Medical Training Review Panel: thirteenth report

Discontinuation of Training

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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.

In 2009, 130 advanced trainees discontinued training (Table 4.9). General practice and pathology had the highest numbers with 39 and 33 discontinuations respectively. The number discontinuing in general practice was, however, relatively small given that there were over two thousand trainees undertaking general practice training (2,309 compared with 361 for pathology) in 2009. Detailed data on discontinuations for individual colleges and faculties has not been shown due to the small numbers for most medical colleges.

Table 4.9: Advanced vocational trainee discontinuations by state/territory, 2007-2009

	(a)NSW	Vic	Qld	SA	WA	Tas	NT	ACT	Aust
2007(b)	15	13	5	6	6	1	1	1	79
2008	37	29	29	6	7	2	1	1	112
2009(c)	40	36	28	7	15	2	0	1	130

^(a) GPET reports joint figures for NSW and ACT.
^(b) Australia in total exceeds state/territory totals, as complete state/territory data are not available for all training programs.
^(c) Includes 1 overseas trainee.

Source: Medical colleges and GPET

Basic Training

Several colleges require periods of defined basic training prior to an individual commencing the advanced training program. Tables 4.10 and 4.11 provide data for those colleges that require a period of recognised basic training.

There were an estimated 4,502 basic trainees, representing 34.7% of all trainees in 2009. This is a six-fold increase from the 757 trainees in 1997, when the data was first reported. The main reason for this increase is that many colleges have since introduced additional basic training as a pre-requisite to advanced training.

The specialties with the largest number of basic trainees were adult medicine (1,666), emergency medicine (732) and psychiatry (661).

Of the total number of basic trainees, 965 were in their first year. The specialty with the largest number of first-year basic trainees was adult medicine (436), followed by anaesthesia (169) and psychiatry (118). As emergency medicine allows new trainees to enter the program at any time during basic or provisional training, the number of first-year emergency medicine trainees is not included.

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

Table 4.10: Basic trainees and first-year basic trainees by medical specialty and state/territory, 2009

Medical specialty	NSW	Vic	Qld	SA	WA	Tas	NT	ACT	Aust
All basic trainees
Adult medicine	431	492	377	141	143	39	6	37	1,666
Anaesthesia	157	116	125	43	34	17	4	13	509
Dermatology	7	9	13	6	4	..	..	..	39
Emergency medicine(a)	209	153	193	58	71	11	18	14	732
Intensive care	32	6	20	10	10	0	0	4	82
Obstetrics and Gynaecology(b)	91	83	75	16	18	7	0	11	301
Ophthalmology	20	13	11	3	3	1	1	1	53
Paediatrics	146	114	93	43	40	9	9	5	459
Psychiatry	243	169	127	49	49	8	5	11	661
Total	1,336	1,155	1,034	369	372	92	43	96	4,502
First-year basic trainees
Adult medicine	99	156	93	42	28	5	0	13	436
Anaesthesia	43	41	44	17	13	7	1	3	169
Dermatology(a)	4	4	4	3	3	..	..	..	18
Emergency medicine(c)	..	..	..	..	..	..	..	..	..
Intensive care(d)	0	0	1	0	1	0	0	0	2
Obstetrics and Gynaecology	26	27	17	3	5	2	0	1	81
Ophthalmology	12	6	5	2	2	0	0	0	27
Paediatrics	21	29	28	14	13	5	2	2	114
Psychiatry	52	23	18	9	13	1	1	1	118
Total	257	286	210	90	78	20	4	20	965

^(a) Includes both basic and provisional trainees registered with ACEM. Total includes 5 trainees working overseas.
^(b) Trainees undertake the 4-year Integrated Training program (ITP), which could be broadly regarded as 'basic training'.
^(c) Unable to provide as trainees may join the program at any time.
^(d) Intensive care trainees commonly receive recognition of prior learning and are generally admitted beyond first year basic training.

Source: Medical colleges

In 2009, 2,133 or 47.4% of the total number of basic trainees were female (Table 4.11). The specialty with the largest number of females was adult medicine, with 747 female basic trainees. However, the specialties with the largest proportion of females are paediatrics, obstetrics and gynaecology and dermatology with 66.4%, 65.1% and 64.1% female basic trainees respectively.

Table 4.11: Female basic trainees by medical specialty and state/territory, 2009

Medical specialty	NSW	Vic	Qld	SA	WA	Tas	NT	ACT	Aust
Number
Adult medicine	196	253	146	62	57	9	4	20	747
Anaesthesia	52	37	38	16	17	5	1	3	169
Dermatology	4	8	8	4	1	..	..	..	25
Emergency medicine	83	66	75	13	26	1	10	5	281
Intensive care	13	1	5	4	2	0	0	1	26
Obstetrics and Gynaecology(a)	62	53	42	13	14	3	0	9	196
Ophthalmology	8	8	1	2	0	0	0	0	19
Paediatrics	97	86	55	30	25	6	5	1	305
Psychiatry	134	105	56	29	29	1	4	7	365
Total	649	617	426	173	171	25	24	46	2,133
Percent (%)
Adult medicine	45.5	51.4	38.7	44.0	39.9	23.1	66.7	54.1	44.8
Anaesthesia	33.1	31.9	30.4	37.2	50.0	29.4	25.0	23.1	33.2
Dermatology	57.1	88.9	61.5	66.7	25.0	..	..	..	64.1
Emergency medicine	39.7	43.1	38.9	22.4	36.6	9.1	55.6	35.7	38.4
Intensive care	40.6	16.7	25.0	40.0	20.0	0.0	0.0	25.0	31.7
Obstetrics and Gynaecology(a)	68.1	63.9	56.0	81.3	77.8	42.9	0.0	81.8	65.1
Ophthalmology	40.0	61.5	9.1	66.7	0.0	0.0	0.0	0.0	35.8
Paediatrics	66.4	75.4	59.1	69.8	62.5	66.7	55.6	20.0	66.4
Psychiatry	55.1	62.1	44.1	59.2	59.2	12.5	80.0	63.6	55.2
Total	48.6	53.4	41.2	46.9	46.0	27.2	55.8	47.9	47.4

^(a) Trainees undertake 4 years of Integrated Training program (ITP), which could be broadly regarded as 'basic training'.

Source: Medical colleges

Caution must be applied when comparing the numbers, particularly across years where the program structure has changed at some point to include a requirement for basic training prior to proceeding to advanced training.

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