; motivation and commitment to self-directed learning; supervision and education of junior medical staff; and research and quality improvement.

Structured references that assess these domains are supplied by the supervisor of training and two ACEM Fellows (FACEMs).

The primary examination examines the basic sciences of anatomy, pathology, physiology and pharmacology as relevant to emergency medicine.

Advanced Training

There is a requirement that competence is achieved in the management of paediatric emergencies evidenced by completion of a logbook or a placement in paediatric ED. A research component is to be completed, during either provisional or advanced training, either via coursework or project pathway.

Assessment continues via the completion of ITAs, as described under provisional training, and the fellowship examination.

Workplace-based Assessments are being used in pilot sites in Advanced Training in 2014. From 2015, these will be a requirement of training in all Emergency Medicine Terms.

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Fellowship Examination

The fellowship examination is an exit examination taken in the last year of training. The criteria are set with the issues of safe specialist practice foremost in mind. The examination consists of a written component (MCQ and written short answer papers), and a clinical component (of short and long cases and a six station structured clinical exam).

Overseas Trained Specialists For those overseas trained specialists seeking fellowship of the ACEM (FACEM), the college conducts an assessment of the overseas trained specialist’s qualification in line with that recommended by the AMC. Key assessment tools are the applicant’s curriculum vitae; response to the questionnaire regarding consultant posts held; referee reports; and response at a structured interview.

The interview addresses the applicant’s basic qualifications; advanced qualifications; experience; research and publications; education and teaching; emergency medicine administration; topical issues in emergency medicine; and knowledge of, and attitude towards, the College. A written report and outcome recommendations are sent to the College council for approval.

Outcomes can include election to fellowship without further requirements, a period of supervised practice in an ACEM accredited emergency department, completion of the research regulation, completion of the fellowship examination or a combination of these.

Assessment of overseas trained specialists for an Area of Need (AoN) position also follows that laid out by the AMC. The college reviews the AoN position description and assesses the applicant’s qualifications to determine if they are suitable for the position. The recommendation of the applicant as suitable for the AoN post does not imply the applicant has demonstrated satisfactory comparability with a FACEM. Assessment for fellowship requirements can now be conducted along with the AoN assessment (concurrent assessment).

Accreditation Hospital emergency departments meeting minimum criteria as stated in the Guidelines for Adult and Mixed Emergency Departments Seeking Training Accreditation, are accredited for either 6, 12 or 24 months of emergency medicine training.

Consideration will be given to staffing levels, case mix of patients, design and equipment, support services, the education and research program, accreditation of other specialties within the hospital and the impact of access block.

Inspections are carried out at the request of a hospital seeking accreditation or as part of a 5-year cycle of reinspection. A team of two senior fellows visits the hospital and meets with staff of the emergency department and other senior staff. The outcome is discussed by the team and reported to the Board of Education where the decision is made.

Further Information Additional information, including details of the ACEM Curriculum Revision Project and revised training requirements to apply from 2015, is available from:

www.acem.org.au

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GENERAL PRACTICE EDUCATION AND TRAINING LIMITED General Practice Education and Training Ltd (GPET) managed the administration of the Australian General Practice Training (AGPT) on behalf of the Australian Government. GPET was a Commonwealth company established in 2001 by the then Minister for Health and Ageing to fund and oversee vocational general practice training throughout Australia. As announced in the Commonwealth Budget 2014-15, GPET’s management of AGPT will be absorbed into the Department of Health on 1 January 2015. The AGPT program is delivered in accordance with the curricula and training standards of the RACGP and/or ACRRM.

The AGPT program offers postgraduate doctors a range of options for urban and rural vocational training, provided through Regional Training Providers (RTPs) throughout Australia.

The RTPs deliver training that on successful completion leads towards Fellowship of the Royal Australian College of General Practitioners (FRACGP) and/or FACRRM. The completion of the college assessment requirements marks the end point of training and is required for vocational registration under Medicare.

The AGPT program consists of a General Pathway and a Rural Pathway. Registrars on the General Pathway are required to undertake a mandatory 12-month placement in a rural, outer metropolitan, Indigenous Health training post, and/or non-capital city ASGC Remoteness Area 1 location as part of their training. Registrars on the Rural Pathway undertake the majority of their training in ASGC Remoteness Area 2-5 locations.

Training Program The AGPT Program is a three or four-year FTE program for trainees. Both colleges have vocational training programs - each with different requirements. Additional information about vocational training requirements can be found on the relevant college websites. Some comparative information can be found in the current GP Registrar’s Guide available from the website.

Trainee Selection Refer to the Applicant Guide provided on the website for further details.

Trainee (Fellowship) Assessment Refer to the RACGP and ACRRM websites.

Accreditation Pursuant to RACGP and ACRRM standards.

Further Information www.agpt.com.au

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ROYAL AUSTRALIAN COLLEGE OF GENERAL PRACTITIONERS The Royal Australian College of General Practitioners (RACGP) sets the standards for general practice training for GP registrars training towards Fellowship of the college. On successful completion of training and success in the RACGP assessments, candidates are usually eligible for the award of fellowship of the RACGP.

Training Program The typical length of training is three years.

The typical training program for a registrar is at least 12-month placement at a hospital; 18 months of core training in an RACGP accredited general practice; and a further 6 months in an extended skills post, which may be hospital or general practice based.

Trainee Selection Applicants for general practice training apply through GPET for selection. The GPET website should be referred to for more information.

Trainee Assessment Formative assessment includes the development of the registrar’s learning plan. This must be done early enough and with sufficient frequency to provide the opportunity for registrars to regularly update their learning plans. Training includes specific, timely and regular feedback to registrars about their performance, including information concerning what needs to be improved and an agreed plan for how to go about making the desired changes.

As part of GP specialist training towards fellowship (FRACGP), registrars undertake the college’s examination. This examination consists of three components - two written and one clinical. Further details are provided on the college’s website.

International Medical Graduates/Overseas Trained Doctors The RACGP conducts assessment of international medical graduates’ general practice qualifications and experience.

Assessment for comparability

The majority of assessments conducted by the RACGP are for comparability of overseas general practice experience to Australian general practice experience. This assessment is designed to assist in determining eligibility:

- to enrol in the college examination or practice based assessment;

- for full membership of the RACGP;

- as part of an Australian rural workforce agency application; and/or

- for entry into a RACGP specialist training pathway.

Further details are provided on the college’s website at:

www.racgp.org.au/assessment/pathways/practiceeligible

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Accreditation The RACGP accreditation criteria are documented in the RACGP Standards for General Practice Education and Training Trainers and Training Posts 2005 found at www.racgp.org.au/ vocationaltraining/standards

Under the delegated arrangements introduced in 2011 the Regional Training Providers (RTPs) conduct the training post accreditation process according to the RACGP standards. On successful completion of process the RTPs send a recommendation to the RACGP for endorsement. The RACGP suggests that all posts consider having at least two RACGP trainers per post. The post and trainer are accredited for a maximum of three years, after which reaccreditation is required.

Further Information www.racgp.org.au

COLLEGE OF INTENSIVE CARE MEDICINE OF AUSTRALIA AND NEW ZEALAND Note: This information is applicable for those who registered prior to 1 January 2014. For trainees who registered from 1 January 2014 onwards, a new curriculum is applicable.

The College of Intensive Care Medicine of Australia and New Zealand (CICM) was established in 2009 and developed from the former Joint Faculty of Intensive Care Medicine, ANZCA and RACP. From 1 January 2010, CICM assumed responsibility for the training program in intensive care medicine. The training program is flexible and allows trainees to undertake training concurrently with other related college programs (e.g. RACP, ANZCA, ACEM). The training program outlined below is relevant to the trainees and graduates captured in this report, however on 1 January 2014 the College launched a new curriculum and Trainee Selection Policy.

Training Program

Pre 2014

There are basic and advanced components of the CICM training program, both requiring three years full-time. Details of the program and subjects covered are outlined in Objectives of Training in Intensive Care available on the CICM web site. Many trainees undertake dual training or have completed training in a primary specialty, such as anaesthesia, medicine or emergency medicine.

The intensive care training program provides for interrupted and part-time training, which is permissible in any year of training. Part-time training must result in the equivalent time being spent in training as required by full-time trainees and the minimum trainee commitment must be 20% of a full-time trainee.

2014 Onwards

Total training time will remain at 6 years, consisting of a minimum of 42 months spent in accredited intensive care medicine training, 12 months of anaesthesia, 12 months of medicine (including 6 months of emergency or acute medicine) and 6 months in an elective placement. Trainees are also required to complete a term in paediatrics in an approved unit and at least 3 months of training must be undertaken in a rural hospital (paediatric and rural requirements may be completed in a discipline other than intensive care medicine).

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Intensive Care Training Time

The required 42 months of specific intensive care training is divided into three stages:

- Foundation Training (6 months) - Undertaken prior to selection into the program.

- Core Training (24 months) - Entry into Core Training requires completion of a recognised First Part (Primary) Examination and other specified learning and assessment tasks.

- Transition Year (12 months) - Entry into the Transition Year requires successful completion of the CICM Second Part Examination in either General or Paediatric Intensive Care Medicine, satisfactory In-Training Evaluation Reports (ITER’s) during Core intensive care training, anaesthetics and medicine, and other specified learning and assessment tasks.

Clinical Anaesthesia - 12 months

Training in clinical anaesthesia must be undertaken in anaesthesia positions approved by the College. Training time may be retrospectively accredited.

Clinical Medicine - 12 months

Clinical medicine training must be undertaken in positions approved by the College. Six months must be in acute medicine (e.g. Emergency) and six months with responsibility for longitudinal care of medical patients. Training time may be retrospectively accredited.

Elective - amount dependent on Censor’s assessment of previous training/experience. Training may be in intensive care, clinical anaesthesia, general medicine, specialist medicine, emergency medicine, surgery, research or other disciplines related to intensive care.

Trainee Selection

Pre 2014

Trainees must be able to register in their region of training, have completed 12 months general hospital experience, are free from alcohol and chemical abuse, and agree to comply with the CICM regulations relating to training. Selection to positions within an intensive care unit (ICU) is conducted by the employing authority not the CICM.

2014 Onwards

Australian applicants must have Limited Registration for postgraduate training or supervised practice as set out in the Medical Board of Australia Registration Standard. If joining the training program in New Zealand, doctors must have appropriate medical registration with the Medical Council of New Zealand.

Applicants are also required to have completed 6 months of supervised experience in an intensive care unit within the last 3 years, and provide two structured references from CICM Fellows or Intensive Care Specialists who provided direct supervision during the 6 months ICU experience.

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Trainee Assessment

Pre 2014

Basic training requires annual assessment by a supervisor. The Fellowship Examination examines various subjects on the theory and practice of intensive care, and the relevant aspects of the basic sciences and related disciplines. The examination consists of written and oral sections. The medical Australian Donor Awareness Program (ADAPT) is required in basic or advanced training.

2014 Onwards

Examinations

Successful completion of the CICM First Part Examination or another qualification approved by the Censor undertaken prior to the commencement of Core training. Successful completion of the CICM Second Part Examination (General or Paediatric) following the satisfactory completion of at least 12 months of Core training.

In-Training Evaluation Reports

For intensive care training, six monthly reports from Supervisors are required. All reports are completed via the online In-Training Evaluation Report (ITER). The ITER will monitor the trainee’s progress throughout the program. An ITER is also required for three month blocks of training in anaesthesia, medicine or elective.

Workplace Competency Assessments (WCA)

Trainees will be required to satisfactorily complete a number of specific Competency Assessments. These can be supervised by any Fellow of the College. The required WCA’s are: ventilator set-up; insertion of Central venous catheter; brain death certification; insertion of Inter-costal catheter; communication skills; performance of tracheostomy.

Observed Clinical Encounters (OCE)

Trainees are required to satisfactorily complete a minimum of eight Observed Clinical Encounters (akin to ‘Mini CExs’), two during each six months of Core Training. OCE’s can be supervised by any Fellow of the College.

Formal Project

All trainees must satisfactorily complete the requirements of the Formal Project. The Project must be submitted for assessment prior to commencing the Transition Year.

Overseas Trained Specialists The assessment process is outlined in the CICM Overseas Trained Specialist Policy document. Applicants are assessed against equivalence with Australian specialists. Applicants not assessed as equivalent may be required to undertake a clinical practice assessment in an approved post and/or all or part of the clinical performance assessment.

Applicants must contact the AMC for advice on registration to practice and whether such registration will allow you to complete the required amount of training. Training is dependent upon applicants securing an accredited training position, as training is hospital based and the College does not take responsibility for securing training posts or assisting with immigration status for applicants.

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Accreditation Assessment criteria are outlined in the CICM Policy Documents. Criteria include, but are not limited to the following:

- the case load and case mix to which trainees will be exposed;

- sufficient numbers of staff in the unit, including FCICMs and ancillary staff;

- suitable operational requirements, such as auditing procedures, educational programs for trainees and staff, research programs, quality assurance, clerical support;

- appropriate ICU design, including office space; and

- appropriate ICU equipment and facilities.

The accreditation level is granted based upon the maximum amount of training time in months that a trainee is allowed to spend in the unit.

Further Information www.cicm.org.au

ROYAL AUSTRALASIAN COLLEGE OF MEDICAL ADMINISTRATORS

Training Program The advanced training program of the Royal Australian College of Medical Administrators (RACMA) is three years full-time or six years part-time. There is no basic training component.

The College’s training program for candidates has three strands:

- approved workplace supervised medical management experience over three years;

- theoretical studies involving an Australian, or equivalent, university masters degree program containing the core units determined by the RACMA; and

- satisfactory completion of the RACMA training program.

Part-time and interrupted training are options. Successful completion of training involves completion of three FTE years, with supervised administrative experience.

Some candidates with significant medical management experience may be awarded Recognition of Prior Learning (RPL), with a reduction in supervised workplace training time.

Trainee Selection The applicant must have:

- completed a medical degree at a recognised Australasian university or equivalent;

- current medical registration in Australia or New Zealand; and

- at least three years clinical experience in an Australian or New Zealand health system.

Having met these requirements, a clinician makes an application to the college and submits supporting evidence. Where necessary, additional information may be sought. Sometimes an applicant may be interviewed. The applicant is then advised of the outcome and upon payment of the appropriate fees, the applicant becomes a candidate, and is allocated a preceptor and supervisor. The first 12 months is a probationary period.

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Trainee Assessment Trainee assessment involves workplace-based assessment and successful completion of both a university masters degree, including core units approved by the college, and the college training program, which has a range of assessment components:

- participation in college workshops;

- presentation of a case study;

- in-training assessment reports;

- management practice folio; and

- final oral examination.

In the final oral examination, each candidate answers four questions with two examiners to assess their management knowledge, skills and attitudes. Supplementary examination may be offered for those who fail to meet the requirements.

Overseas Trained Specialists Overseas trained applicants first apply to the AMC for certification to practise in Australia, then apply to the college for candidacy. The required documentation is reviewed and if found to be a suitable candidate, the applicant is interviewed by a college panel chaired by a senior college Fellow. During this process, the college determines the extent to which the applicant’s education, training, clinical and management experience is comparable to that of an Australian-trained medical administrator and whether the applicant requires any additional training or assessment.

Accreditation The college accredits individual training posts according to the assessment criteria set out in the college’s Accreditation Policy.

Further Information www.racma.edu.au

ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF OBSTETRICIANS AND GYNAECOLOGISTS

Training Program The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) does not use the terms ‘basic’ and ‘advanced’ to distinguish between levels of specialist training, but does distinguish between the Core Training Program (CTP: Years 1-4) and Advanced Training Program (ATP: Years 5-6).

Core Training Program (CTP) The first 4 years (184 weeks) of general obstetric and gynaecological training is known as the Core Training Program (CTP)4.

4 The Core Training Program (CTP) could be broadly regarded as ‘basic training’.

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Advanced Training Program (ATP) Advanced Training5 may involve further general obstetrics and gynaecology, research or training towards a special interest area(s) or towards one of five Subspecialty training programs.

The training and assessment requirements, including workshops, undertaken during the CTP and the ATP, are set out in the RANZCOG curriculum, available on the College’s website.

The training program provides for part-time and interrupted training. Part-time training is on the basis of a minimum 50% of the full-time commitment. The first year of the CTP must be undertaken full-time. Interrupted training of up to two years is allowed without loss of credit of training already undertaken in the program.

Trainee Selection Trainees entering the training program at Year One should:

- hold an approved Australian or New Zealand primary medical degree, or (for applicants in Australia) have successfully completed the requirements necessary to obtain the AMC certificate;

- (in Australia) possess general registration with the Medical Board of Australia under the National Registration and Accreditation Scheme as well as meet any residency or visa requirements enabling employment at any hospital within the jurisdiction(s) for which they are applying; (in New Zealand) have full medical registration with the New Zealand Medical Council and also hold permanent residency;

- have sufficient academic achievement to meet the requirements of the training program;

- have clinical experience that demonstrates the ability to exercise sound clinical ability and judgment;

- demonstrate interpersonal, communication, problem-solving and organisational skills; and

- be familiar with the Australian or New Zealand health system, as applicable.

The RANZCOG has a national selection process in which candidates are ranked nationally based on the scoring of their online applications/CVs, referee reports and interview. Note: not all applicants are shortlisted for interview; only those appropriately ranked based on the scoring of their application and referee reports are interviewed.

Trainee Assessment The assessments undertaken may be summarised as follows:

- three-monthly formative and six-monthly summative in-training assessments;

- In-Hospital Clinical Assessments - one in ultrasound, the other in colposcopy;

- assessment of surgical competencies and satisfactory attendance at various workshops, including obstetrics and gynaecology surgical skills;

- research project - to be completed by the end of Year Five;

- Membership Written Examination - multiple choice and short answer papers; and

- Membership Oral Examination - Objective Structured Clinical Examination (OSCE) format.

5 Advanced Training Program (ATP) could be broadly regarded as ‘advanced training’.

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Specialist International Medical Graduates The assessment of an overseas trained applicant’s qualifications, training and experience is undertaken by the College for the AMC. The AMC delegates to the college the responsibility of determining whether that applicant’s qualifications and professional experience are comparable to those of an Australian-trained specialist in obstetrics and gynaecology. An assessment of the applicant’s specialist training and experience, including three detailed referee reports, is undertaken to determine whether they may be considered comparable to an Australian-trained specialist in obstetrics and gynaecology, and thus proceed to an interview assessment conducted by a College panel, which includes a community representative.

Interviews are held approximately every eight weeks at College House in Melbourne. There are three possible outcomes from the interview:

- an applicant may be deemed to be substantially comparable to an Australian-trained specialist and invited to apply for fellowship of the college following satisfactory completion of a period of up to 12 months supervised specialist work and participation in CPD activities;

- an applicant may be deemed to be partially comparable to an Australian-trained specialist; or

- an applicant may be deemed to be neither partially nor substantially comparable to an Australian-trained specialist, in which case they will need to obtain the AMC Certificate and then apply to enter the college’s specialist training program in order to proceed to fellowship of the College.

If deemed ‘partially comparable’ an applicant is required to complete a minimum of 12 months and a maximum of 24 months of prospectively approved supervised training before being eligible to apply for fellowship. During this time, they must satisfactorily complete the College Membership Written and Oral Examinations, two in-hospital clinical assessments, basic and advanced surgical procedures assessments and the College’s Communication Skills Workshop. They must work closely with an approved training supervisor, submit three-monthly formative and six-monthly summative assessment reports and, be certified as having satisfactorily demonstrated a list of competencies that are drawn from the RANZCOG Curriculum. Applicants assessed as ‘partially comparable’ have a maximum of four years from the date of their assessment to complete their requirements.

Accreditation All FRANZCOG training hospitals are accredited by the college. All sites undergo reaccreditation every four years by the RANZCOG to ensure that the core requirements for clinical and educational experience, as defined in the RANZCOG curriculum, are being met.

Further Information www.ranzcog.edu.au

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ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF OPHTHALMOLOGISTS

Training Program

Basic Training

Basic training of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) is two years in length and occurs in structured terms in training hospitals in Australia and New Zealand. The trainee must demonstrate integrated clinical and surgical skills based on strong foundational knowledge of the ophthalmic sciences, as well as attainment of appropriate social and professional responsibilities. Learning occurs through on the job supervision, didactic sessions and self-study.

Advanced Training

Advanced training is two years in length followed by a final year. In advanced training, years 3 and 4, trainees must demonstrate integrated clinical and surgical skills and knowledge in each of the following clinical practice areas: cataract and lens, clinical refraction, cornea and external eye, glaucoma, neuro-ophthalmology, ocular inflammation, ocular motility, oculoplastics, paediatric, refractive surgery, and vitreo retinal.

In the final year of training the trainee is expected to broaden his or her specialist experience in final preparation for specialist qualification and to function in the community as an independent ophthalmologist. The final year experience may be undertaken in Australia, New Zealand or overseas, preferably in an institution or program other than that at which the trainee completed the first four years.

Trainee Selection

Basic Training

The college cooperates with health and hospital employing bodies to rank, match and appoint applicants on merit to accredited ophthalmology training posts. Hospital networks, as the employing bodies, have primary responsibility for trainee selection. The college provides selection guidelines, which follow the best practice in selection practices, to the hospital networks. It also specifies that the training selection criteria are based on the CanMEDs (Canadian Medical Education Directives for the Specialists) seven key roles framework: medical expert, scholar, communicator, collaborator, manager, health advocate, and professional.

Advanced Training

Selection for advanced training takes place in the second half of each calendar year. Basic trainees are therefore required to pass all ophthalmic sciences and the Ophthalmic Basic Competency and Knowledge requirements, as well as gain satisfactory grades in their work-based assessment reports within 18 months of the commencement of training, to be eligible to apply for advanced training from year 3.

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Trainee Assessment

Basic Training

Assessment in the ophthalmic sciences subjects is by examination. Trainees are required to sit and pass the Clinical Ophthalmic Pharmacology and Emergency Medicine (COPEM) Module 1 prior to starting formal training, but after selection to the Vocational Training Program. Once selected, even if formal training time has not commenced, a trainee must also attempt the Anatomy examination at the first sitting scheduled by the College.

All basic science exams, including the Ophthalmic Basic Competencies and Knowledge clinical examination must be passed within the first 18 months of training. Throughout their basic training, trainees also complete work-based assessments for each rotation.

Advanced Training

Formal assessment comprises of on-the-job assessments, an ophthalmic pathology examination in year 3 and the RANZCO Advanced Clinical Examination (RACE) in year 4.

To be considered eligible to sit the RACE, which has a written and clinical component, a trainee must have completed three years of training supported by satisfactory term supervisors’ reports for clinical and surgical experience and have started their fourth year of training. They must also demonstrate that they have satisfactorily completed the required curriculum competencies and research requirements.

Specialist International Medical Graduates The specialist international medical graduate applies to the AMC, which then refers the specialist international medical graduate application to RANZCO for specialist assessment. RANZCO conducts specialist international medical graduate assessments in six stages:

- Stage 1: college staff assembles full documentation;

- Stage 2: specialist international medical graduate Committee reviews documentation;

- Stage 3: specialist international medical graduate Committee interview the applicant (including medico legal status);

- Stage 4: if required, specialist international medical graduate’s knowledge is further assessed by performance in RACE (one or both components);

- Stage 5: if required, clinical skills are then assessed by performance in supervised assessment; and

- Stage 6: final interview by Specialist International Medical Graduate committee.

At Stage 2 in the process, an initial decision on comparability is made:

- the specialist international medical graduate applicants are deemed substantially comparable pending interview if they are considered comparable to an ophthalmologist trained and qualified in Australia. RANZCO recommends specialist recognition to AMC and the applicant is eligible to apply for RANZCO fellowship (in some cases the applicant may be required to undergo a period of oversight before being eligible to apply for fellowship);

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- the specialist international medical graduate is deemed partially comparable if the specialist international medical graduate committee has identified gaps in the specialist international medical graduate’s knowledge or experience. The applicant is required to undertake further assessment or training, Stages 4 and 5, and if performing satisfactorily he/she proceeds to final interview, Stage 6. If successful in interview, the applicant is eligible to apply for fellowship (in some cases the applicant may be required to undergo a period of oversight before being eligible to apply for fellowship); or

- the specialist international medical graduate is demonstrably not equivalent if the committee identifies gaps in the knowledge of the applicant, which would require more than two years of specialist training to up skill in all clinical curriculum areas. The committee notifies the AMC who, in turn, informs the specialist international medical graduate applicant.

Decisions about comparability are made in accordance with attainment of the clinical curriculum areas, which underpin the practices of a general ophthalmologist in Australia.

Accreditation The college inspects all training locations in the seven training networks in Australia and New Zealand. Site inspections of existing training posts take place on a three-year cycle. Other reasons for site inspections are by request either from an institution applying for a new training post or from the regional Qualification Education Committee Chair because of changes to a training post. Inspections are conducted in consultation with the key stakeholders including hospital administrators, clinical tutors, term supervisors and trainees.

The College Standards for Training Networks describes the college’s standards for hospital-based networks that provide training in specialist ophthalmology, and for each rotational post within those networks. The standards also cover training posts in private settings.

Further Information www.ranzco.edu

ROYAL COLLEGE OF PATHOLOGISTS OF AUSTRALASIA

Training Program The Royal College of Pathologists of Australasia (RCPA) advanced training program requires five years. There is no basic training.

The following subjects are studied: anatomical pathology, chemical pathology, clinical pathology, forensic pathology, general pathology, genetic pathology, haematology, immunopathology and microbiology. Courses offered are not compulsory.

Some programs are joint programs with the RACP. These include haematology, immunology and allergy/immunopathology, endocrinology/chemical pathology and microbiology/infectious diseases.

Part-time training is supported, as long as the trainee is employed for a minimum of eight hours per week on average. Interrupted training is also supported and the college places no limit on the time taken to achieve fellowship.

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Trainee Selection The college accredits laboratories for training, but not the actual positions. As a consequence, the college is not directly involved in selecting trainees for positions. The college does have a guideline for the selection of trainees based on the Brennan principles, which it encourages all laboratories to use. The College does support a number of Trainee Networks in various disciplines and states.

Trainee Assessment All trainees are expected to demonstrate knowledge of basic scientific and pathological principles and laboratory management as it relates to their discipline. Trainees must pass three examinations:

- a basic pathological sciences examination;

- a Part 1 examination, usually undertaken during the third year of training; and

- a final examination, usually undertaken in the fifth and final year of training.

The RCPA Trainee and Curriculum Handbooks contain discipline specific information on assessment and examinations and are available from the college’s website.

Overseas Trained Specialists/International Medical Graduates

The Board of Education and Assessment makes an independent assessment following interview by, and the advice of, an overseas trained specialist assessment subcommittee as described below. At the same time the assessment applicant will be provided with training determinations as to any additional training time or examinations they would need to undertake should they wish to attain the fellowship of the RCPA.

The college follows the nationally consistent approach to assessing overseas trained specialists in relation to accepting them for assessment via the overseas trained specialist pathway; that is, they must be deemed to be a specialist in their original country and not need more than two years of top-up training/assessment before being eligible for the Australasian fellowship.

Accreditation

The college accredits both public and private sector laboratories for training. In order to be accredited, a laboratory must first be accredited from a quality perspective by the separate NATA (National Association of Testing Authorities)/RCPA accreditation process. If the laboratory has this accreditation, it may apply for RCPA training accreditation to assess if the laboratory is able to provide training in pathology. This accreditation examines whether the laboratory has appropriate staffing and equipment, has appropriate selection system in place for trainees, and has training programs and supervision processes in place in accordance with the college’s requirements.

The college conducts site inspections to ensure that standards of training are in accordance with college requirements. Each accredited laboratory is visited at least every four years as part of the required NATA accreditation, or as the need arises. Visits may be carried out in collaboration with representatives of the RACP where joint training programs are in place.

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ROYAL AUSTRALASIAN COLLEGE OF PHYSICIANS

Training Program

The Royal Australasian College of Physicians (RACP) provides vocational training programs in the following areas:

- Adult Medicine; - Paediatrics and Child Health; - Occupational and Environmental Medicine; - Public Health Medicine; - Rehabilitation Medicine; - Palliative Medicine; - Addiction Medicine; and - Sexual Health Medicine.

Each of these has separate training programs which vary in length between three to eight years depending on the specialty chosen. Commencing in 2008, the RACP has phased in a common educational framework called Physician Readiness for Expert Practice (PREP). The PREP program is a comprehensive system of formative education throughout Basic and Advanced Training.

The key principles of PREP centre around provision of a supportive learning environment, a physician led, learner-centred approach and reflective practice. Components of the framework include training program curriculum, professional qualities curriculum, formative and summative assessments, teaching and learning tools, comprehensive supervision and an e-learning environment.

Basic Training - Adult Medicine and Paediatrics and Child Health The Basic Training program is three years in length and is designed to provide trainees with a multi-specialty foundation by introducing and developing the range of core knowledge, skills, attitudes and behaviours required to become a competent physician or paediatrician.

Advanced Training Advanced Training is provided in all the specialties listed above and most programs are a minimum of three years in length.

Within adult medicine and paediatrics there are a broad range of specialties not listed which include cardiology, clinical genetics, clinical pharmacology, community child health (paeds only), endocrinology, gastroenterology and hepatology, general and acute care medicine (adult medicine only), general paediatrics (paeds only), geriatric medicine (adult medicine only), clinical haematology, clinical immunology and allergy, infectious diseases, medical oncology, neonatal/perinatal medicine (paeds only), nephrology, neurology, nuclear medicine, palliative medicine, paediatric rehabilitation medicine, respiratory medicine rheumatology and sleep medicine.

There are also specialty advanced training programs which are conducted jointly with other specialist colleges:

- haematology, immunology and allergy, endocrinology and chemical pathology and infectious diseases and microbiology, with the Royal College of Pathologists of Australasia (RCPA);

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- paediatric emergency medicine with the Australasian College for Emergency Medicine (ACEM);

- nuclear medicine with the Royal Australian and New Zealand College of Radiologists (RANZCR); and

- paediatrics and child and adolescent psychiatry with the Royal Australian and New Zealand College of Psychiatrists (RANZCP)6.

Trainee Selection Applicants for basic training must have successfully completed a medical degree and an internship year, and be currently employed in a suitable training position in an accredited hospital, as confirmed by the Director of Physician Education within the hospital. There are additional requirements for International Medical Graduates.

Selection into advanced training in a specialty is contingent upon the trainee successfully completing basic training requirements and securing a suitable advanced training position in a hospital prior to submitting an application for approval by the relevant training committee.

Trainee Assessment Basic trainees undertake a range of workplace based formative assessments during training. Completion of learning needs analyses and summative assessments (such as a centrally administered written and clinical examination and progress reports) must also be successfully completed before progression to advanced training.

Advanced trainees are also required to undertake a range of formative and summative assessments and requirements vary across the specialties.

On satisfactory completion of all training requirements, trainees are admitted to Fellowship of the Royal Australasian College of Physicians (FRACP). Trainees enrolled in joint training programs with the RCPA must complete all training requirements of the joint program before FRACP is awarded.

Overseas Trained Specialists Applications from overseas trained physicians or paediatricians for specialist recognition in Australia are assessed by the College. An assessment of the applicant’s qualifications and experience, including at least two detailed referee reports, is undertaken against the relevant College training program to determine whether they are eligible to proceed. Applicants are interviewed to assess their comparability to Australian-trained physicians and paediatricians. Representatives from the relevant subspecialty are involved at every stage of the process. The documentation and interview report are assessed by the relevant overseas trained physician/paediatrician (OTP) committee, which determines one of three possible outcomes to the assessment:

- OTP is deemed to be substantially comparable to an Australian-trained physician/paediatrician;

- OTP is deemed to be partially comparable to an Australian-trained physician/paediatrician; or

- OTP is deemed to be not comparable to an Australian-trained physician/paediatrician and is advised to complete the AMC examination and apply to join the RACP training program.

6 This training program is currently under review and closed to new entrants.

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If deemed ‘substantially comparable’, the applicant is generally required to complete 12 months of prospectively approved professional supervised peer review before being eligible to apply for fellowship. If deemed ‘partially comparable’, they may be required to successfully complete up to 24 months of peer review, up to 12 months of top up training, the written and/or clinical/oral examination and/or a practice visit.

Accreditation The college accredits training settings that provide a suitable environment for physician education. Site visits are undertaken as required to verify that criteria relating to the environment for teaching and learning are satisfied. Basic and advanced training specialties all have customised accreditation processes with levels of accreditation depending on the teaching and learning opportunities available at the facility.

Further Information www.racp.edu.au

RACP - THE AUSTRALASIAN FACULTY OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE7

Training Program The Australasian Faculty of Occupational and Environmental Medicine (AFOEM) training program is focused on the ability to assess a person’s fitness for work, facilitate return to work of a person after injury or illness, and identify ways in which work or environment harms health so as to negotiate effective prevention and to respond to the needs of courts and tribunals. The AFOEM training program encourages trainees to assess the effects of harmful exposures in places where they occur, to research the health effects of new and developing work activities and technologies, and to seek and seize opportunities to foster prevention.

Trainees are required to participate in training review meetings, complete six-monthly training status reports, learning plans, formative assessments and work a minimum of ten hours per week in occupational and environmental medicine.

Trainees can apply to prospectively interrupt their training at any time but cannot undertake any assessment components during the time of interruption. Interrupted training is allowed but the training program must be completed within the 10 year time limit. Interruptions of more than 12 continuous months may require additional assessments (determined on a case-by-case basis). Interruptions of more than 24 continuous months may require additional training time and/or assessments (determined on a case-by-case basis).

A maximum period of 24 months of full-time parental leave can be excluded from the time limit to complete training.

7 The Australasian Faculty of Occupational Medicine formally became the ‘Australasian Faculty of Occupational and Environmental Medicine’ (AFOEM) in May 2007. Historically there has always been a strong element of ‘environmental’ medicine in the teaching and practice of Occupational Medicine, and this change was seen as more clearly defining the specialty.

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Trainee Selection For entry into the AFOEM training program, applicants must:

- have obtained unconditional general medical registration with the Medical Board of Australia8;

- have completed at least two years of full-time postgraduate general clinical experience;

- be enrolled in or have completed a postgraduate qualification in occupational and environmental medicine; and

- have obtained a position in occupational medicine in Australia, and be working a minimum of ten hours per week in the field. It is the trainee’s responsibility to find a suitable position for occupational and environmental medicine training.

- have reached an agreement with a Fellow of AFOEM to be an Educational Supervisor

- have not been involuntarily discontinued because of failure to progress from any College training program

Prospective trainees must approach the Director of Training in their region about the possibility of joining the training program. Their previous qualifications are assessed and a recommendation to undertake additional study or to apply is given.

Trainee Assessment Assessment covers the following topics: clinical; workplace assessment; critical appraisal, research methods, management, communication, legislation, rehabilitation and the environment.

Assessment during training includes regular training status reports, written and practical examinations, a research project, a presentation of the abstract from the research project and a Written Communication Portfolio.

Overseas Trained Specialists Refer to the overseas trained specialists section under RACP.

Accreditation AFOEM does not currently offer accredited training positions, but approves each post on a case-by-case basis. Applicants must find employment in occupational & environmental medicine and apply to Director of Training for the position to be endorsed. Any position will not contain the variety of experience required to fulfil all the competencies, so trainees are encouraged to work in different positions throughout training. Each time the trainee moves to a new position, this should be endorsed by the Director of Training.

Further Information www.afoem.racp.edu.au

8 International medical graduates must first have been assessed by the AMC as being competent to practice medicine in Australia and must provide evidence of satisfactory completion of the AMC Certificate.

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RACP - AUSTRALASIAN FACULTY OF PUBLIC HEALTH MEDICINE

Training Program The Australasian Faculty of Public Health Medicine (AFPHM) training program provides trainees with experience in the practice of public health medicine in appropriately supervised and supported environments. In the course of three years (FTE), trainees acquire the knowledge, skills and attitudes of a public health physician by completing, with guidance from Regional Education Coordinators, Supervisors, and Mentors, rotations through a variety of public health activities.

A comprehensive list of competencies expected to be possessed by a graduate of the training program forms the basis for developing individual training plans for each year of training. While strongly regional in its focus, the AFPHM training program is supported by an associate director of training based at the College (RACP). The educational activities of the Faculty are overseen by the Faculty Education Committee.

Trainee Selection For entry into the AFPHM training program, applicants must:

1. Have obtained general medical registration with the Medical Board of Australia9.

2. Have completed basic training requirements:

- at least 3 years of medical experience since graduating (including at least 2 years of clinical experience, one of which being the intern year); and

- have completed, or are enrolled in10 a Master of Public Health (or comparable Masters degree), which includes the Faculty’s core discipline areas:

• Epidemiology;

• Biostatistics;

• Health Protection (includes Environmental health and/or communicable disease prevention and control);

• Health Promotion; and

• Health Policy, Planning or Management.

3. Have obtained a Public Health position in Australia - it is the trainee’s responsibility to find a suitable position for public health training.

Doctors interested in applying for admission to the faculty’s training program are required to contact the regional education coordinator for the region in which they wish to train.

Trainee Assessment The Assessment Scheme involves both formative and summative assessment. The main purpose of formative assessment is to provide feedback to guide learning, while summative assessment is concerned with decisions about progress or satisfactory completion of training. The outcome of formative assessment does not count towards progress or completion but participation in formative assessments will be required of all trainees.

9 International medical graduates must first have been assessed by the AMC as being competent to practice medicine in Australia and must provide evidence of satisfactory completion of the AMC Certificate. 10 The degree program must be completed before applicant can progress to the second year of Advanced Training.

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For trainees who are eligible and wish to gain Fellowship from 2010, the assessment requirements to be completed are as follows:

1. completion of 36 units of Advanced Training (confirmed by approved Supervisor’s Reports);

2. satisfactory completion of three (3) Workplace Reports;

3. completion of an oral presentation (a formative assessment requirement);

4. submission of a Training Summary; and

5. satisfactory completion of an oral examination.

Overseas Trained Specialists Refer to the overseas trained specialists section under RACP.

Accreditation The Faculty has a site accreditation process to accredit training settings that are able to provide a suitable environment for public health medicine training.

Further Information: www.afphm.racp.edu.au

RACP - AUSTRALASIAN FACULTY OF REHABILITATION MEDICINE

Trainee Program The Australasian Faculty of Rehabilitation Medicine (AFRM) has a four-year training program for Adult Rehabilitation Medicine and a three-year program for Paediatric Rehabilitation Medicine. Training occurs in prospectively approved training programs in rehabilitation medicine units during which trainees acquire the professional qualities and specialty specific competencies necessary to practise as a rehabilitation medicine physician. The training program requirements, curriculum, courses and assessments are detailed in the AFRM Handbook for Trainees and the AMC Accreditation Submission, both of which are available on the faculty’s website.

Trainee Selection To register for the Adult Rehabilitation Medicine program, a trainee must have completed at least two years of general clinical experience or general practice. To register for the Paediatric Rehabilitation Medicine program, trainees must have successfully completed the RACP Paediatric & Child Health Division basic training requirements. AFRM trainees are self-selected. In order to have a training program approved and become a registered trainee, a doctor must obtain employment or other supervised work that is accepted as appropriate training by the faculty. Each year, applicants must obtain positions that enable appropriate training. Applications for these service positions are managed by employing bodies.

The faculty is not directly involved in the selection of trainees into employment positions. However, each year some members of the faculty, as hospital employees, may be involved in interviews and placement of doctors into some registrar positions for the following 12-month period. The faculty recommends that official faculty representatives attend these interviews.

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Trainee Assessment As well as on-going assessment requirements and successful completion of the fellowship examinations, admission to fellowship of the faculty requires satisfactory completion of all training requirements as follows:

- four years of supervised clinical training in rehabilitation medicine in an accredited training program (Adult Rehabilitation Medicine); or

- three years of supervised clinical training in rehabilitation medicine in an accredited training program (Paediatric Rehabilitation Medicine); and

- completion of training modules in clinical research, clinical neuropsychology, health service administration and evaluation, and behavioural sciences.

Overseas Trained Specialists Refer to the overseas trained specialists section under RACP.

Accreditation The faculty accredits facilities considered suitable environments for training in rehabilitation medicine, although individual trainees’ proposed training programs, not posts, are approved annually whether undertaken at non-accredited or accredited facilities. The criteria facilities should fulfil for accreditation are listed on the website.

In order to achieve formal accreditation and two-yearly re-accreditation, facilities are required to complete and submit a rehabilitation medicine survey form to accredit training settings. A desktop audit is then conducted. Site visits are conducted on a six-year cycle.

Further Information www.afrm.racp.edu.au

RACP - AUSTRALASIAN CHAPTER OF PALLIATIVE MEDICINE

Training Program The Australasian Chapter of Palliative Medicine (AChPM) has a three-year vocational training program. Training program requirements depend on the trainee’s prior experience and are determined upon application. The minimum training requirement includes five mandatory six-month training terms (30 months) in palliative medicine, a case study and a project. Chapter trainees and RACP advanced trainees in palliative medicine both follow the RACP palliative medicine curriculum.

Trainee Selection Applicants must be a registered medical practitioner in Australia or New Zealand and hold fellowship of a chapter approved college or faculty, or have completed RACP basic training requirements including the examinations.

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Trainee Assessment Assessment during training is by ongoing assessment of clinical competence by approved supervisors. On satisfactory completion of all training requirements, trainees are admitted to fellowship of the chapter (FAChPM). Trainees who complete the RACP advanced training program in palliative medicine are awarded FRACP and may subsequently be awarded FAChPM.

Trainees enrolled in the RACP advanced training program in palliative medicine are automatically invited to become fellows of the chapter upon gaining FRACP.

Overseas Trained Specialists Refer to the overseas trained specialists section under RACP.

Further Information www.racp.edu.au/page/australasian-chapter-of-palliative-medicine

RACP - AUSTRALASIAN CHAPTER OF ADDICTION MEDICINE

Training Program The Australasian Chapter of Addiction Medicine (AChAM) has a three-year vocational training program. Training program requirements depend on the trainee’s prior experience and qualifications and are determined upon application. Program requirements include a minimum of 18 months clinical experience in accredited addiction medicine positions and up to 18 months in approved research, medical, psychiatric or public health positions. Exemptions are available for individuals who have completed addiction psychiatry training with the Royal Australian and New Zealand College of Psychiatrists.

Trainee Selection Applicants must be a registered medical practitioner in Australia or New Zealand and hold fellowship of a chapter approved college or faculty, or have completed RACP basic training requirements including the examinations.

Trainee Assessment Assessment includes regular six-monthly supervisor reports, completion of a log book, completion of a quality improvement project, a research project, regular case studies/presentations and/or observed interviews.

Overseas Training Specialists Refer to the overseas trained specialists section under RACP.

Further Information www.racp.edu.au/page/australasian-chapter-of-addiction-medicine

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RACP - AUSTRALASIAN CHAPTER OF SEXUAL HEALTH MEDICINE

Training Program The Australasian Chapter of Sexual Health Medicine has a three-year vocational training program and can be tailored to be completed in a range of settings. Depending on the trainee’s prior experience and qualifications, credit for prior learning will be considered. The program provides experience in fertility regulation, sexual health counselling, HIV medicine, sexual health medicine, epidemiology and biostatistics.

Trainee Selection Applicants must be a registered medical practitioner in Australia or New Zealand and hold fellowship of a chapter approved college or faculty, or have completed RACP basic training requirements including the examinations.

Trainee Assessment Assessment includes regular supervisor reports, projects, formal coursework and an oral exit exam.

Overseas Trained Specialists Refer to the overseas trained specialists section under RACP.

Further Information www.racp.edu.au/page/australasian-chapter-of-sexual-health-medicine

ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF PSYCHIATRISTS

Training Program The Royal Australian and New Zealand College of Psychiatrists (RANZCP) vocational training program for admission is five years, comprising three years of basic training and two years of advanced training.

Basic Training

Basic training requires a minimum of 36 months FTE. The training is based around rotations in adult general psychiatry, child/adolescent psychiatry, and consultation liaison, together with training experiences in rural psychiatry and indigenous mental health, psychiatry of old age, addiction, electro-convulsive therapy (ECT) and psychotherapy. This curriculum is intended to promote a consumer-focused approach in which the consumer is able to work towards management of their condition in active partnership with their psychiatrist and other mental health professionals.

Advanced Training

Advanced training requires a minimum of 24 months FTE and involves continued rotations in accredited advanced training posts. In generalist training, rotations can be in general psychiatry or any subspecialty and a maximum of 12 months of the two years can be spent doing clinical research. All advanced trainees, whether in the generalist fellowship program or whether undertaking one of the seven certificate streams, must complete leadership and management

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experience, accrue continuing medical education hours across the two years, continue to do regular psychotherapy and receive supervision for this, continue developing their consultative skills and must also complete several learning projects in the fields of biological, social and cultural management as well as the annual Ethical Practice Activities.

Trainee Selection

Basic Training

To be eligible to apply, prospective trainees must have satisfactorily completed at least one FTE year of general medical training, hold current general medical registration in Australia or New Zealand and be in good standing with the relevant medical registration board or equivalent approved body. Applicants apply direct to the local training committee responsible for basic trainee selection.

Advanced Training

To be eligible to commence advanced training for generalist fellowship, trainees must have satisfactorily completed all basic training and assessment requirements.

To be eligible to commence an advanced training subspecialty program, trainees must have satisfactorily completed all basic training and assessment requirements, including the clinical examinations. Applicants apply direct to the state or territory director of advanced training.

Trainee Assessment

Basic Training

During the first three years of training, trainees must demonstrate satisfactory progress in a recognised formal education course. In-training assessment consists of both formative three-monthly and summative six-monthly feedback. In addition, trainees are required to complete two case histories and written and clinical examinations.

Advanced Training

In-training assessment consists of both formative three-monthly and summative six-monthly feedback.

Overseas Trained Specialists Applications for the assessment of international specialist psychiatry qualifications to determine equivalence for fellowship are submitted via the Australasian Medical Council (AMC) or direct to the RANZCP. The applicant, or the employer, employment agency or medical board on behalf of the applicant, provides standard documentation and payment of a standard assessment fee, as part of the AMC approved process. Local panels of trained, College approved, assessors review the documentation provided and the applicant attends a clarification interview.

The Committee for Specialist International Medical Graduate Education considered the recommendations of the local assessment panels and bases all determinations on standard categories within the RANZCP Equivalence Guidelines. Applicants may be required to undertake further clinical training in psychiatry and/or complete all or part of the college examinations.

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Accreditation The local training committees assess and accredit training posts. A heath service submits a training proposal to a local training committee. The proposal is assessed and a site visit conducted according to standard operating procedures to determine if the post meets the RANZCP standards for accreditation.

The Accreditation Sub-Committee of the Committee for Training is responsible for conducting regular accreditation visits to all training programs in Australia and New Zealand on a three-year cycle. The accreditation visitors ascertain whether the program meets the standards of accreditation which include:

- the degree to which the apprenticeship model of training is applied;

- the adequacy of lines of clinical responsibility;

- whether the provision of supervision meets college requirements;

- that the range of individual posts throughout the training program provides satisfactory training and gives a sufficiently broad clinical experience;

- the working conditions, workload of trainees and the facilities provided;

- the overall organisational aspects of the program; and

- the atmosphere and morale within the program.

2012 Fellowship Program In January 2013 after 5 years of development the RANZCP implemented the competency base Fellowship Program, termed the 2012 Fellowship Program. The revised program includes a modified training structure with 3 levels, Stage 1, Stage 2 and Stage 3 completed over 60 months. The revised program includes a modified assessment structure with Entrustable Professional Activities (EPAs) and Workplace Based Assessments (WBAs) being included. A scholarly project has also been included. For more information see www.ranzcp.org/Pre-Fellowship/2012-Fellowship-Program.aspx

Further Information www.ranzcp.org

ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF RADIOLOGISTS

Training Program The Royal Australian and New Zealand College of Radiologists (RANZCR) advanced training program requires five years. There is no basic training.

Both specialties of the RANZCR have undergone curriculum re-development. In radiation oncology, the new curriculum commenced in December 2008 for trainees in New Zealand and January 2009 for trainees in Australia and Singapore. For radiology, the new curriculum commenced in December 2009 for trainees in New Zealand, and in January 2010 for trainees in Australia and Singapore.

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Further information on the radiation oncology curriculum can be found at:

www.ranzcr.edu.au/training/radiation-oncology/current-training-program/curriculum

Further information on the radiology curriculum can be found at:

www.ranzcr.edu.au/training/radiology/current-training-program/curriculum

Radiology

The minimum required period of training for the Radiology Postgraduate Vocational Training Program is five years. The aim of the training program is to provide broadly-based experience in all current imaging modalities and body systems. The standards are set to ensure that, at the end of the five-year training program, the trainee is capable of performing as a consultant in radiology and can be recommended to the various medical boards and specialist recognition committees in Australia and New Zealand for registration as a specialist.

The principal objectives of the program are to ensure that trainees develop the communication and analytical problem solving skills necessary to function as effective diagnostic radiologists. Registrars are expected to develop the finely tuned cognitive and observation skills required to enable accurate interpretation of plain radiographs, CT, nuclear medicine, ultrasound and MRI studies. Additionally, the program is designed to provide trainees with an understanding of the risks associated with radiation, radionuclides, contrast media and interventional procedures.

Radiation Oncology

The minimum requirement for the Radiation Oncology Postgraduate Vocational Training program is five years. The aim of the program is to provide broadly-based experience in the clinical management and use of radiation to treat cancer. The standards are set to ensure that, at the end of the five-year training program, the trainee is capable of performing as a consultant in radiation oncology and can be recommended to the various medical boards and specialist recognition committees in Australia and New Zealand for registration as a specialist.

Part-time or Interrupted Training

Both specialties of the RANZCR allow for part-time and interrupted training. Part-time training must be undertaken at a minimum of 0.5 FTE for radiation oncology and 0.5 of a full-time clinical workload for radiology. Total training time must equate to five years FTE. Applications for part-time or interrupted training are required to be directed to the appropriate education board in either radiology or radiation oncology.

Trainee Selection As the RANZCR accredits training sites, not individual positions, the selection process is undertaken by employers, whether they are private practices or departments in public hospitals, with a RANZCR representative as a member of the selection panel.

Entrants into a specialist training program are required to hold a basic medical degree and appropriate medical registration for the jurisdiction where the position is located. It is also required that all trainees have at least 24 months of general hospital training, that is have completed PGY1 and PGY2.

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In some areas, a joint selection process is undertaken, where representatives from a variety of hospitals, as a group, interview and appoint trainees. This process is facilitated through the RANZCR.

Trainee Assessment

Radiology

The training program in radiology has a portfolio approach to assessment throughout training. The Learning Portfolio details a suite of assessment tools designed primarily to drive learning and provide opportunities for trainees to receive feedback on their performance in a formative manner. This includes assessment tools that are required throughout training, such as DoPs (Directly Observed Procedures), IPX (Individual Patient Evaluations), MSF (multi-source feedback) and Director of Training Assessments, as well as specified assessments that are required in the different Phases of training, for example: in Phase 1 trainees (Years 1-3) complete a Research Project and in Phase 2 (Years 4-5) trainees complete a second research project.

The examination process in assessment comprises:

- Part 1 examination in anatomy and applied imaging technology - this examination may only be attempted by candidates who occupy accredited training positions and candidates are not permitted to sit the Part I subjects separately; and

- Part 2 examination, which consists of examinations in radiology and pathology, which must be taken together at the first attempt not earlier than a candidate’s fourth year of training.

Radiation Oncology

The training program in radiation oncology has a portfolio approach to assessment throughout training. The Learning Portfolio details a suite of assessment tools designed primarily to drive learning and provide opportunities for trainees to receive feedback on their performance in a formative manner. This includes assessment tools that are required throughout training, such as Mini-CEX (Mini-Clinical Evaluation), MSF (multi-source feedback), Director of Training Assessments, Clinical Supervisor Assessments, as well as specified assessments that are required in the different Phases of training. In Phase 1 trainees complete ten Clinical Assignments. In Phase 2 trainees complete Case Reports, a statistics assignment and a research requirement.

The training program in radiation oncology also includes two formal examinations:

- Phase 1 examination is a written examination of Oncology Sciences material; and

- Phase 2 examination is an exit exam and includes written papers and oral viva examinations.

Overseas Trained Specialists The RANZCR conducts assessments of overseas trained radiologists and radiation oncologists. Assessors undertake specific training before undertaking interviews of overseas trained specialists.

Area of Need Process The revised Area of Need (AoN) assessment process was implemented on 1 April 2007 and incorporates the assessment of the applicant’s clinical competencies in addition to an interview component, where applicants are interviewed by two fellows of the RANZCR. Since 2011, this process also includes assessment for specialist recognition. Supervision guidelines have been established after consultation with supervisors of AON appointees and heads of department.

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Specialist Recognition The RANZCR currently has three different pathways to specialist recognition:

- Examination Pathway (partially comparable): The individual is assessed on their comparability to an Australian or New Zealand trained specialist, based on their training and subsequent clinical experience. If found to be partially comparable, candidates are eligible to sit the FRANZCR Part 2/Phase 2 examinations. They are eligible to apply for fellowship of the RANZCR after successful completion of the Part 2/Phase 2 examinations;

- Peer Review Pathway (substantially comparable): The individual applies for specialist recognition and is assessed as per the college process for the examination pathway; however, the applicant must satisfy set criteria to be found substantially comparable. The peer review period of up to 12 months is to be undertaken in an accredited department; upon satisfactory completion of peer assessment in the workplace and multi-source feedback exercise, the applicant is eligible to apply for fellowship of the RANZCR;

- International Recognition: The individual applies for admission to fellowship of the RANZCR on the basis of international recognition, being of an extremely high calibre, having an extensive record of publications, presentations, recipient of academic awards and holding a high level academic appointment. They are interviewed by the Chief Censor and a councillor and, if successful, are granted specialist recognition. Admission to fellowship under this provision is recommended only upon taking up a position in Australia or New Zealand.

Accreditation The RANZCR accredits training sites, not individual positions, against criteria that are publicly available. All public and private providers of radiology and radiation oncology services are able to seek accreditation of their sites for the purpose of specialist training.

New sites applying for accreditation need to complete a site self-assessment form, which is forwarded to RANZCR. A site visit is then scheduled by the Accreditation Officer who, on completion of the visit, makes a report and recommendation to the education board. A detailed report and recommendation letter, with improvement plan if required, is then sent to the site.

The purpose of training site accreditation is to ensure that trainees will have exposure to an educationally supportive environment, where they will gain exposure to the learning opportunities that will enable them to acquire the competencies articulated in the curriculum. The RANZCR is moving towards a Training Network approach to training to facilitate this.

Further Information www.ranzcr.edu.au

AUSTRALIAN COLLEGE OF RURAL AND REMOTE MEDICINE The Australian College of Rural and Remote Medicine (ACRRM) vocational training programs in rural and remote medicine have been developed by rural doctors, for rural doctors. The programs are based on comprehensive curricula that prepare doctors to attain the full scope of knowledge, skills and attitudes required to provide quality health care to rural and remote communities.

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Training Program There are three ACRRM models/pathways for candidates training towards fellowship of ACRRM (FACRRM):

- Vocational Preparation Pathway - this pathway is suited to new graduates and is implemented through the Australian General Practice Training System;

- Remote Vocational Training Scheme - provides structured distance based learning for isolated and solo practitioners; and

- Independent Pathway - provides structured distance based learning for more experienced practitioners.

These models are underpinned by ACRRM standards, which define the learning outcomes, as well as the operating principles, policies, procedures and administrative mechanisms to ensure that ACRRM accredited training posts and providers are supported to provide quality training against ACRRM standards.

Trainee Selection Registrars completing the fellowship of ACRRM through the Australian General Practice Training (AGPT) program and the Rural Vocational Training Scheme (RVTS) are subject to the selection criteria of those organisations. The ACRRM works collaboratively with the AGPT and the RVTS to embed ACRRM’s selection principles within theirs. The ACRRM recruits registrars directly to its Independent Pathway and uses a set of selection criteria to assess them.

Trainee Assessment The ACRRM commenced its assessment process in 2008. There is no final exam in the assessment process, but rather progressive assessment, including five different assessment items, across the totality of the training program.

Successful completion of training requires:

- 12 months core clinical training in an ACRRM-accredited metropolitan, provincial or regional/rural hospital;

- 24 months primary rural and remote training in rural or remote ACRRM-accredited posts such as hospitals, Aboriginal Medical Services or community/general practice based facilities;

- 12 months advanced specialised training in ACRRM-accredited posts in one of the following disciplines: surgery, obstetrics, anaesthetics, Aboriginal and Torres Strait Islander health, emergency medicine, adult internal medicine, population health, paediatrics, mental health or remote health;

- successful completion of the college assessment program;

- completion of four modules from ACRRM’s online learning platform; and

- completion of two emergency courses.

Overseas Trained Doctors Overseas trained specialists or international medical graduates seeking entry into ACRRM’s Specialist Pathway to Fellowship must first submit their application to the AMC. ACRRM’s Specialist Pathway program initially assesses a doctor’s comparability to an Australian-trained

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Fellow of ACRRM (FACRRM) through a paper-based assessment of the documentation provided by the AMC followed by an interview with the overseas trained specialist.

The purpose of the interview is to assess the overseas trained specialist’s level of comparability and identify knowledge or experience gaps. If an overseas trained specialist is deemed substantially comparable to an Australian-trained FACRRM they will undergo a period of peer review, complete the requirements as set out in their learning plan, and undertake a Multi-Source Feedback (MSF) assessment.

If an overseas trained doctor is found partially comparable to an Australian-trained FACRRM they will undertake the same process as an overseas trained specialist deemed substantially comparable but may be required to undertake a longer period of peer review and potentially undertake further assessment such as the Mini Clinical Examination (Mini-CEX), or a Structured Assessment using Multiple Patient Scenarios (StAMPS).

On successful completion of the period of peer review and assessment the overseas trained specialist is recommended for a FACRRM.

Accreditation There are different categories of training post accreditation for different parts of ACRRM’s program. There is accreditation of posts for core clinical training, primary rural and remote training and advanced specialised training. All candidates training towards fellowship of ACRRM must be trained by accredited training providers and teachers in accredited posts. ACRRM has developed standards for accreditation of training providers, as well as standards for accreditation of training posts and teachers. Those that meet the ACRRM standards will be formally recognised and certified by ACRRM to deliver training towards FACRRM.

Further Information www.acrrm.org.au

AUSTRALASIAN COLLEGE OF SPORTS PHYSICIANS

Training Program

Basic/Foundation

Applicants for selection for advanced training are required to complete the equivalent of three years general medical and surgical experience since graduation from their undergraduate medical degree, in posts recognised by the Australasian College of Sports Physicians (ACSP). At least two of these three years must have been in full-time positions in hospitals approved by the College.

Advanced

The advanced training program is four years’ duration with a requirement that 3 years FTE are spent fully supervised at Level 1 supervision whereby the supervisor is available in the institution. The fourth year comprises continued supervised training at an accredited training post at Level 2 supervision where the supervisor is not in the institution but is on call locally.

The College’s advanced training program is conducted almost exclusively in the private practice environment.

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During advanced training, trainees acquire and demonstrate the knowledge, skills and attitudes that are outlined in the curriculum as being required for specialist clinical practice in sport and exercise medicine. The full curriculum is available on the College website at www.acsp.org.au/ acsp-training/curriculum

Trainee Selection Trainees undergo a selection process for advanced training. Although there is no quota applied, training placements are limited. Selection to advanced training requires successful completion of the College’s Part 1, basic medical sciences, examination, curriculum vitae demonstrating an interest in, and commitment to, sport and exercise medicine, satisfactory structured references and satisfactory attendance at interview. Applicants must also be eligible for permanent residency and unconditional registration in Australia or New Zealand. Applicants satisfying all these requirements will be considered for selection into advanced training.

The College conducts one selection process annually.

Trainee Assessment

Advanced Training

Trainees are required to attend six-monthly interviews throughout the period of training. In order to be accredited for the training period, trainees must provide a satisfactory six monthly progress review form prior to the scheduled meeting. The six-monthly progress review form is essentially a summary of the learning experiences of the registrar over the preceding six month period and includes reports from all supervisors.

Trainees are also required to demonstrate progress towards completion of a number of workplace based assessments including:

- Mini Clinical Evaluation Exercise (Mini-CEX);

- Direct Observation of Procedural Skills (DOPS); and

- Case based Discussion (CbD).

In addition, trainees are required to produce their learning portfolio with all required documentation in relation to their annual learning plan and progress as stipulated in the curriculum.

Trainees are also required to complete a series of post-graduate academic modules in the following subjects:

- Research Methods;

- Sports Nutrition;

- Sport Psychology;

- Sports Pharmacology; and

- Biomechanics.

Fellowship Examination

The fellowship examination is an exit examination taken after completion of all supervised training, usually in the final year of training. The examination is designed to verify the clinical competence and safety of the trainee prior to being designated as a specialist. The examination consists of six sections, a written examination comprising a multiple choice question paper and a short answer

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paper, a long case clinical examination, a short case (acute) clinical examination, a short case (overuse) clinical examination and a viva, all of which must be passed by the candidate.

Overseas Trained Specialists For those overseas trained specialists seeking fellowship of the ACSP (FACSP), the College conducts an assessment of the overseas trained specialist’s qualification in line with that recommended by the AMC. Key assessment tools are the applicant’s curriculum vitae, followed by response to any specific questions raised by the College.

Accreditation Training practices are accredited for a period of up to two years and are subject to regular site assessments by the College.

Assessments of all training practices are carried out on a regular cycle. A team of two senior fellows visits the practice and meets with staff, trainees, supervisors and other relevant personnel. The outcome is discussed by the team and reported to the Training Committee, where the decision is made. A written report, which includes both commendations and recommendations, is provided to the training practice on completion of the process.

Further Information www.acsp.org.au

ROYAL AUSTRALASIAN COLLEGE OF SURGEONS

Training Program The Royal Australasian College of Surgeons (RACS) Surgical Education and Training (SET) program requires four to seven years of specialist surgical training in one of nine specialty training areas.

Surgical training is primarily a ‘hands on’ learning experience. The training programs are similar to an apprenticeship system, with a trainee progressing through an incremental learning structure that peaks at the point of the award of Fellowship. The trainee’s hospital rotations are closely monitored by supervisors to ensure that sufficient and competent experience is obtained in specified surgical procedures.

The college’s vocational training programs are designed to provide progressive, supervised training and experience in all aspects of clinical assessment, decision making and patient management, including preoperative care, postoperative care, postoperative follow up and operating room responsibility. The trainee is expected to assume increasing responsibilities in each of these areas as he/she progresses through the program.

The training program in each specialty is designed to allow the surgical trainee to achieve competency in the domains of medical and technical expertise, clinical judgment, communication, collaboration, management and leadership, health advocacy, scholar and teacher, and professionalism, leading to competent, independent practice as a specialist surgeon.

Surgical trainees choose from the nine specialty areas described below.

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Cardiothoracic Surgery

Cardiothoracic Surgery is the medical specialty devoted to the surgical management of intrathoracic diseases and abnormalities. The Cardiothoracic surgeon may perform surgical procedures that involve the lung, heart, and/or the great vessels.

General Surgery

General surgery is the core specialty within the discipline of surgery and is the broadest. The General Surgeon is a surgical specialist engaged in the comprehensive care of surgical patients and in some situations the General Surgeon may require knowledge of the whole field of surgery. The General Surgeon is frequently the one first confronted with the acutely ill or injured person and is responsible for the early investigation of obscure surgical illness.

Neurosurgery

Neurosurgery provides for the operative and non-operative management of disorders that affect the central, peripheral and autonomic nervous system, including their supportive structures and vascular supply. This includes prevention, diagnosis, evaluation, treatment, critical care and rehabilitation as well as the operative and non-operative management of pain.

Orthopaedic Surgery

Orthopaedic Surgery is a medical specialty that focuses on the diagnosis, care and treatment of patients with disorders of the bones, joints, muscles, ligaments, tendons, nerves and skin.

Otolaryngology, Head and Neck Surgery

Otolaryngology Head and Neck surgeons investigate and treat conditions of the ear, nose, throat, and head and neck, such as nasal and sinus conditions, snoring and breathing problems, tonsillitis, cancers of the head and neck including thyroid surgery, voice problems, plastic surgery of the nose and face, hearing difficulties and deafness, and tumours of the head, neck and ears.

Paediatric Surgery

Paediatric Surgery is the specialty that includes surgeons who have specialist training in the management of children (usually up to the age of about 16 years) who have conditions that may require surgery. Specialist paediatric surgeons normally deal with non-cardiac thoracic surgery, general paediatric surgery and paediatric urology. Their responsibilities include involvement in the antenatal management of congenital structural abnormalities, neonatal surgery and oncological surgery for children.

Plastic and Reconstructive Surgery

Plastic and Reconstructive Surgery is a wide ranging specialty involving manipulation, repair and reconstruction of the skin, soft tissue and bone. Plastic surgery is a specialty not restricted to one organ or tissue type. The main emphasis is on maintaining or restoring form and function, often working in a team approach with other specialties.

Urology

Urology is the medical specialty dedicated to the treatment of men, women and children with problems involving the kidney, bladder, prostate and male reproductive organs. These conditions include cancer, stones, infection, incontinence, sexual dysfunction and pelvic floor problems.

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Urologists prescribe and administer medications and perform surgical procedures in the treatment of disease or injury.

Vascular Surgery

Vascular Surgery is a specialty of surgery in which diseases of the vascular system, or arteries and veins, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction.

Trainee Selection Trainees are selected directly into one of the nine specialty training programs. The earliest point at which application can be made for the first year of training (SET1) is during PGY2 with entry for successful trainees in PGY3.

Any person wishing to apply for selection into one or more of the surgical specialties must fulfil all of the generic eligibility criteria, plus the eligibility criteria for the specific specialty or specialties.

There are four general eligibility criteria which apply across all nine specialties. The trainee must:

- have permanent residency or citizenship status of Australia or New Zealand;

- have unconditional general registration to practise in Australia or general scope registration to practise in New Zealand;

- be willing to consent to a full criminal history check, including submission of relevant documentation on request, to enable this to be undertaken;

- have satisfied the hand hygiene module.

All generic eligibility requirements must be completed prior to the closing of registration for selection in the year of application. A detailed list of the specific eligibility criteria for each specialty is provided on the college website.

Trainee Assessment SET trainees complete rotations in approved surgical training hospitals. In addition, all trainees must complete required skills courses which may include the Australian and New Zealand Surgical Skills Education and Training (ASSET) course, the Early Management of Severe Trauma (EMST) course, and the Care of the Critically Ill Surgical Patient (CCrISP) course. Early assessment requirements include generic and specialty-specific basic sciences examinations and generic clinical examinations.

Trainees perform clinical rotations in units designated by the specialty in which they are selected as providing career aligned requirements. During training there is an increased focus on workplace competency assessment and in-training assessment. All trainees are required to achieve satisfactory performance in clinical rotation and must successfully complete the fellowship examination before being awarded fellowship of the college.

Overseas Trained Specialists The processes for assessing the suitability of overseas trained doctors for practice as surgeons in Australia are in accordance with the principles outlined in the:

- AMC application procedures and requirements for specialist assessment;

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- AMC/Committee of Presidents of Medical Colleges (CPMC)/state and territory medical boards/Australian Government Department of Health/state and territory health departments’ Assessment Process for Area of Need specialists: User’s Guide; and

- AMC/CPMC Joint Standing Committee on Overseas Trained Specialists Assessment of Overseas Trained Specialists: Template for Colleges.

The college aims to assess an overseas trained specialist (referred to by the College as an International Medical Graduate) within three months of the receipt of a complete application. Interviews are currently undertaken six times per year; in February, April, June, August, October and December.

The specialist assessment of the overseas trained specialist focuses on education, training, quality, quantity and scope of clinical experience, level of formal assessment including specialist qualifications in surgery, recency of relevant practice and relevant professional skills and attributes in order to determine substantial comparability with Australian standards. The elements of such a test of substantial comparability are that the doctor has an acceptable overseas qualification, acceptable competency according to the RACS list of competencies and acceptable recency and currency of surgical practice.

The college assesses each international medical graduate on an individual basis, scrutinising a range of documentation supplied by the doctor that covers their education, training, qualifications and surgical experience. If this assessment determines that the applicant is not comparable to an Australian or New Zealand trained surgeon, a written assessment with recommendations is made. Where the written assessment suggests comparability, an interview is scheduled with the applicant.

As a result of the new policies implemented in 2006, assessment panels may recommend a period of assessment of clinical practice by oversight or supervision and/or a requirement to sit the fellowship examination for applicants to achieve fellowship of the college. Where an applicant is deemed not comparable to an Australian or New Zealand trained surgeon, the applicant is required to complete medical registration requirements, including the AMC examinations before applying for specialist training.

Accreditation With the accreditation of hospital posts for SET, the specialties each accredit specific hospital positions according to the level of training they are able to offer a trainee.

Specialist surgical training is conducted in surgical training posts in which the trainees are supervised and mentored by appropriately qualified surgeons. Accreditation is based on 43 criteria grouped within seven standards as follows:

- Standard 1 - education facilities and systems required;

- Standard 2 - quality of education, training and learning;

- Standard 3 - surgical supervisors and staff;

- Standard 4 - support services for trainees;

- Standard 5 - clinical load and theatre sessions;

- Standard 6 - equipment and clinical support services; and

- Standard 7 - clinical governance, quality and safety.

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Hospitals that wish to host a new training post or seek reaccreditation of current posts are invited to make a submission to the college documenting how the post satisfies the minimum requirements for accreditation. Submissions are considered by the relevant specialty board for compliance and posts may be accredited on the basis of this assessment. However, the usual practice is the recommendation of an inspection visit.

Inspection teams are nominated by the specialty board and jurisdictions are invited to nominate a representative as a full member of the team. On completion of an inspection visit, the team will prepare a draft report containing the recommendation. This report is sent to the hospital for comment on factual matters. The final draft report is then prepared for review by the specialty board, which makes a recommendation on accreditation to the Board of Specialist Surgical Education and Training.

The recommendation of the Board is incorporated into the final report and the decision communicated to the hospital.

Hospital accreditation is regularly reviewed. It is recognised that facilities at different hospitals positions will vary throughout a training program and the specialties maintain a constant vigil as to the efficacy of each position.

Further Information www.surgeons.org

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Appendix C: GLOSSARY OF TERMS

University Medical Education and Training International Student

An international student is a student studying onshore in Australia as a private or sponsored student who is not an Australian or New Zealand citizen, or permanent resident.

Continuing Student

A continuing student is a student enrolled in any year of a medical program other than commencing.

Prevocational Training Postgraduate Year 1 (PGY1)

The year of supervised clinical training completed by graduates of an AMC accredited medical school and international medical graduates holding an AMC Certificate. This is also known as the intern year.

Satisfactory completion is a requirement for full medical registration.

Postgraduate Year 2 (PGY2)

The year of structured supervised clinical training placements, commenced once medical practitioners have completed their internship and gained general medical registration.

Vocational Training

Vocational Training Positions and Programs

Applicant

A medical graduate, including an international medical graduate, who applies in open competition for entry to a vocational training program. Due to variation in college training programs, an applicant may apply for a training post or training program within an accredited training hospital department or other type of accredited facility.

Successful Applicant

An applicant who has been offered and has accepted a place in a training program.

Trainee

A medical practitioner who has been accepted by a specialist medical college or General Practice Education and Training (GPET) into a position supervised by a member of the accredited specialist medical college or training provider for the purposes of completing the set vocational training program. Non-Australian trainees who are being trained overseas through an Australian medical college are not included in this category.

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Basic Training

A defined period of elementary training required by some specialist medical colleges prior to admission to an advanced training program.

Advanced Training

A period of defined and structured education and training that, when successfully completed, will result in eligibility to apply for fellowship of a specialist medical college and to practise as a specialist. In some cases this must be preceded by completion of basic training requirements.

Completion and Successful Completion

When the trainee has successfully completed all examination and clinical requirements of the training program and is eligible to apply for fellowship and to practise as a specialist.

Year of Training

The year of training currently being undertaken by a trainee in a training program, as it relates to their progression through the program.

Discontinuation

The trainee is no longer pursuing the completion of a training program, either when the trainee has officially withdrawn from the training program or when the college or training provider has terminated or dismissed a trainee in accordance with college regulations or employment conditions.

Trainees who have been given approved extended leave are excluded.

Rural or Remote Recognised Vocational Positions or Trainees

Vocational positions or trainees who are based in rural and remote areas.

Medical College Accreditation

Accreditation

The process by which a college determines whether its specified requirements for the clinical experience, infrastructure and educational support required of a hospital, other facility or training position are met.

Re-accreditation

An accreditation of a hospital, other facility or training position that has previously been accredited by the college.

Accreditation Period

The accreditation period begins when the college receives a formal request for assessment and ends when the hospital or other facility undergoing accreditation is notified of the recommendation by mail.

Appeals

Appeals include review and reconsideration processes and formal appeals.

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Medical College Examinations

Eligibility to Sit Exams

The trainee has fulfilled the eligibility criteria necessary to sit a college examination as prescribed by that college.

Trainees Sitting

The total number of trainees who sat an examination given by a college in Australia.

Pass Rate

The proportion of all trainees sitting examinations in the specified period who passed.

College Fellows

Fellow

A medical practitioner who has either completed a college training program, or has been overseas trained and exempted from assessments for admission into the college, and has been admitted to fellowship of the college.

New Fellow

A fellow who has been admitted to the specialist college in the year of data collection.

International supply International Medical Graduate

A doctor whose basic medical qualifications were acquired in a country other than Australia. Also referred to as an overseas trained doctor.

Overseas Trained Specialist

A doctor whose specialist medical qualifications were acquired in a country other than Australia.

Area of Need

An Area of Need is any location or position in which there is a lack of specific medical practitioners or where there are medical positions that remain unfilled even after recruitment efforts have taken place over a period of time. These are determined by the state and territory governments and methods of defining them vary.

Most overseas trained doctors are required to work in an Area of Need when they first come to Australia, unless they hold full Australian medical registration or have completed the standard pathway for specialist assessment or for general practice/family physician assessment.

Area of Need Applicant

An applicant for a medical position with a specific category of medical registration that requires him or her to work in an Area of Need.

Non-Area of Need Applicants

An applicant for a medical position that is not an Area of Need position.

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Area of Need and Non-Area of Need Assessment Period

The assessment period begins when the college receives an application, with all accompanying documentation including payment, for recognition of specialist qualifications and ends when the applicant is notified of the recommendation by mail.

Applicants may also be assessed by a variety of other parties outside of college processes, including the AMC, Commonwealth and employers. The time taken for these is not included in data reported.

Assessment Outcome

The outcome of a college’s consideration of an application from an international medical graduate for recognition of his or her specialist qualifications or assessment of his or her skills against Area of Need position requirements.

District of Workforce Shortage

A District of Workforce Shortage (DWS) is a geographic area in which the general population need for health care is not met. Population needs for health care are deemed to be unmet if a district has less access to Medicare services than the national average.

Remoteness Area

The Remoteness Area (RA) Structure within the Australian Bureau of Statistics (ABS) Standard Geographical Classification (ASGC) is produced by ABS.

RAs are based on the Accessibility/Remoteness Index of Australia (ARIA), where the remoteness index value of a point is based on the physical road distance to the nearest town or service in each of six population size classes based on the 2006 Census of Population and Housing. These classes are:

- Major cities;

- Inner regional areas;

- Outer regional areas;

- Remote areas;

- Very remote areas; and

- Migratory.

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Appendix D: EXTENDED DATA TREND TABLES Table D1: Commencing medical students: Domestic, international and proportion of females, 2000-2014

Table D2: Commencing medical students by university and state/territory, 2005-2014

Table D3: Commencing domestic medical students by university and state/territory, 2005-2014

Table D4: Commencing international medical students by university and state/territory, 2005-2014

Table D5: Medical students in Australian universities, 2000-2014

Table D6: Medical students: Domestic, international and total by state/territory, 2005-2014

Table D7: Domestic medical school graduates from Australian universities, 1997-2013

Table D8: Medical graduates: Domestic, international and proportion of domestic, international and females, 1999-2013

Table D9: Medical graduates: Domestic, international and total by state/territory, 2004-2013

Table D10: Postgraduate year 1: Commencing trainees or supervised training places by state/territory, 2004-2014

Table D11: Postgraduate year 2: Commencing doctors by state/territory, 2004-2014

Table D12: Basic training positions/trainees by medical specialty, 2000-2014

Table D13: Basic training positions/trainees by state/territory, 2000-2014

Table D14: Basic training first-year positions/trainees by medical specialty, 2000-2014

Table D15: Basic training first-year positions/trainees by state/territory, 2000-2014

Table D16: Basic trainees: Proportion of females by medical specialty, 2000-2014

Table D17: Basic trainees: Proportion of females by state/territory, 2000-2014

Table D18: Vocational training positions/trainees: Total, basic, female basic and first-year basic trainees, 2000-2014

Table D19: Advanced training positions/trainees by medical specialty, 1997-2014

Table D20: Advanced training positions/trainees by state/territory, 1997-2014

Table D21: Advanced training first-year positions/trainees by medical specialty, 1997-2014

Table D22: Advanced training first-year positions/trainees by state/territory, 1997-2014

Table D23: Advanced trainees: Proportion of females by medical specialty, 1997-2014

Table D24: Advanced trainees: Proportion of females by state/territory, 1997-2014

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Table D25: Vocational training positions/trainees: Total, advanced, female advanced and part-time advanced trainees, 1997-2014

Table D26: New fellows by medical specialty, 2000-2013

Table D27: New fellows by state/territory, 2000-2013

Table D28: New female fellows by state/territory, 2000-2013

Table D29: New fellows: Proportion of females by medical specialty, 2000-2013

Table D30: New fellows: Proportion of females by state/territory, 2000-2013

Table D31: Fellows by medical speciality 2008-2013

Table D32: Fellows by state/territory, 2008-2013

Table D33: Female fellows by state/territory, 2008-2013

Table D34: Fellows: Proportion of females by medical specialty, 2008-2013

Table D35: Fellows: Proportion of females by state/territory, 2008-2013

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2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

(a)

Change

2000-2014 (%)

Domestic

1,361

1,471

1,470

1,511

1,699

1,871

2,071

2,560

2,934

2,955

2,940

3,241

3,035

3,033

3,185

134.0

Proportion female (%)

52.9

54.4

55.3

55.8

57.3

55.2

55.1

54.4

54.0

54.8

52.9

50.9

48.1

51.2

52.3

..

Annual change (%)

..

8.1

-0.1

2.8

12.4

10.1

10.7

23.6

14.6

0.7

-0.5

10.2

-6.4

-0.1

5.0

..

International

299

309

367

378

421

460

426

436

499

487

529

529

651

636

552

84.6

Proportion female (%)

na

53.1

50.4

48.7

51.1

57.2

53.1

49.8

50.9

47.0

42.5

47.6

47.5

45.6

50.4

..

Annual change (%)

..

3.3

18.8

3.0

11.4

9.3

-7.4

2.3

14.4

-2.4

8.6

0.0

23.1

-2.3

-13.2

..

Total

1,660

1,780

1,837

1,889

2,120

2,331

2,497

2,996

3,433

3,442

3,469

3,770

3,686

3,669

3,737

125.1

Annual change (%)

..

7.2

3.2

2.8

12.2

10.0

7.1

20.0

14.6

0.3

0.8

8.7

-2.2

-0.5

1.9

..

(a) Figures for 2014 exclude all offshore programs including UQ Ochsner and Monash Malaysia. Source: Medical Deans Australia and New Zealand Inc Table D1: Commencing medical students: Domestic, international and proportion of females, 2000-2014

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2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

(a)

New South Wales

Newcastle/UNE

..

0

113

193

196

223

198

204

218

194

Notre Dame Sydney

..

0

..

111

113

108

113

115

121

120

Sydney

..

0

264

267

299

276

327

302

310

298

UNSW

242

257

275

274

277

283

275

263

273

295

UWS

..

..

104

120

133

130

122

126

120

127

Wollongong

..

..

79

82

86

84

85

85

85

85

Total NSW

242

257

835

1,047

1,104

1,104

1,120

1,095

1,127

1,119

Victoria

Deakin

..

..

..

120

136

141

132

139

136

134

Melbourne PG

..

..

93

79

85

..

..

0

0

0

Melbourne UG

227

298

230

248

..

..

0

0

0

0

Melbourne MD

..

..

..

na

..

..

331

328

330

347

Monash PG

..

..

..

na

73

78

89

87

82

81

Monash UG

251

272

313

293

301

306

305

316

321

310

Total VIC

478

570

636

740

595

525

857

870

869

872

Queensland

Bond

..

0

85

90

91

92

87

95

96

94

Griffith

..

0

150

149

156

156

154

154

158

153

Queensland

..

0

374

402

429

483

447

444

421

413

UQ Ochsner (USA) Cohort

..

..

..

..

..

..

..

83

105

..

James Cook

99

99

112

174

180

209

195

192

235

214

Total QLD

99

99

721

815

856

940

883

968

1,015

874

Table D2: Commencing medical students by university and state/territory, 2005-2014

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2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

(a)

Western Australia

Notre Dame Fremantle

..

0

100

105

109

104

102

106

111

113

UWA MD

..

..

..

..

..

..

..

..

..

233

UWA PG

..

..

..

59

64

63

65

69

0

0

UWA UG

174

188

199

147

173

173

171

0

0

0

Total WA

174

188

299

311

346

340

338

175

111

346

South Australia

Adelaide

138

133

170

177

179

201

190

208

159

150

Flinders

..

0

123

136

144

136

167

166

168

166

Total SA

138

133

293

313

323

337

357

374

327

316

Tasmania

Tasmania

62

64

127

125

124

127

121

116

120

117

Australian Capital Territory

ANU

..

0

85

82

94

96

94

88

100

93

Total

1,193

1,311

2,996

3,433

3,442

3,469

3,770

3,686

3,669

3,737

UG - undergraduate PG - postgraduate MD - Doctor of Medicine (a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia. Source: Medical Deans Australia and New Zealand Inc

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2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

New South Wales

Newcastle/UNE

..

..

92

167

172

195

179

183

192

173

Notre Dame Sydney

..

..

..

111

113

108

113

115

121

120

Sydney

..

..

226

226

251

223

261

223

232

229

UNSW

186

211

214

208

210

215

206

199

214

214

UWS

..

..

104

115

118

109

104

103

103

108

Wollongong

..

..

72

71

74

74

78

75

76

80

Total NSW

186

211

708

898

938

924

941

898

938

924

Victoria

Deakin

..

..

..

120

134

134

131

130

131

129

Melbourne PG

..

..

84

74

79

..

..

0

0

0

Melbourne UG

147

220

157

172

..

..

..

0

0

0

Melbourne MD

..

..

..

..

..

..

305

290

294

302

Monash PG

..

..

..

..

67

70

67

77

75

76

Monash UG

176

187

238

227

247

251

249

253

263

242

Total VIC

323

407

479

593

527

455

752

750

763

749

Queensland

Bond

..

..

85

85

83

88

85

95

95

94

Griffith

..

..

150

149

156

156

154

154

152

150

Queensland

..

..

320

302

306

318

305

302

308

306

James Cook

95

93

106

169

162

182

182

166

201

182

Total QLD

95

93

661

705

707

744

726

717

756

732

Table D3: Commencing domestic medical students by university and state/territory, 2005-2014

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2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Western Australia

Notre Dame Fremantle

..

..

100

105

109

104

102

106

111

113

UWA MD

..

..

..

..

..

..

..

..

..

210

UWA PG

..

..

..

59

64

63

65

60

0

0

UWA UG

148

169

174

119

145

146

146

0

0

0

Total WA

148

169

274

283

318

313

313

166

111

323

South Australia

Adelaide

102

117

146

157

155

185

175

178

124

116

Flinders

..

..

105

116

125

122

142

147

143

152

Total SA

102

117

251

273

280

307

317

325

267

268

Tasmania

Tasmania

55

55

106

106

99

103

100

94

100

99

Australian Capital Territory

ANU

..

..

81

76

86

94

92

85

98

90

Total

909

1,052

2,560

2,934

2,955

2,940

3,241

3,035

3,033

3,185

UG - undergraduate PG - postgraduate MD - Doctor of Medicine Source: Medical Deans Australia and New Zealand Inc

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2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

(a)

New South Wales

Newcastle/UNE

..

0

21

26

24

28

19

21

26

21

Notre Dame Sydney

..

0

0

0

0

0

0

0

0

0

Sydney

..

0

38

41

48

53

66

79

78

69

UNSW

56

46

61

66

67

68

69

64

59

81

UWS

..

0

0

5

15

21

18

23

17

19

Wollongong

..

0

7

11

12

10

7

10

9

5

Total NSW

56

46

127

149

166

180

179

197

189

195

Victoria

Deakin

..

0

0

0

2

7

1

9

5

5

Melbourne PG

..

..

9

5

6

..

0

0

0

0

Melbourne UG

80

78

73

76

0

..

0

0

0

0

Melbourne MD

..

..

..

..

..

..

26

38

36

45

Monash PG

0

0

0

0

6

8

22

10

7

5

Monash UG

75

85

75

66

54

55

56

63

58

68

Total VIC

155

163

157

147

68

70

105

120

106

123

Queensland

Bond

..

0

0

5

8

4

2

0

1

0

Griffith

..

0

0

0

0

0

0

0

6

3

Queensland

..

0

54

100

123

165

142

142

113

107

UQ Ochsner (USA)

..

..

..

..

..

..

..

83

105

..

James Cook

4

6

6

5

18

27

13

26

34

32

Total QLD

4

6

60

110

149

196

157

251

259

142

Table D4: Commencing international medical students by university and state/territory, 2005-2014

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MTRP 18th Report

 

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

(a)

Western Australia

Notre Dame Fremantle

..

0

0

0

0

0

0

0

0

0

UWA MD

..

..

..

..

..

..

..

..

0

23

UWA PG

..

0

0

0

0

0

0

9

0

0

UWA UG

26

19

25

28

28

27

25

0

0

0

Total WA

26

19

25

28

28

27

25

9

0

23

South Australia

Adelaide

36

16

24

20

24

16

15

30

35

34

Flinders

..

0

18

20

19

14

25

19

25

14

Total SA

36

16

42

40

43

30

40

49

60

48

Tasmania

Tasmania

7

9

21

19

25

24

21

22

20

18

Australian Capital Territory

ANU

..

0

4

6

8

2

2

3

2

3

Total

284

259

436

499

487

529

529

651

636

552

UG - undergraduate PG - postgraduate MD - Doctor of Medicine (a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia. Source: Medical Deans Australia and New Zealand Inc

216

MTRP 18th Report

 

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

(a)

Increase

2000-2014

(%)

Domestic

6,617

6,803

6,962

7,108

7,484

8,026

8,768

9,796

11,028

12,097

12,946

13,956

14,177

14,267

14,384

117.4

Proportion female (%)

49.5

50.9

52.6

54.0

48.3

55.2

55.7

55.8

55.3

54.6

54.2

53.0

51.5

51.2

51.3

..

Annual increase (%)

..

2.8

2.3

2.1

5.3

7.2

9.2

11.7

12.6

9.7

7.0

7.8

1.6

0.6

0.8

..

International

1,129

1,192

1,386

1,573

1,749

1,909

2,081

2,153

2,309

2,424

2,451

2,535

2,691

2,727

2,453

117.3

Proportion female (%)

na

46.6

49.4

49.3

34.3

53.4

53.9

52.3

52.5

51.4

50.1

49.1

48.7

47.3

48.8

..

Annual increase (%)

..

5.6

16.3

13.5

11.2

9.1

9.0

3.5

7.2

5.0

1.1

3.4

6.2

1.3

-10.0

..

Total

7,746

7,995

8,348

8,681

9,233

9,935

10,849

11,949

13,337

14,521

15,397

16,491

16,868

16,994

16,837

117.4

Annual change (%)

..

3.2

4.4

4.0

6.4

7.6

9.2

10.1

11.6

8.9

6.0

7.1

2.3

0.7

-0.9

..

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia. Source: Medical Deans Australia and New Zealand Inc Table D5: Medical students in Australian universities, 2000-2014

217

MTRP 18th Report

Year

 

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2005

Domestic

2,257

1,891

1,610

872

860

371

..

165

8,026

 

International

495

801

117

335

60

90

..

11

1,909

 

2005 Total

2,752

2,692

1,727

1,207

920

461

..

176

9,935

2006

Domestic

2,308

2,147

1,876

895

938

364

..

240

8,768

 

International

532

888

168

316

84

82

..

11

2,081

 

2006 Total

2,840

3,035

2,044

1,211

1,022

446

..

251

10,849

2007

Domestic

2,573

2,060

2,253

945

1,229

406

..

330

9,796

 

International

562

863

213

307

102

90

..

16

2,153

 

2007 Total

3,135

2,923

2,466

1,252

1,331

496

..

346

11,949

2008

Domestic

3,004

2,326

2,540

1,059

1,351

422

..

326

11,028

 

International

599

888

323

270

114

94

..

21

2,309

 

2008 Total

3,603

3,214

2,863

1,329

1,465

516

..

347

13,337

2009

Domestic

3,414

2,523

2,830

1,124

1,433

452

..

321

12,097

 

International

661

822

419

247

145

106

..

24

2,424

 

2009 Total

4,075

3,345

3,249

1,371

1,578

558

..

345

14,521

2010

Domestic

3,870

2,606

2,957

1,243

1,461

471

..

338

12,946

 

International

700

724

530

219

157

104

..

17

2,451

 

2010 Total

4,570

3,330

3,487

1,462

1,618

575

..

355

15,397

2011

Domestic

4,231

2,993

3,068

1,324

1,518

472

..

350

13,956

 

International

774

638

628

210

155

113

..

17

2,535

 

2011 Total

5,005

3,631

3,696

1,534

1,673

585

..

367

16,491

Table D6: Medical students: Domestic, international and total by state/territory, 2005-2014

218

MTRP 18th Report

Year

 

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2012

Domestic

4,331

3,091

3,151

1,398

1,363

487

..

356

14,177

 

International

847

578

774

225

147

98

..

22

2,691

 

2012 Total

5,178

3,669

3,925

1,623

1,510

585

..

378

16,868

2013

Domestic

4,412

3,200

3,266

1,393

1,174

467

..

355

14,267

 

International

871

518

858

233

122

103

..

22

2,727

 

2013 Total

5,283

3,718

4,124

1,626

1,296

570

..

377

16,994

2014

(a)

Domestic

4,439

3,214

3,313

1,404

1,208

450

..

356

14,384

 

International

894

466

606

244

123

112

..

8

2,453

 

2014 Total

5,333

3,680

3,919

1,648

1,331

562

..

364

16,837

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia. Source: Medical Deans Australia and New Zealand Inc

219

MTRP 18th Report

University

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

Adelaide

96

93

103

98

90

84

81

94

85

92

85

98

83

94

97

111

127

ANU

..

..

..

..

..

..

..

..

..

..

71

90

72

83

75

87

85

Bond

..

..

..

..

..

..

..

..

..

..

..

..

55

74

81

69

85

Deakin

..

..

..

..

..

..

..

..

..

..

..

..

..

..

109

123

136

Flinders

72

56

56

54

54

58

56

67

62

66

77

75

74

102

109

113

111

Griffith

..

..

..

..

..

..

..

..

..

..

..

70

116

151

133

150

144

James Cook

..

..

..

..

..

..

..

..

58

74

65

66

82

94

88

92

136

Melbourne

161

168

184

190

193

174

206

179

178

211

186

199

198

212

234

231

240

Monash

131

131

132

125

129

150

145

144

143

123

137

159

165

181

219

290

297

Newcastle

56

62

65

60

65

65

59

65

59

61

67

77

85

104

70

140

147

Notre Dame Fremantle

..

..

..

..

..

..

..

..

..

..

..

75

80

86

98

104

114

Notre Dame Sydney

..

..

..

..

..

..

..

..

..

..

..

..

..

..

103

106

107

Queensland

219

211

224

191

220

220

215

225

218

215

284

238

279

332

290

307

314

Sydney

197

205

201

137

119

185

188

190

176

147

202

208

208

221

222

237

231

Tasmania

52

42

45

56

54

53

45

55

46

62

58

64

73

89

67

97

104

UNSW

156

134

145

157

158

165

159

163

188

166

186

177

163

166

187

198

203

UWA

104

117

101

127

121

110

112

105

107

118

126

142

182

207

172

165

183

UWS

..

..

..

..

..

..

..

..

..

..

..

..

..

..

86

91

108

Wollongong

..

..

..

..

..

..

..

..

..

..

..

..

..

63

67

66

72

Total

1,244

1,219

1,256

1,195

1,203

1,264

1,266

1,287

1,320

1,335

1,544

1,738

1,915

2,259

2,507

2,777

2,944

Source: Medical Deans Australia and New Zealand Inc Table D7: Domestic medical school graduates from Australian universities, 1997-2013

220

MTRP 18th Report

 

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

(a)

Domestic

1,256

1,195

1,203

1,264

1,266

1,287

1,320

1,335

1,544

1,738

1,915

2,259

2,507

2,777

2,944

Proportion domestic (%)

89.7

88.7

91.4

88.7

86.2

85.6

83.2

81.8

83.0

81.3

80.5

82.7

84.6

84.6

85.6

Proportion female (%)

na

na

na

na

na

na

na

na

56.2

57.2

54.1

54.1

55.0

53.2

52.8

International

144

152

113

161

203

216

267

298

316

401

465

474

457

507

497

Proportion international (%)

10.3

11.3

8.6

11.3

13.8

14.4

16.8

18.2

17.0

18.7

19.5

17.3

15.4

15.4

14.4

Proportion female (%)

na

na

na

na

na

na

na

na

52.5

54.6

51.6

54.2

51.6

52.9

49.1

Total

1,400

1,347

1,316

1,425

1,469

1,503

1,587

1,633

1,860

2,139

2,380

2,733

2,964

3,284

3,441

Annual change (%)

..

-3.8

-2.3

8.3

3.1

2.3

5.6

2.9

13.9

15

11.3

14.8

8.5

10.8

4.8

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia. Source: Medical Deans Australia and New Zealand Inc Table D8: Medical graduates: Domestic, international and proportion of domestic, international and females, 1999-2013

221

MTRP 18th Report

 Year

 

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2004

Domestic

418

323

225

161

105

55

..

..

1,287

 

International

69

80

4

53

2

8

..

..

216

 

2004 Total

487

403

229

214

107

63

..

..

1,503

2005

Domestic

423

321

276

147

107

46

..

..

1,320

 

International

79

111

8

57

2

10

..

..

267

 

2005 Total

502

432

284

204

109

56

..

..

1,587

2006

Domestic

374

334

289

158

118

62

..

..

1,335

 

International

81

126

10

62

7

12

..

..

298

 

2006 Total

455

460

299

220

125

74

..

..

1,633

2007

Domestic

455

323

349

162

126

58

..

71

1,544

 

International

85

124

21

68

4

13

 ..

1

316

 

2007 Total

540

447

370

230

130

71

..

72

1,860

2008

Domestic

462

358

374

173

217

64

..

90

1,738

 

International

112

140

51

70

10

14

 ..

4

401

 

2008 Total

574

498

425

243

227

78

..

94

2,139

2009

Domestic

456

363

532

157

262

73

..

72

1,915

 

International

111

171

75

66

15

21

..

6

465

 

2009 Total

567

534

607

223

277

94

..

78

2,380

2010

Domestic

554

393

651

293

196

89

..

83

2,259

 

International

115

184

81

25

54

11

..

4

474

 

2010 Total

669

577

732

318

250

100

..

87

2,733

Table D9: Medical graduates: Domestic, international and total by state/territory, 2004-2013

222

MTRP 18th Report

 Year

 

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2011

Domestic

735

562

592

206

270

67

..

75

2,507

 

International

98

159

101

40

27

28

..

4

457

 

2011 Total

833

721

693

246

297

95

..

79

2,964

2012

Domestic

838

644

618

224

269

97

0

87

2,777

 

International

133

151

134

43

21

16

0

9

507

 

2012 Total

971

795

752

267

290

113

..

96

3,284

2013

(a)

Domestic

868

673

679

238

297

104

..

85

2,944

 

International

144

152

118

35

28

12

..

8

497

 

2013 Total

1012

825

797

273

325

116

..

93

3,441

(a) Excludes all offshore programs, including UQ Ochsner and Monash Malaysia. Source: Medical Deans Australia and New Zealand Inc

223

MTRP 18th Report

 

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

New South Wales/Australian Capital Territory

554

566

628

(b) 533

688

..

..

..

..

..

..

New South Wales

..

..

..

..

..

668

657

(e) 756

(f) 849

(h) 923

(i) 957

Australian Capital Territory

..

..

..

..

..

62

62

78

88

93

96

Victoria

371

397

406

447

454

506

557

625

698

707

(j) 753

Queensland

246

280

323

357

411

444

558

644

(g) 663

678

695

South Australia

155

171

183

213

227

(d) 246

230

247

256

276

278

Western Australia

136

132

137

155

175

228

240

267

282

300

312

Tasmania

49

52

71

(c) 56

51

62

58

71

73

75

76

Northern Territory

20

24

23

15

24

27

32

35

41

44

44

Commonwealth funded

(a)

..

..

..

..

..

..

..

..

..

22

76

Australia

1,531

1,622

1,771

1,776

2,030

2,243

2,394

2,723

2,950

3,118

3,287

(a) Includes PGY1 positions funded by the Commonwealth Government under the Additional Medical Internships Initiative 2013 and Commonwealth Medical Internships Initiative 2014. (b) January allocation only, previous years include mid-year allocation. (c) Actual allocation figures are not available. Figures based on number of offers made. (d) South Australia has 233 accredited positions, plus 17 interns carried over from 2008 and 8 of these share 4 full time positions. (e) Total number of intern positions available for 2011 was 770. (f) Total number of intern positions available for 2012 was 850. (g) Approximate numbers only based on acceptances registered in eRecruitment system. (h) Total number of intern positions available for 2013 was 927. (i) Total number of intern positions available for 2014 was 959. (j) Includes 10 graduates of an Australian Medical Council Accredited Overseas University (Monash Malaysia). Source: Australian Government Department of Health and state and territory government health departments Table D10: Postgraduate year 1: Commencing trainees or supervised training places by state/territory, 2004-2014

224

MTRP 18th Report

 

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

New South Wales/Australian Capital Territory

394

416

414

449

..

..

..

..

..

..

..

New South Wales

..

..

..

..

na

640

686

617

803

881

912

Australian Capital Territory

..

..

..

..

36

40

62

58

73

64

85

Victoria

(a)

436

412

432

477

467

540

543

(f) 585

(i) 644

(k) 742

(m) 742

Queensland

na

337

na

284

(c) 441

(d) 458

474

(g) 575

(g) 734

683

671

South Australia

124

134

172

220

161

(e) 300

183

(h) 189

(j) 244

(j) 356

238

Western Australia

190

145

172

96

224

276

241

330

469

(l) 308

333

Tasmania

54

68

88

(b) 28

49

107

79

103

87

104

71

Northern Territory

18

24

24

32

44

44

45

64

47

56

55

Australia

1,216

1,536

1,302

1,586

1,422

2,405

2,313

2,521

3,101

3,194

3,107

(a) Victoria does not collect data regarding the fee status of domestic students studying in Victoria or interstate. Also these numbers are an underestimate as not all PGY2 posts are included in the postgraduate medical council computer match. (b) Actual allocation is not available. Figures based on number of offers made. (c) Figure based on number of offers made. (d) Commencement data are based upon the total number of declined job offers registered in the eRecruitment system. (e) Approximate number only. Postgraduate Medical Council of SA was in its first year of managing TMO recruitment. (f) A total of 667 Hospital medical officer 2 positions were included in the computer matching process and 644 positions were matched. Of these 644 matched positions, 18 candidates declined their Victorian offer. All Hospital medical officer positions (i.e. 667) were filled either from candidates who participated in the Match (and were unmatched) or via direct recruitment of a health service. This figure is based on incomplete data and only reflects the number of PGY2 positions advised by health services to include in the Victorian Hospital medical officer match. Health services are able to exempt positions from the matching process, so the number is an underestimate.

(g) Commencement data are approximate and based upon the total number of acceptances registered in the eRecruitment system. (h) Includes only the number of PGY2 commencing who completed internship in SA. (i) A total of 667 Hospital medical officer 2 positions were included in the computer matching process and 644 positions were matched. Of the 644 matched positions, 18 candidates declined their Victorian offer. All Hospital medical officer positions (i.e. 667) were filled either from candidates who participated in the Match (and were unmatched) or via direct recruitment of a health service. (j) Data based on the total number of positions made to PGY2 doctors via the SA MET centralised process. Additional employment could occur outside of this process. Data are not available. (k) A total of 708 Hospital medical officer 2 positions were included in the Hospital medical officer Computer Match and of these, 689 positions were matched. From the 689 matched candidates 17 subsequently declined their offer. A further 36 candidates were offered and accepted a Hospital medical officer 2 position. A further 34 positions were directly recruited by health services.

(l) New data checking processing has enabled cleaner data and ensured the capture of PGY2 doctors only. (m) This figure only reflects the number of PGY2 positions advised by health services to include the Victorian hospital medical offer match. Health services exempted at least 37 positions from the match, so the number is underestimated. Source: State and territory government health departments Table D11: Postgraduate year 2: Commencing doctors by state/territory, 2004-2014

225

MTRP 18th Report

Medical specialty

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Adult medicine

487

585

765

626

784

726

809

967

1,609

1,666

1,893

1,951

2,197

2,475

2,699

Anaesthesia

..

..

..

..

324

318

318

360

410

509

504

617

615

555

543

Dermatology

..

..

..

..

..

..

..

38

41

39

42

44

42

46

45

Emergency medicine

21

165

183

214

244

231

292

320

319

732

803

785

821

727

756

General practice - ACRRM

..

..

..

..

..

..

..

..

..

..

50

141

..

..

..

Intensive care

..

..

..

 

..

..

..

125

114

82

167

152

192

199

208

Obstetrics and gynaecology

..

..

..

..

..

..

..

na

277

301

295

330

354

356

376

Ophthalmology

..

..

..

..

22

48

52

50

51

53

55

53

55

53

54

Paediatrics

155

199

240

143

259

199

173

190

436

459

554

530

664

812

818

Psychiatry

..

..

..

..

..

638

602

610

623

661

677

661

804

833

868

Rehabilitation medicine

18

..

..

..

..

..

..

..

..

..

..

..

..

..

..

Surgery

901

225

151

164

168

493

557

607

207

..

..

..

..

..

..

Total

1,582

1,174

1,339

1,147

1,801

2,653

2,803

3,267

4,087

4,502

5,040

5,264

5,744

6,056

6,367

Source: Medical colleges Table D12: Basic training positions/trainees by medical speciality, 2000-2014

226

MTRP 18th Report

Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2000

551

420

254

154

142

32

4

25

1,582

2001

376

336

180

125

92

28

12

25

1,174

2002

432

408

212

100

114

32

13

28

1,339

2003

360

357

188

95

86

27

9

25

1,147

2004

596

496

306

137

152

51

22

41

1,801

2005

869

761

453

209

232

54

18

57

2,653

2006

930

782

543

196

214

55

27

56

2,803

2007

1,162

988

831

375

409

238

188

225

3,267

2008

1,262

1,078

870

309

352

93

45

78

4,087

2009

1,336

1,155

1,034

369

372

92

43

96

4,502

2010

1,492

1,275

1,148

424

437

106

53

105

5,040

2011

1,508

1,388

1,189

419

481

130

42

107

5,264

2012

1,607

1,548

1,285

478

537

134

46

109

5,744

2013

1,710

1,603

1,382

469

583

132

53

124

6,056

2014

1,824

1,650

1,414

476

644

146

66

147

6,367

Change 2000-2014 (%)

231.0

292.9

456.7

209.1

353.5

356.3

1550.0

488.0

302.5

Source: Medical colleges Table D13: Basic training positions/trainees by state/territory, 2000-2014

227

MTRP 18th Report

Medical specialty

2000

2001

(b)

2002

(b)

2003

(b)

2004

(b)

2005

(b)

2006

(b)

2007

2008

2009

2010

2011

2012

2013

2014

Adult medicine

na

177

247

na

207

253

262

202

336

436

522

583

610

585

662

Anaesthesia

na

..

..

na

..

162

159

195

197

169

240

321

314

215

201

Dermatology

na

..

..

na

..

..

..

16

23

18

23

20

26

22

26

Emergency medicine

na

..

..

na

..

na

na

54

9

..

..

..

240

241

277

Intensive care

na

..

..

na

..

..

..

14

7

2

11

7

9

28

5

Obstetrics and gynaecology

na

..

..

na

..

..

..

..

81

81

77

87

83

89

88

Ophthalmology

na

..

..

na

..

25

30

24

24

27

25

26

28

25

23

Paediatrics

na

52

57

na

33

49

66

23

67

114

123

142

181

151

168

Psychiatry

na

..

..

na

..

..

124

90

109

118

223

239

314

313

(c) 216

Surgery

(a)

na

..

164

na

168

195

220

234

1

..

..

..

..

..

..

Total

na

229

468

na

408

684

861

852

854

965

1,244

1,425

1,805

1,669

1,666

(a) With the introduction of the SET program in 2008, which does not distinguish between basic and advanced trainees, all trainees are reported under advanced training. (b) Estimated number of positions that were likely to be available in this particular year. (c) Includes Stage 1 trainees that started in 2014 and existing trainees in Stage 1. Source: Medical colleges Table D14: Basic training first-year positions/trainees by medical speciality, 2000-2014

228

MTRP 18th Report

Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2000

na

na

na

na

na

na

na

na

na

2001

62

74

42

30

11

2

3

5

229

2002

164

146

49

41

37

12

6

13

468

2003

na

na

na

na

na

na

na

na

na

2004

137

123

45

36

38

11

5

13

408

2005

230

188

119

54

50

16

10

17

684

2006

260

245

150

61

74

12

12

17

861

2007

215

240

233

55

65

25

6

13

852

2008

214

250

196

71

70

25

11

17

854

2009

257

286

210

90

78

20

4

20

965

2010

350

341

267

124

100

22

16

24

1,244

2011

387

410

298

124

130

39

15

22

1,425

2012

407

545

420

146

190

50

17

30

1,805

2013

397

494

402

132

154

38

15

37

1,669

2014

391

505

397

122

153

47

15

36

1,666

(a) Covers basic training in anaesthesia from 2004, dermatology from 2007, general practice (ACRRM) from 2010, intensive care from 2007, obstetrics and gynaecology from 2008, ophthalmology from 2004, psychiatry from 2005, rehabilitation medicine for 2000 and surgery up to 2008. Source: Medical colleges Table D15: Basic training first-year

(a) positions/trainees by state/territory, 2000-2014

229

MTRP 18th Report

Medical specialty

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Adult medicine

42.5

44.4

41.6

41.1

43.1

42.6

60.8

41.0

44.8

47.4

49.9

48.9

49.5

49.2

Anaesthesia

..

..

..

..

16.0

18.2

18.2

38.9

40.0

33.2

45.0

45.9

46.0

45.8

44.2

Dermatology

..

..

..

..

..

..

..

63.2

73.2

64.1

64.3

63.6

45.2

56.5

66.7

Emergency medicine

38.1

44.8

38.3

40.7

43.0

42.4

46.2

45.9

46.7

38.4

38.2

39.4

42.4

42.9

45.4

Intensive care

..

..

..

..

..

..

..

24.8

28.1

31.7

33.5

24.3

32.3

40.2

40.4

Obstetrics and gynaecology

..

..

..

..

..

..

..

..

63.2

65.1

69.8

77.6

79.4

80.6

81.6

Ophthalmology

..

..

..

..

45.5

35.4

26.9

34.0

33.3

35.8

40.0

43.4

41.8

34.0

35.2

Paediatrics

61.9

58.3

58.3

61.5

62.9

66.8

72.8

0

66.7

66.4

67.9

70.6

72.7

71.4

72.9

Psychiatry

..

..

..

..

..

52.2

53.3

54.3

50.6

55.2

54.1

55.4

48.3

54.5

56.1

Surgery

14.8

27.1

24.5

22.0

24.4

21.5

23.5

25.5

22.2

..

..

..

..

..

..

Total (%)

28.9

43.5

42.0

40.8

40.4

39.9

40.3

56.1

46.0

47.4

49.6

50.8

51.6

53.4

53.9

Total female trainees

457

511

562

468

727

1,058

1,130

1,834

1,878

2,133

2,498

2,672

2,962

3,235

3,433

Source: Medical colleges Table D16: Basic trainees: Proportion of females by medical speciality, 2000-2014

230

MTRP 18th Report

Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2000

29.6

28.8

33.9

29.2

23.9

9.4

25.0

16.0

28.9

2001

45.5

39.0

51.1

42.4

43.5

35.7

33.3

40.0

43.5

2002

44.4

40.4

42.5

40.0

39.5

43.8

38.5

39.3

42.0

2003

41.1

40.9

45.2

37.9

37.2

29.6

44.4

36.0

40.8

2004

37.7

45.4

38.6

38.7

42.1

39.2

45.0

35.0

40.4

2005

39.1

44.4

36.2

40.2

38.8

25.9

38.9

36.8

39.9

2006

39.6

42.8

36.6

44.4

39.7

34.5

48.1

42.9

40.3

2007

51.2

54.7

40.7

35.7

34.2

11.8

4.8

20.0

56.1

2008

49.1

50.0

40.5

42.4

42.0

32.3

37.8

52.6

46.0

2009

48.6

53.4

41.2

46.9

46.0

27.2

55.8

47.9

47.4

2010

51.3

56.0

42.0

50.0

49.7

29.2

41.5

51.4

49.6

2011

52.2

56.5

44.5

48.2

49.5

40.8

52.4

53.3

50.8

2012

51.9

55.6

46.9

51.5

52.0

44.0

52.2

51.4

51.6

2013

53.6

57.0

48.8

53.9

53.9

45.5

58.5

58.9

53.4

2014

53.3

56.3

49.9

57.4

53.6

54.1

63.6

59.2

53.9

Source: Medical colleges Table D17: Basic trainees: Proportion of females by state/territory, 2000-2014

231

MTRP 18th Report

Year

Training

positions/trainees

Basic training

positions/trainees

Proportion basic positions/trainees

(%)

Female basic

trainees

Proportion female basic trainees (%)

First-year basic

trainees

Proportion

first-year basic trainees (%)

2000

7,262

1,582

21.8

457

28.9

na

na

2001

6,835

1,174

17.2

511

43.5

229

19.5

2002

7,213

1,339

18.6

562

42.0

468

35.0

2003

7,273

1,147

15.8

468

40.8

na

..

2004

8,188

1,801

22.0

727

40.4

408

22.7

2005

8,710

2,653

30.5

1,058

39.9

684

25.8

2006

9,317

2,803

30.1

1,130

40.3

861

30.7

2007

11,249

3,267

29.0

1,834

56.1

852

26.1

2008

11,668

4,087

35.0

1,878

46.0

854

20.9

2009

12,958

4,502

34.7

2,133

47.4

965

21.4

2010

14,679

5,040

34.3

2,498

49.6

1,244

24.7

2011

15,478

5,264

34.0

2,672

50.8

1,425

27.1

2012

16,740

5,744

34.3

2,962

51.6

1,805

31.4

2013

17,888

6,056

33.9

3,235

53.4

1,669

27.6

2014

19,158

6,367

33.2

3,433

53.9

1,666

26.2

Change 2000-2014 (%)

163.8

302.5

52.5

651.2

86.6

..

..

Source: Medical colleges Table D18: Vocational training positions/trainees: Total, basic, female basic and first-year basic trainees, 2000-2014

232

MTRP 18th Report

Medical specialty

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Addiction medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

11

13

18

24

22

Adult medicine

444

478

426

443

440

510

596

663

672

690

948

1,043

1,157

1,406

1,469

1,468

1,513

1,699

Anaesthesia

426

578

459

454

452

478

531

465

477

477

416

463

485

612

566

609

657

664

Anaesthesia - pain medicine

..

..

..

..

..

..

..

..

..

36

49

45

53

51

58

59

65

66

Dermatology

(b)

42

43

50

56

55

58

60

61

60

64

31

33

39

45

54

57

49

54

Emergency medicine

(c)

602

678

655

688

498

489

489

471

458

486

462

480

811

881

1,090

1,204

1,339

1,355

General practice

1,603

1,441

1,478

1,455

1,525

1,429

1,446

1,569

1,905

2,003

2,003

2,162

2,309

2,642

- GPET

2,948

3,289

3,932

(t) 4,315

- ACRRM

(d)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6

(l) 156

155

171

Intensive care

108

126

100

102

142

220

186

146

187

180

285

326

375

332

312

302

281

336

Medical administration

107

99

99

102

95

88

90

96

81

84

86

80

92

105

86

98

(p) 107

(u) 115

Obstetrics and gynaecology

350

317

333

309

312

288

258

292

299

325

338

109

131

(h) 123

143

(h) 133

(h) 159

(h) 165

Occupational and environmental medicine

24

na

49

46

46

44

49

62

72

74

59

61

55

87

80

84

102

92

Ophthalmology

(e)

90

90

91

91

100

95

102

105

53

50

47

70

77

(i) 49

(j) 86

(m) 80

(q) 90

(v) 90

Oral and maxillofacial surgery

..

..

..

..

..

..

..

..

..

..

..

..

..

..

..

38

38

38

Paediatrics

(c)

179

143

135

141

147

180

233

258

234

284

286

395

453

583

640

593

556

662

Palliative medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

58

71

24

80

(w) 28

Pathology

224

224

221

236

224

251

251

273

282

194

176

211

224

301

314

314

301

307

Pathology and RACP, jointly

..

..

..

..

..

..

..

..

..

107

95

124

137

131

173

208

213

236

Psychiatry

(e)

..

..

..

..

..

..

..

..

87

178

177

278

322

350

(k) 368

(n) 417

(r) 418

(x) 418

Public health medicine

75

75

75

56

52

62

62

65

71

80

75

75

61

60

72

61

81

81

Radiation oncology

50

50

51

52

58

61

69

68

77

57

96

104

328

110

137

141

122

117

Radiodiagnosis

186

186

189

187

195

205

236

241

263

288

299

314

101

333

366

372

364

410

Rehabilitation medicine

68

46

61

67

77

92

97

118

118

125

131

121

138

143

162

177

191

202

Sexual health medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

19

7

10

20

13

Sport and exercise medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

na

27

28

(s) 30

41

Surgery

(f)

478

498

541

546

590

604

660

652

663

732

774

791

901

1,000

966

(o) 1,094

983

1,094

Total

5,056

5,072

5,013

5,031

5,008

5,154

5,415

6,387

6,059

6,514

6,833

(g) 7,324

8,249

9,432

10,214

11,034

11,870

12,791

Table D19: Advanced training positions/trainees by medical speciality, 1997-2014

233

MTRP 18th Report

(a) Addiction medicine, palliative medicine, sexual health medicine and sports and exercise medicine were recognised as specialties in 2009. (b) Dermatology was able to identify and report advanced trainees separately from 2007. (c) Emergency medicine and paediatrics data account for trainees undertaking paediatric emergency medicine. (d) Includes registrars on the Independent Pathway only. (e) Ophthalmology and psychiatry was able to identify and report advanced trainees separately from 2005. (f) RACS does not differentiate between basic and advanced surgical trainees as the surgical program is an integrated program (SET). (g) Includes 39 trainees undertaking dual training in adult medicine and paediatrics. Also includes 6 ophthalmology trainees in overseas training positions. (h) Includes advanced Australian trainees who were undertaking FRANZCOG training only and not overseas trained specialists (referred to by the College as SIMG) who were also undertaking RANZCOG advanced training as a requirement to obtain college fellowship. (i) Includes 3rd and 4th years only, not 5th year. (j) Includes 6 trainees who were completing their final year of training overseas. (k) Includes 170 fellows undertaking subspecialty training. (l) Excludes 4 trainees living overseas. The definition of what counted as advanced training changed in 2012, hence the significant change in the number of posts. (m) Includes 11 trainees who were completing their final year of training overseas. (n) Includes 229 fellows in subspecialty training. (o) Includes 183 New Zealand, 7 overseas accredited training posts and 7 New Zealand and 2 overseas SET trainees on approved extended leave. (p) Excludes 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. (t) Figures for 2014 are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. (u) Excludes New Zealand and Hong Kong advanced trainees. (v) Includes 10 trainees who were completing their final year of training overseas. (w) Includes Chapter trainees only. Excludes Clinical Diploma Chapter trainees as this training program is not leading to fellowship of RACP or AChPM. (x) Includes 215 fellows in subspecialty training. Source: Medical colleges and GPET

234

MTRP 18th Report

Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

(a)

1997

1,827

1,447

947

497

540

115

70

164

5,665

1998

1,825

1,407

939

534

534

108

73

166

5,561

1999

1,839

1,438

950

476

555

121

79

146

5,645

2000

1,826

1,487

947

498

581

112

77

138

5,680

2001

1,839

1,472

930

580

572

116

80

148

5,661

2002

1,971

1,524

968

502

556

109

86

140

5,874

2003

2,044

1,656

1,020

543

562

94

99

100

6,126

2004

2,185

1,786

1,051

531

565

103

81

76

6,378

2005

2,093

1,673

1,030

486

513

111

76

77

6,059

2006

2,188

1,770

1,144

524

529

116

102

98

6,514

2007

2,312

1,831

1,220

525

619

121

101

107

6,833

2008

2,486

2,040

1,351

599

689

147

120

129

(b) 7,581

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

2014

4,203

3,160

2,634

969

1,205

264

203

153

12,791

Change 1997-2014 (%)

130.0

118.4

178.1

95.0

123.1

129.6

190.0

-6.7

125.8

(a) Australian total differs from the sum of state/territory totals in some years because it includes trainees in overseas placements. (b) Australian total is higher because state/territory data on 20 positions were not available. Source: Medical colleges and GPET Table D20: Advanced training positions/trainees by state/territory, 1997-2014

235

MTRP 18th Report

Medical specialty

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Addiction medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

2

4

6

7

7

Adult medicine

148

118

192

204

166

184

228

257

274

247

na

na

384

432

408

418

437

677

Anaesthesia

145

165

148

141

158

134

219

153

159

159

155

145

159

214

193

196

201

174

Anaesthesia - pain medicine

..

..

..

..

..

..

..

..

..

..

20

24

19

22

26

26

29

28

Dermatology

13

8

6

9

14

15

12

3

17

17

18

18

16

18

28

28

16

32

Emergency medicine

(b),(c)

120

121

150

150

98

115

91

108

122

110

102

(d) na

305

282

262

293

332

180

General practice - GPET

400

400

410

450

450

450

600

624

626

648

648

648

684

814

918

1,006

(i) 1,152

(k) 1,222

- ACRRM

..

..

..

..

..

..

..

..

..

..

..

..

..

..

6

(f) 43

 0

..

Intensive care

..

..

..

..

..

..

..

..

..

..

na

na

156

60

58

82

96

48

Medical administration

20

20

20

20

20

21

27

27

27

30

19

15

32

8

25

24

32

33

Obstetrics and gynaecology

55

55

50

50

50

47

47

48

56

69

65

56

65

59

58

66

89

87

Occupational and environmental medicine

12

na

10

na

na

na

8

na

na

na

na

na

6

27

19

23

21

Ophthalmology

21

24

18

18

18

26

28

25

22

26

27

27

20

27

28

27

29

28

Oral and maxillofacial surgery

..

..

..

..

..

..

..

..

..

..

..

..

..

..

..

..

..

6

Paediatrics

(c)

59

43

68

68

50

48

63

97

89

119

na

na

162

131

170

141

119

315

Palliative medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

41

11

9

67

15

Pathology

50

43

49

48

71

54

44

46

58

87

90

(e) 85

(e) 66

50

40

51

65

57

Pathology and RACP (jointly)

..

..

..

..

..

..

..

..

..

..

..

..

..

..

41

49

54

65

Psychiatry

118

122

118

117

126

127

106

115

142

131

39

102

99

129

112

(g) 216

119

105

Public health medicine

24

24

24

na

na

16

15

18

12

10

10

14

8

28

22

12

 0

33

Table D21: Advanced training first-year positions/trainees by medical speciality, 1997-2014

236

MTRP 18th Report

Medical specialty

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Radiation oncology

..

4

na

11

12

6

10

14

15

14

25

15

24

15

27

24

27

18

Radiodiagnosis

43

50

62

41

41

34

37

21

9

51

48

32

47

56

96

70

65

86

Rehabilitation medicine

13

14

19

20

25

27

29

29

30

30

32

20

38

30

34

57

 0

61

Sexual health medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

1

1

..

3

1

Sport and exercise medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

..

8

1

7

8

Surgery

128

139

139

162

184

185

188

197

240

208

421

218

299

250

207

246

(j) 238

249

Total

1,369

1,350

1,483

1,509

1,483

1,489

1,752

1,782

1,898

1,956

1,719

1,419

2,589

2,696

2,802

(h) 3,114

3,184

3,556

(a) Addiction medicine, palliative medicine, sexual health medicine and sports and exercise medicine were recognised as specialties in 2009. (b) RACP data is included with ACEM totals. (c) Emergency medicine and paediatrics data account for trainees undertaking paediatric emergency medicine. (d) Due to retrospective data collection, the number of estimated first year advanced trainees in 2009 is unavailable. (e) Includes trainees from pathology and RACP (jointly). (f) Excludes 1 trainee living overseas. (g) Includes 71 fellows in subspecialty training. (h) Total number of first year registrars across all states (excluding double counting of registrars and one trainee from overseas). (i) Figures include both basic and advanced trainees together. It also includes those who are enrolled or who have completed training. (j) Excludes 28 trainees that deferred SET training commencement in 2012. (k) Figures are for those enrolled in the 2014 training year and include those now withdrawn or fellowed. Source: Medical colleges and GPET

237

MTRP 18th Report

Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

1997

378

321

187

108

130

24

15

42

1,205

1998

403

324

242

133

133

28

21

46

1,330

1999

469

384

233

120

148

31

17

35

1,437

2000

478

392

250

111

129

41

17

41

1,459

2001

474

397

252

124

139

31

19

47

1,483

2002

485

394

247

110

142

27

23

45

1,473

2003

507

416

265

157

129

34

29

12

1,549

2004

511

445

259

120

144

38

39

17

1,573

2005

561

448

286

119

153

37

32

21

1,657

2006

669

492

351

157

176

49

33

29

1,956

2007

364

290

235

94

102

24

25

9

1,143

2008

471

364

271

110

135

31

22

15

1,419

2009

830

717

473

201

229

64

32

44

2,590

2010

856

687

581

227

243

53

46

40

2,733

2011

1,022

724

522

190

214

70

30

45

2,817

2012

1,034

788

657

222

257

77

44

41

3,114

2013

1,070

747

662

248

290

64

62

44

3,184

2014

1,139

860

722

281

370

76

59

49

3,556

Source: Medical colleges and GPET Table D22: Advanced training first-year positions/trainees by state/territory, 1997-2014

238

MTRP 18th Report

Medical specialty

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Addiction medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

36.4

30.8

44.4

46.0

45.5

Adult medicine

34.2

39.5

36.7

39.2

43.9

42.0

47.8

40.3

41.2

43.2

43.0

43.1

40.2

42.3

43.0

45.6

48.0

50.7

Anaesthesia

39.7

55.0

55.6

36.8

35.0

37.0

44.3

37.4

36.5

36.5

39.7

37.1

50.7

39.9

43.1

44.0

44.9

47.6

Anaesthesia - pain medicine

..

..

..

..

..

..

..

..

..

..

26.5

31.1

35.8

29.4

27.6

38.9

52.3

42.4

Dermatology

38.1

32.5

36.0

41.1

43.6

54.7

50.0

49.2

55.0

54.7

51.6

66.7

59.0

55.6

61.1

73.7

63.3

50.0

Emergency medicine

30.7

28.0

39.4

37.8

38.4

39.5

39.9

39.9

39.1

41.4

44.2

43.5

41.9

38.6

41.1

40.9

41.4

40.5

General practice

56.6

59.7

58.9

60.3

60.8

60.6

60.5

59.1

58.2

58.9

58.9

62.0

63.8

64.9

..

..

..

..

- GPET

..

..

..

..

..

..

..

..

..

..

..

..

..

..

65.8

64.9

64.9

64.9

- ACRRM

..

..

..

..

..

..

..

..

..

..

..

..

..

..

33.3

27.5

25.0

18.1

Intensive care

11.1

9.5

19.0

24.5

18.3

22.3

36.0

28.1

23.5

20.0

34.7

24.5

24.3

27.1

26.9

30.5

32.7

32.1

Medical administration

34.6

25.7

25.7

41.2

49.5

50.0

44.4

37.5

35.8

33.3

20.9

10.0

14.1

27.6

41.9

39.8

40.2

37.4

Obstetrics and gynaecology

48.6

61.2

56.8

49.5

60.0

62.5

60.5

59.6

63.2

65.5

65.7

68.8

67.9

65.0

60.1

65.4

69.2

74.5

Occupational and environmental medicine

25.0

na

16.3

19.6

23.9

34.1

24.5

24.2

25.0

23.0

23.7

16.4

25.5

14.9

21.3

20.2

24.5

31.5

Ophthalmology

20.0

18.2

19.8

23.1

25.0

31.4

34.3

41.9

39.6

48.0

31.9

34.3

31.2

38.8

38.4

23.8

40.0

42.2

Oral and maxillofacial surgery

na

na

na

na

na

na

na

na

na

na

na

na

na

na

na

7.9

7.9

10.5

Paediatrics

62.0

66.7

66.7

65.2

63.3

65.0

57.9

63.4

62.0

64.1

63.6

60.1

58.7

61.4

65.9

65.3

67.0

72.8

Palliative medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

53.4

63.8

60.0

67.5

57.1

Pathology

(b)

46.6

43.3

42.7

42.8

48.7

50.2

51.8

55.7

55.3

77.5

53.9

45.3

64.5

80.1

59.2

64.3

58.8

62.5

Pathology and RACP (jointly)

..

..

..

..

..

..

..

..

..

..

..

..

..

..

47.4

35.7

56.3

57.6

Psychiatry

44.6

45.8

45.9

46.0

48.4

47.6

49.4

52.3

55.2

47.8

52.5

26.3

53.1

55.1

63.0

55.6

55.0

50.7

Public health medicine

50.7

50.7

50.7

48.2

48.1

51.6

66.7

64.6

66.2

68.8

69.3

54.7

59.0

61.7

52.8

67.0

65.0

72.8

Radiation oncology

..

..

51.0

48.1

56.9

60.1

55.1

58.8

54.5

70.2

44.8

52.9

57.4

58.2

51.8

56.7

53.2

51.3

Radiodiagnosis

27.8

25.8

24.9

26.7

32.3

34.1

33.5

31.5

33.1

33.0

30.4

30.9

34.8

31.8

31.4

46.5

34.0

37.6

Rehabilitation medicine

34.0

30.8

26.8

42.9

57.1

54.3

52.6

55.1

51.7

60.8

60.3

60.3

61.6

61.5

64.8

68.9

69.0

66.3

Sexual health medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

52.6

28.6

80.0

70.0

69.2

Sport and exercise medicine

(a)

..

..

..

..

..

..

..

..

..

..

..

..

..

..

22.2

25.0

20.5

22.0

Surgery

17.2

13.3

12.6

12.8

13.4

12.1

14.4

17.1

16.0

18.0

18.3

23.3

23.1

22.8

(c) 23.8

25.5

28.1

27.5

Total (%)

45.9

47.2

49.6

48.8

50.7

51.4

52.5

45.9

45.5

46.3

46.6

46.7

48.1

47.6

49.9

50.4

52.0

52.6

Total number

2,322

2,393

2,488

2,456

2,538

2,650

2,845

2,930

2,758

3,015

3,181

3,421

3,967

4,494

5,116

5,536

6,160

6,733

(a) Addiction medicine, palliative medicine, sexual health medicine and sport and exercise medicine were recognised as specialties in 2009. (b) Data includes trainees undertaking pathology and RACP jointly up to 2010. (c) The total proportion of female surgical trainees including Australian, New Zealand and overseas trainees was 24.4%. Source: Medical colleges and GPET Table D23: Advanced trainees: Proportion of females by medical speciality, 1997-2014

239

MTRP 18th Report

Medical specialty 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Addiction medicine

(a)

.. .. .. .. .. .. .. .. .. .. .. .. .. 36.4 30.8 44.4 46.0 45.5

Adult medicine 34.2 39.5 36.7 39.2 43.9 42.0 47.8 40.3 41.2 43.2 43.0 43.1 40.2 42.3 43.0 45.6 48.0 50.7

Anaesthesia 39.7 55.0 55.6 36.8 35.0 37.0 44.3 37.4 36.5 36.5 39.7 37.1 50.7 39.9 43.1 44.0 44.9 47.6

Anaesthesia - pain medicine .. .. .. .. .. .. .. .. .. .. 26.5 31.1 35.8 29.4 27.6 38.9 52.3 42.4

Dermatology 38.1 32.5 36.0 41.1 43.6 54.7 50.0 49.2 55.0 54.7 51.6 66.7 59.0 55.6 61.1 73.7 63.3 50.0

Emergency medicine 30.7 28.0 39.4 37.8 38.4 39.5 39.9 39.9 39.1 41.4 44.2 43.5 41.9 38.6 41.1 40.9 41.4 40.5

General practice 56.6 59.7 58.9 60.3 60.8 60.6 60.5 59.1 58.2 58.9 58.9 62.0 63.8 64.9 .. .. .. ..

- GPET .. .. .. .. .. .. .. .. .. .. .. .. .. .. 65.8 64.9 64.9 64.9

- ACRRM .. .. .. .. .. .. .. .. .. .. .. .. .. .. 33.3 27.5 25.0 18.1

Intensive care 11.1 9.5 19.0 24.5 18.3 22.3 36.0 28.1 23.5 20.0 34.7 24.5 24.3 27.1 26.9 30.5 32.7 32.1

Medical administration 34.6 25.7 25.7 41.2 49.5 50.0 44.4 37.5 35.8 33.3 20.9 10.0 14.1 27.6 41.9 39.8 40.2 37.4

Obstetrics and gynaecology 48.6 61.2 56.8 49.5 60.0 62.5 60.5 59.6 63.2 65.5 65.7 68.8 67.9 65.0 60.1 65.4 69.2 74.5

Occupational and environmental medicine 25.0 na 16.3 19.6 23.9 34.1 24.5 24.2 25.0 23.0 23.7 16.4 25.5 14.9 21.3 20.2 24.5 31.5

Ophthalmology 20.0 18.2 19.8 23.1 25.0 31.4 34.3 41.9 39.6 48.0 31.9 34.3 31.2 38.8 38.4 23.8 40.0 42.2

Oral and maxillofacial surgery na na na na na na na na na na na na na na na 7.9 7.9 10.5

Paediatrics 62.0 66.7 66.7 65.2 63.3 65.0 57.9 63.4 62.0 64.1 63.6 60.1 58.7 61.4 65.9 65.3 67.0 72.8

Palliative medicine

(a)

.. .. .. .. .. .. .. .. .. .. .. .. .. 53.4 63.8 60.0 67.5 57.1

Pathology

(b)

46.6 43.3 42.7 42.8 48.7 50.2 51.8 55.7 55.3 77.5 53.9 45.3 64.5 80.1 59.2 64.3 58.8 62.5

Pathology and RACP (jointly) .. .. .. .. .. .. .. .. .. .. .. .. .. .. 47.4 35.7 56.3 57.6

Psychiatry 44.6 45.8 45.9 46.0 48.4 47.6 49.4 52.3 55.2 47.8 52.5 26.3 53.1 55.1 63.0 55.6 55.0 50.7

Public health medicine 50.7 50.7 50.7 48.2 48.1 51.6 66.7 64.6 66.2 68.8 69.3 54.7 59.0 61.7 52.8 67.0 65.0 72.8

Radiation oncology .. .. 51.0 48.1 56.9 60.1 55.1 58.8 54.5 70.2 44.8 52.9 57.4 58.2 51.8 56.7 53.2 51.3

Radiodiagnosis 27.8 25.8 24.9 26.7 32.3 34.1 33.5 31.5 33.1 33.0 30.4 30.9 34.8 31.8 31.4 46.5 34.0 37.6

Rehabilitation medicine 34.0 30.8 26.8 42.9 57.1 54.3 52.6 55.1 51.7 60.8 60.3 60.3 61.6 61.5 64.8 68.9 69.0 66.3

Sexual health medicine

(a)

.. .. .. .. .. .. .. .. .. .. .. .. .. 52.6 28.6 80.0 70.0 69.2

Sport and exercise medicine

(a)

.. .. .. .. .. .. .. .. .. .. .. .. .. .. 22.2 25.0 20.5 22.0

Surgery 17.2 13.3 12.6 12.8 13.4 12.1 14.4 17.1 16.0 18.0 18.3 23.3 23.1 22.8

(c) 23.8 25.5 28.1 27.5

Total (%) 45.9 47.2 49.6 48.8 50.7 51.4 52.5 45.9 45.5 46.3 46.6 46.7 48.1 47.6 49.9 50.4 52.0 52.6

Total number 2,322 2,393 2,488 2,456 2,538 2,650 2,845 2,930 2,758 3,015 3,181 3,421 3,967 4,494 5,116 5,536 6,160 6,733

(a) Addiction medicine, palliative medicine, sexual health medicine and sport and exercise medicine were recognised as specialties in 2009.

(b) Data includes trainees undertaking pathology and RACP jointly up to 2010.

(c) The total proportion of female surgical trainees including Australian, New Zealand and overseas trainees was 24.4%.

Source: Medical colleges and GPET

Table D23: Advanced trainees: Proportion of females by medical speciality, 1997-2014 Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

1997

41.8

39.5

40.0

37.7

39.1

38.3

57.1

44.4

41.0

1998

43.5

41.3

40.7

43.4

44.2

35.2

39.5

53.3

43.0

1999

44.8

43.3

41.6

44.7

45.1

45.1

50.6

45.2

44.1

2000

42.6

43.9

43.0

45.2

43.5

43.8

40.3

42.8

43.2

2001

45.5

46.3

42.0

45.2

41.1

48.3

46.3

45.9

44.8

2002

46.1

47.8

40.9

41.4

44.4

43.1

53.5

42.9

45.1

2003

48.0

46.1

43.6

45.3

47.2

56.4

53.5

39.0

46.4

2004

46.3

46.7

44.0

44.1

46.0

52.4

50.6

42.1

45.9

2005

45.3

46.2

44.2

41.4

46.1

51.3

55.7

40.3

45.6

2006

46.9

47.7

46.0

41.4

46.8

49.1

55.9

39.8

46.3

2007

47.5

47.5

45.2

43.6

46.0

43.8

60.4

30.8

46.6

2008

46.3

45.0

44.3

44.9

42.7

46.9

59.2

33.3

45.1

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

2014

54.0

53.4

49.4

50.9

53.8

55.3

58.6

45.1

52.6

Source: Medical colleges and GPET Table D24: Advanced trainees: Proportion of females by state/territory, 1997-2014

240

MTRP 18th Report

Year

Training

positions/trainees

Advanced training positions/trainees

Proportion

advanced positions/

trainees

(%)

Female advanced

trainees

Proportion female advanced trainees

(%)

Part-time

advanced

Proportion

part-time advanced

(%)

1997

6,422

5,665

88.2

2,332

41.2

296

5.2

1998

6,818

5,561

81.6

2,393

43.0

337

6.1

1999

6,910

5,645

81.7

2,488

44.1

388

6.9

2000

7,262

5,680

78.2

2,456

43.2

368

6.5

2001

6,835

5,661

82.8

2,538

44.8

325

5.7

2002

7,213

5,874

81.4

2,650

45.1

357

6.1

2003

7,273

6,126

84.2

2,845

46.4

534

8.7

2004

8,188

6,387

78.0

2,930

45.9

704

11.0

2005

8,710

6,059

69.6

2,765

45.6

932

15.4

2006

9,317

6,514

69.9

3,018

46.3

676

10.4

2007

(a)

11,249

6,833

60.7

3,181

46.6

739

10.8

2008

(b)

11,668

7,324

62.8

3,421

46.7

556

7.6

2009

12,958

8,249

63.7

3,967

48.1

1,052

12.8

2010

14,679

9,432

64.3

4,494

47.6

971

10.3

2011

15,478

10,214

66.0

5,116

50.1

1,416

13.9

2012

16,740

10,996

65.7

5,536

50.3

1,220

11.1

2013

17,888

11,832

66.1

6,160

52.1

1,576

13.3

2014

19,158

12,791

66.8

6,733

52.6

2,075

16.2

Change 1997-2014 (%)

198.3

125.8

-24.3

188.7

27.9

601

210.5

(a) Figure for the number of training positions/trainees has been revised from the 2007 report. (b) Figure for the number of advanced training positions/trainees has been revised from the 2008 report. Source: Medical colleges and GPET Table D25: Vocational training positions/trainees: Total, advanced, female advanced and part-time advanced trainees, 1997-2014

241

MTRP 18th Report

Medical specialty

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

Change 2000-2013

Change

2000-2013

(%)

Addiction medicine

..

..

..

..

..

..

..

..

..

6

3

1

4

3

..

..

Adult medicine

159

129

170

168

190

181

247

209

303

397

346

362

456

438

279

175.5

Anaesthesia

95

123

165

133

128

198

135

150

234

197

243

223

229

256

161

169.5

Anaesthesia - pain medicine

..

..

..

..

..

5

5

7

11

9

17

12

19

14

..

..

Dermatology

8

14

21

9

12

13

14

23

11

11

26

21

20

23

15

187.5

Emergency medicine

40

61

34

82

80

58

78

69

95

82

77

78

135

115

75

187.5

General practice

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

- RACGP

365

324

670

746

661

671

628

592

819

928

(c) 835

(d) 1,037

(h) 1,216

(j) 1,096

731

200.3

- ACRRM

..

..

..

..

..

..

..

21

22

40

28

(e) 38

63

85

..

..

Intensive care

11

22

20

15

20

29

23

36

62

63

60

50

63

(k) 52

41

372.7

Medical administration

9

7

6

10

15

4

13

11

10

9

18

(f) 14

19

13

4

44.4

Obstetrics and gynaecology

54

49

46

57

29

28

49

46

66

56

82

90

81

68

14

25.9

Occupational and environmental medicine

3

1

4

4

6

6

6

6

11

11

5

2

4

8

5

166.7

Ophthalmology

25

21

20

30

20

26

16

30

14

11

26

(g) 29

(i) 38

(l) 36

11

44.0

Oral and maxillofacial surgery

na

na

na

na

na

na

na

na

na

na

na

4

8

11

..

..

Paediatrics

40

41

51

55

57

74

73

47

114

116

91

102

146

134

94

235.0

Palliative medicine

..

..

..

..

..

..

..

..

..

8

6

7

16

15

..

..

Pathology

(a)

42

35

37

43

41

48

46

77

68

64

94

88

99

98

56

133.3

Psychiatry

80

70

82

70

109

85

90

72

147

125

154

131

136

141

61

76.3

Public health medicine

11

11

13

6

8

4

13

15

13

12

15

4

7

7

-4

-36.4

Table D26: New fellows by medical speciality, 2000-2013

242

MTRP 18th Report

Medical specialty

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

Change 2000-2013

Change

2000-2013

(%)

Radiation oncology

14

12

10

9

10

19

9

12

11

18

13

22

20

23

9

64.3

Radiodiagnosis

46

26

36

40

37

39

74

54

54

44

54

77

115

100

54

117.4

Rehabilitation medicine

13

10

13

12

15

13

19

24

21

13

22

23

26

20

7

53.8

Sexual health medicine

..

..

..

..

..

..

..

..

..

1

0

3

3

3

..

..

Sport and exercise medicine

..

..

..

..

..

..

7

3

5

1

1

3

2

(m) 2

..

..

Surgery

111

103

108

117

115

155

155

176

171

(b) 174

(b) 184

(b) 212

(b) 217

(b) 193

82

73.9

Total

1,126

1,059

1,506

1,606

1,553

1,656

1,700

1,680

2,262

2,396

2,400

2,633

3,142

2,954

1,828

162.3

a) From 2010 data includes new fellows from pathology, and pathology and RACP (jointly). b) Includes new fellows through SET program and overseas trained specialists that have been awarded fellowship. c) An additional 151 new fellows who live overseas joined the college in 2010. d) Excludes 96 new fellows awarded fellowship who live overseas. e) Excludes 2 new fellows who live overseas. f) Includes 5 New Zealand and Hong Kong new fellows. g) Includes 10 new fellows trained overseas. h) Excludes 107 new fellows awarded fellowship but living overseas. i) Includes 13 overseas trained specialists. j) Excludes 99 new fellows who live overseas. k) Excludes 17 new fellows who live overseas. l) Excludes 6 new fellows who live overseas. m) Excludes 1 New Zealand new fellow. Source: Medical colleges

243

MTRP 18th Report

Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

(a)

2000

361

301

197

90

108

29

11

29

1,126

2001

361

260

172

96

114

27

10

19

1,059

2002

499

392

254

115

155

38

15

25

1,493

2003

518

384

324

140

167

43

8

9

1,592

2004

476

414

262

161

173

23

4

10

1,553

2005

501

434

310

157

179

35

10

14

1,640

2006

530

468

308

165

163

30

11

18

1,693

2007

538

470

327

151

135

30

11

15

1,677

2008

635

543

441

213

246

49

15

23

2,165

2009

620

548

471

196

225

47

25

41

2,285

2010

734

603

479

179

272

52

29

40

2,388

2011

744

713

603

198

242

45

31

41

2,617

2012

863

759

702

241

328

89

43

64

3,103

2013

832

747

660

204

364

61

44

42

2,954

Change 2000-2013 (%)

130.5

148.2

235.0

126.7

237.0

110.3

300.0

44.8

162.3

(a) Australian totals differ for 2009 and 2012 from the sum of state/territory numbers due to the inclusion of new fellows who completed their training overseas. Source: Medical colleges Table D27: New fellows by state/territory, 2000-2013

244

MTRP 18th Report

Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2000

152

109

84

36

45

8

3

15

454

2001

136

104

74

43

56

12

4

10

439

2002

210

172

87

48

63

17

9

12

618

2003

228

162

130

47

71

17

5

2

662

2004

222

166

120

62

77

12

2

8

683

2005

213

171

114

65

74

20

3

7

667

2006

233

192

119

74

55

12

3

9

697

2007

218

194

131

63

54

13

5

4

682

2008

261

225

182

78

102

19

6

12

885

2009

256

234

178

83

90

29

11

14

895

2010

315

289

201

66

121

24

19

17

1,052

2011

330

340

248

83

86

27

9

22

1,145

2012

395

351

296

103

148

38

19

35

1,385

2013

411

344

266

99

155

28

20

18

1,341

Change 2000-2013 (%)

170.4

215.6

216.7

175.0

244.4

250.0

566.7

20.0

195.4

Source: Medical colleges Table D28: New female fellows by state/territory, 2000-2013

245

MTRP 18th Report

Medical specialty

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

Addiction medicine

..

..

..

..

..

..

..

..

..

50.0

33.3

..

25.0

33.3

Adult medicine

42.1

34.0

41.8

40.5

38.4

38.7

36.8

38.3

41.6

35.8

37.6

37.0

39.9

42.7

Anaesthesia

18.9

32.5

30.9

27.8

28.9

36.4

43.0

31.3

35.0

29.4

32.5

31.8

41.5

42.2

Anaesthesia - pain medicine

..

..

..

..

..

40.0

40.0

0.0

9.1

33.3

29.4

33.3

15.8

35.7

Dermatology

37.5

42.9

33.3

33.3

66.7

69.2

42.9

34.8

90.9

90.9

53.8

57.1

65.0

52.2

Emergency medicine

25.7

29.5

25.0

39.0

42.5

37.9

30.8

33.3

36.8

36.6

44.2

34.6

45.2

38.3

General practice - RACGP

59.2

56.8

47.9

47.6

46.8

45.8

46.8

50.0

44.8

43.3

56.0

52.6

50.8

52.6

- ACRRM

..

..

..

..

..

..

..

14.3

31.8

27.5

39.3

23.7

31.7

32.9

Intensive care

18.2

18.2

10.0

20.0

20.0

20.7

8.7

13.9

25.8

23.8

23.3

24.0

11.1

30.8

Medical administration

22.2

28.6

66.7

50.0

53.3

100.0

30.8

27.3

50.0

11.1

27.8

7.1

42.1

46.2

Obstetrics and gynaecology

44.4

59.2

56.5

56.1

51.7

53.6

46.9

58.7

62.1

62.5

56.6

63.3

54.3

60.3

Occupational and environmental medicine

0

0

16.7

50.0

0

50.0

33.3

16.7

45.5

9.1

20.0

0

50.0

0

Ophthalmology

24.0

19.0

20.0

13.3

50.0

38.5

31.3

50.0

35.7

36.4

30.8

10.3

28.9

30.6

Oral and maxillofacial surgery

..

..

..

..

..

..

..

..

..

..

..

..

..

0

Paediatrics

77.5

52.2

64.7

50.9

64.9

59.5

45.2

57.4

56.1

47.4

57.1

63.7

64.4

56.7

Palliative medicine

..

..

..

..

..

..

..

..

..

62.5

66.7

85.7

56.3

86.7

Pathology

45.2

42.9

45.9

37.2

45.0

54.2

65.2

53.2

51.5

46.9

47.6

59.3

55.7

50.9

Pathology and RACP (jointly)

..

..

..

..

..

..

..

..

..

..

48.4

37.9

51.7

44.2

Psychiatry

32.5

45.7

42.7

42.9

45.9

50.6

54.4

43.1

42.2

42.4

46.8

45.0

52.9

45.4

Public health medicine

63.6

45.5

30.8

66.7

62.5

75.0

84.6

80.0

69.2

58.3

53.3

75.0

57.1

71.4

Radiation oncology

35.7

41.7

50.0

66.7

50.0

52.6

55.6

50.0

36.4

44.4

53.8

50.0

45.0

65.2

Radiodiagnosis

19.6

38.5

22.2

25.0

37.8

21.1

33.8

24.1

25.9

40.9

24.1

29.9

31.3

32.0

Rehabilitation medicine

15.4

60.0

61.5

75.0

40.0

38.5

63.2

62.5

52.4

69.2

59.1

60.9

57.7

70.0

Sexual health medicine

..

..

..

..

..

..

..

..

..

100.0

..

100.0

33.3

33.3

Sport and exercise medicine

..

..

..

..

..

..

..

..

..

..

..

33.3

50.0

100.0

Surgery

7.2

12.6

13.0

14.0

6.1

10.3

13.5

16.5

15.2

19.5

14.1

15.1

19.4

19.2

Total

40.3

40.9

41.1

41.3

44.0

40.8

41.2

40.7

41.0

39.0

44.0

43.7

44.7

45.4

Source: Medical colleges Table D29: New fellows: Proportion of females by medical speciality, 2000-2013

246

MTRP 18th Report

Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2000

42.1

36.2

42.6

40.0

41.7

27.6

27.3

51.7

40.3

2001

37.7

40.0

43.0

44.8

49.1

44.4

40.0

52.6

41.5

2002

42.1

43.9

34.3

41.7

40.6

44.7

60.0

48.0

41.4

2003

44.0

42.2

40.1

33.6

42.8

39.5

62.5

22.2

41.6

2004

46.6

40.1

45.8

38.5

44.5

52.2

50.0

80.0

44.0

2005

42.5

39.4

36.8

41.4

41.3

57.1

30.0

50.0

40.7

2006

44.0

41.0

38.6

44.8

33.7

40.0

27.3

50.0

41.2

2007

40.5

41.3

40.1

41.7

40.0

43.3

45.5

26.7

40.7

2008

41.1

41.4

41.3

36.6

41.5

38.8

40.0

52.2

40.9

2009

41.3

42.7

37.8

42.3

40.0

61.7

44.0

34.1

39.2

2010

42.9

47.9

42.0

36.9

44.5

46.2

65.5

42.5

44.1

2011

44.4

47.7

41.1

41.9

35.5

60.0

29.0

53.7

43.8

2012

45.8

46.2

42.2

42.7

45.1

42.7

44.2

54.7

44.8

2013

49.4

46.1

40.3

48.5

42.6

45.9

45.5

42.9

45.4

Source: Medical colleges Table D30: New fellows: Proportion of females by state/territory, 2000-2013

247

MTRP 18th Report

Medical specialty

2008

2009

2010

2011

2012

2013

Change

2008-2013

Change

2008-2013

(%)

Addiction medicine

..

171

164

167

182

(b) 155

..

..

Adult medicine

6,436

6,765

6,284

6,861

7,754

(b) 6,823

387

6.0

Anaesthesia

3,448

3,197

3,425

3,612

3,815

4,043

595

17.3

Anaesthesia - pain medicine

187

191

212

221

239

252

65

34.8

Dermatology

354

434

390

411

491

(c) 495

141

39.8

Emergency medicine

1,009

1,106

1,134

1,204

1,340

1,453

444

44.0

General practice - RACGP

9,956

14,748

14,651

(a) 16,563

(a) 17,822

(d) 17,261

7,305

73.4

- ACRRM

1,392

1,365

1,352

(a) 1,363

1,443

(e) 1,459

67

4.8

Intensive care

642

554

584

634

640

(f) 713

71

11.1

Medical administration

436

441

299

(a) 458

485

411

-25

-5.7

Obstetrics and gynaecology

1,330

1,696

1,492

1,497

1,559

1,586

256

19.2

Occupational and environmental medicine

265

323

245

253

252

(b) 240

-25

-9.4

Ophthalmology

767

784

796

797

822

827

60

7.8

Oral and maxillofacial surgery

..

..

..

..

..

172

..

..

Paediatrics

1,923

2,013

1,723

1,955

2,325

(b) 1,984

61

3.2

Palliative medicine

..

210

181

227

261

(b) 220

..

..

Pathology

1,416

1,488

1,379

1,387

1,263

1,241

-175

-12.4

Pathology and RACP (jointly)

..

..

225

236

410

501

..

..

Psychiatry

2,588

2,741

2,949

3,101

3,073

3,154

566

21.9

Public health medicine

454

799

725

(a) 574

571

(b) 402

-52

-11.5

 

Table D31: Fellows by medical speciality, 2008-2013

248

MTRP 18th Report

Medical specialty

2008

2009

2010

2011

2012

2013

Change

2008-2013

Change

2008-2013

(%)

Radiation oncology

249

253

269

293

314

327

78

31.3

Radiodiagnosis

1,284

1,457

1,562

1,674

1,714

1,786

502

39.1

Rehabilitation medicine

317

323

354

365

398

400

83

26.2

Sexual health medicine

..

130

111

(a) 156

145

(b) 111

..

..

Sport and exercise medicine

..

..

140

(a) 119

(a) 155

70

..

..

Surgery

3,841

3,912

4,089

4,281

4,467

4,618

777

20.2

Total

38,294

45,092

44,735

48,403

51,967

50,704

12,410

32.4

(a) Includes fellows living overseas. (b) Numbers are down from 2012 due mainly to the inclusion in 2012 of ‘Retired’ and ‘Life’ fellows (i.e. fellows aged 70+). These fellows have been excluded from the count in 2013. (c) Excludes 17 fellows who live overseas. (d) Excludes 1,729 fellows who live overseas. (e) Excludes 19 fellows who live overseas. (f) Excludes 197 fellows who live overseas. Source: Medical colleges

249

MTRP 18th Report

Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2008

11,820

9,311

7,033

3,350

3,327

869

179

519

36,408

2009

13,261

10,538

7,930

3,573

3,927

999

360

814

42,739

2010

14,233

11,323

8,577

3,824

4,232

1,059

386

879

44,513

2011

14,843

11,911

9,088

3,938

4,404

1,103

394

922

46,603

2012

15,143

12,307

9,628

4,029

4,629

1,137

441

972

50,215

2013

15,816

12,948

10,188

4,170

4,971

1,178

454

977

50,704

Change 2008-2013 (%)

33.8

39.1

44.9

24.5

49.4

35.6

153.6

88.2

39.3

Source: Medical colleges Year

NSW

VIC

QLD

SA

WA

TAS

NT

ACT

AUS

2008

3,534

2,861

2,121

989

990

278

79

141

10,993

2009

4,155

3,393

2,458

1,068

1,233

327

164

290

13,586

2010

4,575

3,764

2,725

1,165

1,367

362

172

316

14,446

2011

4,827

4,044

2,916

1,206

1,433

385

174

333

15,318

2012

5,179

4,365

3,218

1,310

1,565

406

201

374

17,271

2013

5,534

4,680

3,435

1,382

1,719

435

215

383

17,783

Change 2008-2013 (%)

56.6

63.6

62.0

39.7

73.6

56.5

172.2

171.6

61.8

Source: Medical colleges Table D32: Fellows by state/territory, 2008-2013 Table D33: Female fellows by state/territory, 2008-2013

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Medical specialty 2008 2009 2010 2011 2012 2013

Addiction medicine .. 25.1 25.0 24.6 24.2 25.8

Adult medicine 24.7 25.4 24.2 25.1 28.6 29.8

Anaesthesia 21.1 24.4 25.1 25.6 26.9 27.9

Anaesthesia - pain medicine 17.6 18.8 19.8 20.8 20.5 21.4

Dermatology 39.3 36.2 39.5 40.4 39.7 40.4

Emergency medicine 27.2 28.7 28.9 29.4 31.0 31.3

General practice - RACGP 44.4 43.5 45.8 45.3 45.8 46.7

- ACRRM 29.1 19.9 19.5 19.6 20.8 21.3

Intensive care 15.0 14.4 14.9 14.7 15.8 16.8

Medical administration 24.5 24.5 27.8 24.0 26.4 27.0

Obstetrics and gynaecology 32.2 34.9 36.2 37.1 38.7 39.8

Occupational and environmental medicine 17.7 18.0 18.8 19.0 19.0 19.2

Ophthalmology 16.7 17.3 17.3 17.6 19.2 19.5

Oral and maxillofacial surgery .. .. .. .. .. 9.3

Paediatrics 41.8 42.2 40.9 42.8 46.8 47.2

Palliative medicine .. 47.1 44.2 48.0 47.5 51.8

Pathology 34.5 35.7 35.9 37.2 40.5 41.7

Pathology and RACP (jointly) .. .. 45.3 45.3 36.6 36.9

Psychiatry 34.1 33.9 34.7 35.9 38.3 37.6

Public health medicine 36.8 36.5 38.1 40.8 36.3 42.0

Radiation oncology 34.5 35.2 35.7 39.2 40.1 41.3

Radiodiagnosis 22.7 22.8 24.3 24.0 25.0 25.6

Rehabilitation medicine 37.9 38.4 40.7 40.8 43.2 44.0

Sexual health medicine .. 46.9 47.7 51.3 53.1 54.1

Sport and exercise medicine .. .. 16.4 22.7 19.4 37.1

Surgery 7.3 7.7 8.2 8.6 9.2 9.7

Total 30.1 31.8 32.5 33.1 34.6 35.1

Source: Medical colleges

Year NSW VIC QLD SA WA TAS NT ACT AUS

2008 29.9 30.7 30.2 29.5 29.8 32.0 44.1 27.2 30.2

2009 31.3 32.2 31.0 29.9 31.4 32.7 45.6 35.6 31.8

2010 32.1 33.2 31.8 30.5 32.3 34.2 44.6 35.9 32.5

2011 32.5 34.0 32.1 30.6 32.5 34.9 44.2 36.1 32.9

2012 34.2 35.5 33.4 32.5 33.8 35.7 45.6 38.5 34.4

2013 35.0 36.1 33.7 33.1 34.6 36.9 47.4 39.2 35.1

Source: Medical colleges

Table D34: Fellows: Proportion of females by medical speciality, 2008-2013

Table D35: Fellows: Proportion of females by state/territory, 2008-2013

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Appendix E:

DATA SPECIFICATIONS To assist in preparation of data inputs, data templates and specifications were first developed for the MTRP 12th report. In order to improve data comparability and quality these were refined for the 13th report and the specifications further expanded to cover the prevocational and vocational levels, and international medical graduates and overseas trained specialists for the MTRP 14th report onwards.

The data specifications used for the production of the MTRP 18th report are listed below. These were sent to all jurisdictions, medical colleges, General Practice Education and Training Ltd, the Australian Medical Council and the Australian Government Department of Immigration and Border Protection as relevant to the data each provides.

Prevocational training Definition: Postgraduate training undertaken by junior doctors who enter the medical workforce.

Postgraduate Year 1 (PGY1)

The year of supervised clinical training completed by graduates of an Australian Medical Council (AMC) accredited medical school. This is also known as the intern year.

Rural area

Rural area classification as RA2 to RA5 under the Australian Standard Geographical Classification - Remoteness Areas (ASGC-RA) system.

Rural internship

Rural internship is a type of internship when all or majority of it is undertaken in an RA2-RA5 hospital.

Rotational positions

Rotational positions are the rural based intern positions that are filled on rotation by doctors from a metropolitan hospital.

Postgraduate Year 2 (PGY2)

The year of structured supervised clinical training placements, commenced once medical practitioners have completed their internship and gained general medical registration.

Data source: State and territory health departments, Australian Government Department of Health (for Commonwealth Medical Internships initiative).

Scope: All junior doctors undertaking postgraduate prevocational training in Australia. This includes all junior doctors who accepted their applications to commence their training either at the beginning of the academic year or during additional intakes during the given year of data collection.

It also includes International Medical Graduates (IMGs) who have completed the Australian Medical Council (AMC) multiple choice questionnaire (MCQ) and clinical examinations and who must complete a supervised year of training to be eligible for general medical registration.

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Statistical unit: Number of trainees/doctors

Number of supervised training positions

Number of rural intern positions

Number of rotational positions (RA2-RA5)

Collection period: Academic year 2014

Guide for use

State/Territory: This is the state/territory where training is being provided.

It is not the place of residence of trainees undertaking the vocational training.

Prevocational medical training 2014

Data items Values

Commencing postgraduate year 1 trainees or supervised training positions

Type of graduate Australian trained local (own state) - Commonwealth-supported - Full-fee paying

Australian trained local (interstate) - Commonwealth-supported - Full-fee paying

New Zealand medical graduates

International students who graduated from an Australian medical school and were placed by states/territories - Own state - Interstate

Australian Medical Council graduates

International students who graduated from an Australian medical school and were placed by the Commonwealth

Sex Female

State/Territory NSW

VIC

QLD

SA

WA

TAS

NT

ACT

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Data items Values

Commencing postgraduate year 1 trainees or supervised training positions (RA2-RA5)

Type of graduate Rural intern positions where postgraduate year 1 trainees can undertake majority of their internship in a rural location

Postgraduate year 1 trainees undertaking rural internship (RA2-RA5)

Rotational positions (RA2-RA5)

State/Territory NSW

VIC QLD SA WA TAS NT ACT

Commencing doctors in postgraduate year 2 training positions

Type of graduate Australian trained local (own state)

Australian trained local (interstate)

New Zealand medical graduates

International students who graduated from an Australian medical school

Australian Medical Council graduates

Other/Unspecified

Sex Female

State/Territory NSW

VIC QLD SA WA TAS NT ACT

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Vocational training

Definition: Vocational trainee

Trainees who were successful in their application and are undertaking training in a position supervised by a member of the accredited specialist medical college or other vocational training provider.

Data source: Medical colleges

General Practice Education and Training Limited

Scope: The scope includes Australian medical school graduates who are:

- undertaking basic or advanced training; - undertaking their training overseas; and - undertaking research programs.

New Zealand and other international medical graduates who are working/training in an accredited training position/post within Australia are to be included.

Whereas non-Australian medical school graduates who are being trained overseas through an Australian medical college are to be excluded.

The scope includes those who are undertaking training on a part-time basis or who have interrupted their training through approved extended leave.

It excludes those who have withdrawn from their training either on a voluntary basis or have been discontinued by the college or other vocational training provider.

Statistical unit: Number of trainees

Collection period: Calendar year 2014

Latest available data for trainees who are undertaking basic or advanced training in 2014.

Calendar year 2013

Examination/assessment outcome data, new fellow and fellow data are to be reported for the previous year, 2013.

Definition: Overseas trained specialist

A doctor whose specialist medical qualifications were acquired in a country other than Australia.

Data source: Medical colleges

Scope: All overseas trained specialists who have applied to the Australian Medical Council for recognition of their specialty qualifications and who have been referred to the relevant medical college for assessment of the comparability of their qualifications to Australian standards.

Statistical unit: Number of overseas trained specialists

Collection period: Calendar year 2013

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Guide for use

Basic training A period of defined training required by some specialist medical colleges to be undertaken in order for trainees to meet eligibility criteria for entering an advanced training program.

Advanced training A period of defined and structured education and training, that, when successfully completed, will result in eligibility to apply for fellowship of a specialist medical college and/or to practise as a specialist. This may be preceded by completion of basic training requirements.

Some colleges have an integrated training program and do not have separate basic and advance components. Data on these programs should be included under advanced training.

State/Territory This is the state/territory in which the vocational training is provided by the accredited specialist medical college/faculty or other vocational training provider.

This is not the place of residence of trainees undertaking the vocational training.

State/Territory of fellow This is the place of residence of fellows.

It includes fellows who have been trained overseas and are accepted by the college to practise in Australia. It excludes fellows who are residing overseas.

Accreditation approach Approach that is adopted by a college or other vocational training provider whereby a college determines whether its specified requirements for the clinical experience, infrastructure and educational support required of a hospital/training position are met.

Accreditation varies depending upon whether positions or posts, sites, facilities, units or programs are accredited.

Training discontinuation A trainee is considered discontinued either when he or she has officially withdrawn from the training program or the medical college has terminated or dismissed a trainee in accordance with the college regulations or employment conditions.

Trainees who have been given approved extended leave are excluded.

Part-time training Trainees who have been given approval to undertake training for a period at less than full time during the year of data collection.

Examination outcome The total number of trainees who have sat an examination and the number who have sat and passed the examination.

Data excludes examination results from overseas medical practitioners wishing to practise in Australia.

Examination results for international medical graduates who have been assessed as being partially comparable are not to be included.

Examination name This refers to the name of the college training programs for which vocational trainees are being examined as part of their medical college training requirements.

Rural pathway Rural Pathway registrars undertake their training in rural and remote areas. These areas were previously defined as Rural, Remote and Metropolitan Area (RRMA) classification areas 3-7. Since 1 January 2010 rural areas have been defined using the Australian Standard Geographical Classification - Remoteness Area (ASGC-RA) as Remoteness Areas 2-5.

New fellow A fellow who has been admitted to the medical college in the specified year. This includes trainees who have completed their training in Australia or overseas.

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Guide for use

Fellow A medical practitioner, who has been granted fellowship of the medical college through completion of a college training program or by other mechanisms.

This includes active fellows who have been trained overseas and who either successfully completed assessment or were exempted from assessments for admission into the college.

It excludes those who hold life membership by virtue of their age and those who are retired.

Substantially comparable Medical colleges assess overseas trained specialists to determine whether they meet Australian standards to practise their specialty within Australia.

Overseas trained specialists who are assessed as substantially comparable are eligible to become fellows of the relevant medical college without further examination but may require a period of up to 12 months oversight and peer review prior to admission to Fellowship.

Partially comparable Partially comparable overseas trained specialists require up to two years additional training and/or supervision and formal assessments, prior to being considered to be eligible to become fellows.

Vocational medical training Medical colleges

Accreditation approach

Data item Value

Accreditation approach

Specialty As defined by the medical college

Accreditation approach Positions/Posts

Facilities/Programs

Vocational training

Data item Value

Basic and advanced training

Specialty As defined by the medical college

Sex Female

State/Territory NSW

VIC

QLD

SA

WA

TAS

NT

ACT

Part-time status

Training discontinuation

Country of primary medical qualification Australia, New Zealand, UK and Ireland, India, United States, Canada, South Africa, Malaysia, Iran, Philippines, Sri Lanka and Other

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Data item Values

Examination type Written

Clinical Oral Fellowship Viva Other

Examination outcome Number sitting examination

Number passing examination

Examination name

Basic training - first year

Specialty As defined by the medical college

Sex Female

State/Territory NSW

VIC QLD SA WA TAS NT ACT

Advanced training - first year

Specialty As defined by the medical college

Sex Female

State/Territory NSW

VIC QLD SA WA TAS NT ACT

GPET - first year trainees

Regional Training Provider

State/Territory NSW

VIC QLD SA WA TAS NT ACT

GPET - all trainees

Regional Training Provider

Sex Female

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Data item Values

State/Territory NSW

VIC

QLD

SA

WA

TAS

NT

ACT

Rural pathway - all trainees

State/Territory NSW

VIC

QLD

SA

WA

TAS

NT

ACT

Subspecialty - all vocational trainees

Subspecialty As defined by medical college

Sex Female

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College fellows

Data item Values

New fellows

Specialty As defined by medical college

Sex Female

State/Territory NSW

VIC QLD SA WA TAS NT ACT

Subspecialty - new fellows

Subspecialty As defined by medical college

Sex Female

Fellows

Specialty As defined by medical college

Sex Female

State/Territory NSW

VIC QLD SA WA TAS NT ACT

Subspecialty - fellows

Subspecialty As defined by medical college

Sex Female

Overseas trained specialists

Data item Value

Recognition/Fellowship

Specialty As represented by colleges

Type of overseas trained specialist assessment Substantially comparable Partially comparable

Not comparable

Fellows

Specialty As represented by colleges

Sex Female

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International medical graduates

Overseas trained specialists

Definition: International medical graduate

A doctor whose basic medical qualifications were acquired in a country other than Australia.

Overseas trained specialist

A doctor whose specialist medical qualifications were acquired in a country other than Australia.

Data source: - AMC for pathway data relating to international medical graduates - Medical colleges.

Scope: The scope includes international medical graduates who have applied and whose qualification have been assessed as suitable for entering into the training program to allow them eligibility for fellowship by the college.

It also includes overseas trained specialists who have applied to the college and who were assessed as being exempted from any assessment or requiring further assessment to allow them eligibility for fellowship by the college.

Statistical unit: - Number of international medical graduates - Number of overseas trained specialists

Collection period: Calendar year 2013.

Latest available data at a specified time of data collection for international medical graduates and overseas trained specialists.

International medical graduates Overseas trained specialists 2013

Data item Values

International medical graduates and overseas trained specialists

AMC pathways Competent authority

Standard pathway (AMC examination)

Standard pathway (workplace based assessment)

Specialist assessment

Type of overseas trained specialist assessment Substantially comparable Partially comparable

Not comparable

Overseas trained specialist assessment Initial processing College processing

Substantially comparable

Partially comparable

Not comparable

Withdrawn

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Appendix F: TRAINING PROGRAM TERMINOLOGY

Medical colleges

Guide for use as defined in MTRP

Basic training A defined period of elementary training required by some specialist medical colleges prior to admission to an advanced training program.

Advanced training

A period of defined and structured education and training, that, when successfully completed, will result in eligibility to apply for fellowship of a specialist medical college and/or to practise as a specialist. This may be preceded by completion of basic training requirements.

Some colleges have an integrated training program and do not have separate basic and advanced components. Data on these programs should be included under advanced training.

The table below illustrates what is defined under the category of the terms used in MTRP for ‘basic training’ and ‘advanced training’ for each medical specialty. These are not the training requirements of each medical college, but rather show what is included under the term ‘basic’ or ‘advanced’ for each medical specialty.

Specialty

MTRP defined

Year of training Medical College defined

Anaesthesia Basic Year 1 0.5 year Introductory Training/0.5 year Basic Training

Basic Year 2 Basic Training

Advanced Year 3 Advanced Training

Advanced Year 4 Advanced Training

Advanced Year 5 Provisional Fellowship Training

Dermatology Basic Year 1 Basic Training

Basic Year 2 Basic Training

Advanced Year 3 Advanced Training

Advanced Year 4 Advanced Training

Advanced Year 5 Advanced Training(a)

Emergency medicine - Year 1 Usually PGY1(b)

- Year 2 Usually PGY2(b)

Basic Year 3 Provisional Training Year

Advanced Year 4 Advanced Training Year

Advanced Year 5 Advanced Training Year

Advanced Year 6 Advanced Training Year

Advanced Year 7 Advanced Training Year

(a) Offered as an additional year if required, most trainees finish in the fourth year. (b) Refers to two years of ‘basic training’ preceding provisional training but it usually comprises of PGY1 and PGY2.

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Specialty MTRP defined

Year of training Medical College defined

General practice (ACRRM and RACGP)(c) Advanced Year 1 ACRRM - Core clinical training time

Advanced Year 2 ACRRM - Primary rural and remote training Advanced Year 3 ACRRM - Primary rural and remote training Advanced Year 4 ACRRM - Advanced specialised training Advanced Year 1 RACGP - Hospital training time

Advanced Year 2 RACGP - GP Terms - GPT1, GPT2

Advanced Year 3 RACGP - GP Terms - GPT3/extended skills Advanced Year 4 RACGP - Advanced skills training (only for FARGP) Intensive care Basic Year 1 Basic Training

Basic Year 2 Basic Training

Basic Year 3 Basic Training

Advanced Year 4 Advanced Training

Advanced Year 5 Advanced Training

Advanced Year 6 Advanced Training

Medical administration Advanced Year 1 Advanced Training

Advanced Year 2 Advanced Training

Advanced Year 3 Advanced Training

Obstetrics and gynaecology

Basic Year 1 Integrated Training Program (Year 1)

Basic Year 2 Integrated Training Program (Year 2)

Basic Year 3 Integrated Training Program (Year 3)

Basic Year 4 Integrated Training Program (Year 4)

Advanced Year 5 Elective Training (Year 1)

Advanced Year 6 Elective Training (Year 2)

Ophthalmology Basic Year 1 Basic Training

Basic Year 2 Basic Training

Advanced Year 3 Advanced Training

Advanced Year 4 Advanced Training

Advanced Year 5 Advanced Training

Pain medicine(d) Advanced Year 1 Advanced Training

Advanced Year 2 Advanced Training

Advanced Year 3 Advanced Training

Pathology Advanced Year 1 Advanced Training

Advanced Year 2 Advanced Training

Advanced Year 3 Advanced Training

Advanced Year 4 Advanced Training

Advanced Year 5 Advanced Training

Physicians - addiction medicine(e) Advanced Year 1 Advanced Training

Advanced Year 2 Advanced Training

Advanced Year 3 Advanced Training

(c) GP titles are more curricula descriptors rather than actual training year names. (d) Training requirements vary from one to three years, depending on the primary specialist qualification. (e) Basic training program requirements are to be met prior to entering the particular physician training program.

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Specialty

MTRP defined

Year of training Medical college defined

Physicians - adult medicine Basic Year 1 Basic Training

Basic Year 2 Basic Training

Basic Year 3 Basic Training

Advanced Year 4 Advanced Training

Advanced Year 5 Advanced Training

Advanced Year 6 Advanced Training

Physicians - occupational and environmental medicine(f) Advanced Year 1 Stage A/B

Advanced Year 2 Stage B

Advanced Year 3 Stage B/C

Advanced Year 4 Stage C

Physicians - paediatrics Basic Year 1 Basic Training

Basic Year 2 Basic Training

Basic Year 3 Basic Training

Advanced Year 4 Advanced Training

Advanced Year 5 Advanced Training

Advanced Year 6 Advanced Training

Physicians - palliative medicine(f) Advanced Year 1 Advanced Training

Advanced Year 2 Advanced Training

Advanced Year 3 Advanced Training

Physicians - public health medicine(f) Advanced Year 1 Advanced Training Advanced Year 2 Advanced Training

Advanced Year 3 Advanced Training

Physicians - rehabilitation medicine (f),(g) Advanced Year 1 Advanced Training Advanced Year 2 Advanced Training

Advanced Year 3 Advanced Training

Advanced Year 4 Advanced Training

Physicians - sexual health medicine(f) Advanced Year 1 Advanced Training Advanced Year 2 Advanced Training

Advanced Year 3 Advanced Training

Psychiatry Basic Year 1 Basic Training Year 1

Basic Year 2 Basic Training Year 2

Basic Year 3 Basic Training Year 3

Advanced Year 4 Advanced Training Year 1 Advanced Year 5 Advanced Training Year 2

Radiation oncology Advanced Year 1 Phase 1 (18-24 months)

Advanced Year 2 Phase 1 (18-24 months)

Advanced Year 3 Phase 2 (36-42 months)

Advanced Year 4 Phase 2 (36-42 months)

Advanced Year 5 Phase 2 (36-42 months)

(f) Entry requirement of a minimum of two years clinical experience. (g) An exception for paediatric rehabilitation which is three years basic and three years advanced training.

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Specialty

MTRP defined

Year of training Medical College defined

Radiodiagnosis Advanced Year 1 Phase 1 - General radiology training

Advanced Year 2 Phase 1 - General radiology training Advanced Year 3 Phase 1 - General radiology training Advanced Year 4 Phase 2 - Systems focused rotations Advanced Year 5 Phase 2 - Systems focused rotations Sport and exercise medicine(h)

Advanced Year 1 Advanced Training Advanced Year 2 Advanced Training Advanced Year 3 Advanced Training Advanced Year 4 Advanced Training

Surgery(i) Advanced Year 1 Surgical education and training year 1

Advanced Year 2 Surgical education and training year 2 Advanced Year 3 Surgical education and training year 3 Advanced Year 4 Surgical education and training year 4 Advanced Year 5 Surgical education and training year 5 Advanced Year 6 Surgical education and training year 6

(h) Three years basic training (PGY1-PGY3) to be completed prior to entering the medical college training program.

(i) Five year training programs for general surgery, orthopaedic surgery, otolaryngology, plastic surgery, urology and vascular surgery, six year training programs for cardiothoracic surgery and, neurosurgery, and up to seven years for paediatric surgery.

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