Blog

The way forward

Wednesday July 1, 2020

Dr Rebecca Wood, Co-Chair of the Federal AMA’s Council of Doctors in Training (CDT)

Over the past three months, there have been many changes afoot in the federal doctors in training (DiT) landscape. Even before the formation of the new executive, the COVID-19 crisis kept us all at the Council of Doctors in Training (CDT) busy with policy, papers and meetings.

In late February at our most recent face-to-face meeting, we celebrated the Immediate Past Chair Dr Tessa Kennedy and thanked her for her leadership, passion and representation. Dr Kennedy has been a staunch advocate for DiTs, parent doctors and gender equity and diversity throughout her tenure.

In March, we welcomed a new Federal Chair in Dr Hashim Abdeen. Following Dr Abdeen’s election as CDT Chair, we had a hotly contested election for CDT Deputy Co-Chair with 16 candidates nominating for the two positions. There was considerable discussion over four days to find the new deputies – Dr Laura Raiti and me. We are so lucky to have such engaged, enthusiastic DiTs ready to take on more active roles within the AMA DiT community and we want to harness that energy going forward.

The CDT has been meeting more frequently than in previous years to address the big issues affecting DiTs during the current COVID-19 crisis and to make progress on those longstanding issues. This wouldn’t be possible without access to teleconferencing technology and more so, the outstanding secretarial support we get from our federal senior policy adviser Sally Cross.

As the pandemic was developing and the crisis unfolding internationally, we at the CDT were looking for pressure points in the DiT scope and seeking safeguards.

In April, the CDT released the document AMA advocacy to support doctors in training during the COVID-19 response (link: https://bit.ly/2A9YCHk)

Dr Abdeen has been meeting frequently with the Council of Presidents of Medical Colleges (CPMC), the Australian Medical Council (AMC), Medical Deans Australia and New Zealand (MDANZ), the Australian Medical Students’ Association (AMSA), the Medical Workforce Reform Advisory Committee (MWRAC), indemnity providers and the jurisdictional bodies, shining a light on these issues and more as they have been surfacing.

The  organisations around the nation have been listening to our concerns. Some early wins were made with the Medical Board of Australia (MBA) and the Australian Health Practitioner Regulation Agency (AHPRA) approving the intern year for 2020 to allow flexibility to meet requirements and jurisdictions automatically renewing DiT contracts for the 2021 year. But it hasn’t all been rainbows and fairy godmothers granting wishes.

The COVID-19 crisis has highlighted some of the existing inequalities we have seen affecting DiTs for years, which still remain unresolved. Some of those affected are DiTs who are GP registrars, Psychiatry trainees in community placements and Australian College of Sport & Exercise Physicians (ACSEP) registrars. These DiTs have poorer working conditions than their hospitalist counterparts. Often they are unable to access parental leave, aren’t salaried and have starting wages that are much lower than hospitalist registrars – to the extent that the ACSEP registrars are having to supplement their income through multiple streams during non-COVID times. This has all been exacerbated by the pandemic.

We have heard of GP registrars being stood down from practices and ACSEP registrars who have lost more than 50 per cent of their clinical training time. This will have a huge effect on their ability to put food on the table let alone progress through training.

COVID-19 has had pronounced effects on all training programs – with disruptions to exams, access to required volumes of practice, cancelled courses and conferences just to name a few. The steps before specialist medical training are even more disrupted for those prevocational DiTs. Candidates applying to college training programs are suffering from a lack of access to conferences, courses and research opportunities in this highly competitive process.

On the weekly agenda at our CDT executive meetings are the issues that are affecting DiTs across the nation. We discuss training and workforce, wellbeing (financial, social, workplace), safety (safe work hours, PPE), valuing our members and engaging DiTs, diversity and gender equity, and how we can strengthen the AMA DiT community.

This month, we will call for expressions of interest in our new Special Interest Groups (SIGs) – Industrial, Wellbeing, Prevocational and Vocational Training SIGs. These SIGs will sit alongside our new advisory committees and report to the CDT. Our advisory committees will allow us to engage and listen to DiT members from across the nation on issues affecting them. The first advisory committee will be for GP registrar representatives from each state.

We expect to see the far-reaching effects of COVID-19 on the DiT workforce for years to come, from medical school graduates through to fellows. Through the crisis, we have experienced the benefit of increased uptake of technology and we hope to see this trend continuing for the AMA. As a group, we want to listen to our members, represent our peers and advocate for improvements to the systems we work in, and for improvements within our organisation.