Medical Training Review Panel

Medical Training Review Panel

Eighteenth Report

May 2015

MTRP 18th Report 29

Medical Training Review Panel 18th Report

ISBN: 978-1-76007-162-2

Online ISBN: 978-1-76007-163-9

Publications approval number: 11027

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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.

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

Contents

LIST OF TABLES ix

LIST OF FIGURES xvi

ACRONYMS xvii

EXECUTIVE SUMMARY 1

University Medical Training 1

Prevocational Medical Training 5

Vocational Medical Training 7

Fellowship 9

Female Medical Training 11

International Supply of Medical Practitioners 12

CHAPTER 1: INTRODUCTION 14

Medical Training Review Panel Structure and Responsibilities 14

Report Structure 15

University Medical Education 15

Prevocational Medical Training 15

Vocational Medical Training 15

International Supply 15

Special Purpose Training Programs 16

Appendices 16

Notes on the Data and its Preparation 16

Data Sources 16

Data Quality Issues 17

Reporting Periods 17

Examination of Trends 18

Medical College Acronyms and Specialties 18

CHAPTER 2: UNIVERSITY MEDICAL EDUCATION AND TRAINING 19

Medical Students 19

Current Data 20

Types of Student Places 23

Scholarships 26

Student Characteristics 27

Aboriginal and/or Torres Strait Islander Students 32

Rural Exposure 32

Attrition Rates 35

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 54

Trends 54

Postgraduate Year 2 55

Current Data 55

Trends 56

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 60

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 91

Medical College Examinations 92

Current Data 92

Trends 95

New College Fellows 98

Current Data 98

Trends 101

New Fellows by Subspecialty – Selected Colleges 104

College Fellows 107

Fellows by Subspecialty – Selected Colleges 111

CHAPTER 5: INTERNATIONAL SUPPLY 115

Australian Government Department of Immigration and Border Protection

Entry Processes 115

Temporary Work (Skilled) visa (subclass 457) 115

Medical Practitioner (Temporary) visa (subclass 422) 116

Occupational Trainee visa (subclass 442) 117

Training and Research visa (subclass 402) 117

Current Data 118

Requirements for Practicing Medicine in Australia 120

Common Assessment Requirements 121

Competent Authority Pathway 121

Standard Pathway 123

Assessment of Overseas Trained Specialists 126

Standard Specialist Assessment 126

Medicare Provider Number Restrictions 130

Restrictions of Practice 130

Current Distribution of Overseas Trained Doctors 131

CHAPTER 6: SPECIAL PURPOSE TRAINING PROGRAMS 135

Background 135

3GA Programs Providers 136

Section 3GA Programs 138

Approved Medical Deputising Services Program 138

Approved Private Emergency Department Program 138

Approved Placements for Sports Physicians Program 138

Sports Physician Trainees 138

Australian General Practice Training 139

Prevocational General Practice Placements Program 139

Queensland Country Relieving Doctors Program 140

Rural Locum Relief Program 140

Special Approved Placements Program 141

Temporary Resident Other Medical Practitioners Program 141

Remote Vocational Training Scheme 141

APPENDICES 144

Appendix A: MEDICAL TRAINING REVIEW PANEL ROLE AND MEMBERSHIP 145

Appendix B: MEDICAL COLLEGE TRAINING REQUIREMENTS 149

Appendix C: GLOSSARY OF TERMS 210

Appendix D: EXTENDED DATA TREND TABLES 215

Appendix E: DATA SPECIFICATIONS 255

Appendix F: TRAINING PROGRAM TERMINOLOGY 266

List of Tables

TABLE DESCRIPTION PAGE

CHAPTER 1: INTRODUCTION

Table 1.1: Medical colleges: Acronyms, names and specialities 18

CHAPTER 2: UNIVERSITY MEDICAL EDUCATION AND TRAINING

Table 2.1: Medical students in Australian universities, 2014 20

Table 2.2: Domestic medical students in Australian universities, 2014 21

Table 2.3: International medical students in Australian universities, 2014 22

Table 2.4: International students studying in Australian offshore programs, 2014 23

Table 2.5: Medical students by type of student place and university, 2014 24

Table 2.6: Commencing medical students by type of student place and
university, 2014 25

Table 2.7: Medical students by type of student place: Number and proportion
of places, 2010–2014 26

Table 2.8: Commencing medical students source of scholarships, 2013 27

Table 2.9: Commencing medical students by sex and age, 2013 27

Table 2.10: Commencing medical students discipline of highest
tertiary qualification completed, 2013 28

Table 2.11: Commencing medical students level of highest prior
tertiary qualification by medical degree entry program, 2013 28

Table 2.12: Preferred type of medical practice in final year of medical degree
by gender, 2013 29

Table 2.13: Preferred type of medical practice in postgraduate year 1
by gender, 2013 30

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 32

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 34

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

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 45

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 CHAPTER

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

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 93

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 96

Table 4.39: Proportion of vocational trainees sitting a final or fellowship
examination who passed by medical specialty, 2009-2013 97

Table 4.40: New fellows: Total, females and overseas trained specialists
by medical specialty, 2013 98

Table 4.41: New fellows by medical specialty and state/territory, 2013 99

Table 4.42: Female new fellows by medical specialty and state/territory, 2013 100

Table 4.43: New fellows by medical specialty, 2009-2013 101

Table 4.44: New fellows by state/territory, 2009-2013 102

Table 4.45: Proportion of female new fellows by medical specialty, 2009-2013 103

Table 4.46: Proportion of female new fellows by state/territory, 2009-2013 104

Table 4.47: Obstetrics and gynaecology subspecialties: New fellows, females
and proportion of females by subspecialty, 2013 104

Table 4.48: Pathology subspecialties: New fellows, females and proportion
of females by subspecialty, 2013 104

Table 4.49: Physician adult medicine subspecialties: New fellows, females
and proportion of females by subspecialty, 2013 105

Table 4.50: Physician paediatric and child health subspecialties: New fellows,
females and proportion of females by subspecialty, 2013 106