While these changes are welcome with a view to ensuring ongoing high standards for the medical profession, I am concerned for DiTs who are PGY3+ and yet to enter a specialist training program. The WA Health workforce is hugely dependent on this junior cohort of RMOs and service registrars, who will all need to find CPD homes.
But who will provide these? It’s unlikely specialist colleges will enter the pre-vocational space, and this would highly likely represent a conflict of interest (will potential trainee candidates get additional CV points for participating in their particular college’s CPD home program?).
Employing hospitals will already be busy covering the CPD programs for interns and PGY2s. Universities potentially could offer programs, with attaining a postgraduate degree as an outcome. However, they already attract many pre-vocational DiTs to their master’s programs (without needing to meet CPD accreditation and which, on average, cost $30,000).
I am interested to see what other potential training organisations could come forward as potential CPD homes. I have no doubt that organisations setting up these CPD homes for pre-vocational DiTs will pass the costs on to them. These will likely be significant, given they still need to be established, and will need accreditation annually in the first two years to gain full accreditation from AMC.
The financial wellbeing of DiTs is already of concern, with the forever increasing costs of training post medical school. Many DiTs cover these costs while also repaying their HECS debts. For example, it is not uncommon now to find surgical service registrars who have spent in excess of $50,000 post medical school; all in the quest to boost their CV and secure a training position. This is not that short of a 10 per cent deposit for a house, given the median house price in Perth is currently $525,000.2
Once enrolled in specialist training programs, DiTs must pay for annual college training fees and examination fees (which keep rising).
Now, DiTs will need to consider the costs of membership to a CPD home to continue to meet AHPRA requirements for professional development.
As a medical profession, we need to consider how sustainable these increasing costs are, and if they disadvantage certain populations within the DiT cohort. Is the study and practice of medicine becoming viable only for those who can afford it?
More information on the revised CPD standards can be found here: https://bit.ly/3FSV9ud
References available upon request.