Medical Training Review Panel: sixteenth report

Advanced Training

Page last updated: 09 April 2013

In 2012, there were 10,996 advanced vocational training positions/trainees in programs in Australia (Table 4.13). This constitutes almost two thirds (65.7%) of the total number of vocational training positions/trainees. General practice had the highest number of advanced trainees (3,445), followed by adult medicine (1,468), emergency medicine (1,204) and surgery (1,094).

Table 4.13 also shows the distribution of advanced training positions/trainees across states and territories.

Table 4.13: Advanced vocational training positions/trainees by medical specialty and state/territory, 2012

(a) Trainees are included in ACEM total.
(b) Includes 60 Australian trainees on approved extended leave.
(c) Based on Dec 2011 data.
(d) ACT data is included in NSW figures.
(e) RACP Paediatric Emergency Medicine trainees may also be accounted for the RACP Paediatrics figures, as they may be undertaking training in another paediatrics specialty.
(f) Total number of registrars across all states is 3325 as it includes double counting of some registrars.
(g) Total excludes 4 currently living overseas.
(h) RANZCP includes 229 Fellows completing subspecialty training.

Source: Medical colleges and GPET

Medical specialtyNSWVicQldSAWATasNTACTAust
Addiction medicine
6
1
5
2
3
0
1
0
18
Adult medicine
455
448
258
133
101
27
12
34
1,468
Anaesthesia
177
156
134
43
61
15
5
18
609
Anaesthesia - Pain medicine
24
19
6
3
4
2
0
1
59
Dermatology
21
16
11
5
4
0
0
0
57
Emergency medicine - ACEM
325
288
299
93
133
27
19
20
1,204
Emergency medicine - RACP(a)
13
8
16
4
4
0
0
0
(e)45
General practice - GPET
(d)1,119
734
695
295
288
108
86
..
(f)3,289
General practice - ACRRM
38
13
63
6
20
6
10
0
(g)156
Intensive care
96
75
65
25
24
6
6
5
302
Medical administration
19
22
35
2
14
0
1
5
98
Obstetrics and Gynaecology
47
28
36
8
8
3
1
2
133
Occupational and Environmental medicine
30
9
20
5
17
1
0
2
84
Ophthalmology
33
20
12
7
6
1
1
0
80
Paediatrics
207
150
102
43
67
6
13
5
593
Palliative medicine
3
5
8
7
0
1
0
0
24
Pathology
105
79
62
21
32
5
3
7
314
Pathology and RACP (jointly)
73
60
33
15
17
3
1
6
208
Psychiatry
137
134
75
23
37
3
2
6
(h)417
Public health medicine
18
9
4
6
7
1
8
8
61
Radiation oncology
61
33
23
11
7
2
0
4
141
Radiodiagnosis
112
99
77
35
34
5
0
10
372
Rehabilitation medicine
80
42
30
12
7
4
1
1
177
Sexual health medicine
4
2
0
3
1
0
0
0
10
Sport and exercise medicine
9
13
1
0
3
0
1
1
28
Surgery(b),(c)
381
314
190
85
88
13
7
16
1,094
Total
3,580
2,769
2,244
888
983
239
178
151
10,996

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 across states and territories also roughly mirrored the relative proportions of the population in each (Table 4.14).

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Table 4.14: Proportion of advanced vocational training positions/trainees by medical specialty and state/territory, 2012

(a) ACT data are included in NSW figures.
(b) Population data from ABS. 3101.0 – Australian Demographic Statistics, June 2012, released 18/12/2012.

Source: Medical colleges and GPET

Medical specialtyNSWVicQldSAWATasNTACT
Addiction medicine
33.3
5.6
27.8
11.1
16.7
0.0
5.6
0.0
Adult medicine
31.0
30.5
17.6
9.1
6.9
1.8
0.8
2.3
Anaesthesia
29.1
25.6
22.0
7.1
10.0
2.5
0.8
3.0
Anaesthesia - Pain medicine
40.7
32.2
10.2
5.1
6.8
3.4
0.0
1.7
Dermatology
36.8
28.1
19.3
8.8
7.0
0.0
0.0
0.0
Emergency medicine - ACEM
26.9
24.2
24.4
7.7
11.1
2.3
1.6
1.7
Emergency medicine - RACP
28.9
17.8
35.6
8.9
8.9
0.0
0.0
0.0
General practice - GPET
(a)33.7
22.1
20.9
8.9
8.7
3.2
2.6
..
General practice - ACRRM
24.4
8.3
40.4
3.8
12.8
3.8
6.4
0.0
Intensive care
31.8
24.8
21.5
8.3
7.9
2.0
2.0
1.7
Medical administration
19.4
22.4
35.7
2.0
14.3
0.0
1.0
5.1
Obstetrics and Gynaecology
35.3
21.1
27.1
6.0
6.0
2.3
0.8
1.5
Occupational and Environmental medicine
35.7
10.7
23.8
6.0
20.2
1.2
0.0
2.4
Ophthalmology
41.8
25.5
12.7
7.3
9.1
1.8
1.8
0.0
Paediatrics
34.9
25.3
17.2
7.3
11.3
1.0
2.2
0.8
Palliative medicine
12.5
20.8
33.3
29.2
0.0
4.2
0.0
0.0
Pathology
33.4
25.2
19.7
6.7
10.2
1.6
1.0
2.2
Pathology and RACP (jointly)
35.1
28.8
15.9
7.2
8.2
1.4
0.5
2.9
Psychiatry
32.9
32.1
18.0
5.5
8.9
0.7
0.5
1.4
Public health medicine
29.5
14.8
6.6
9.8
11.5
1.6
13.1
13.1
Radiation oncology
43.3
23.4
16.3
7.8
5.0
1.4
0.0
2.8
Radiodiagnosis
30.1
26.6
20.7
9.4
9.1
1.3
0.0
2.7
Rehabilitation medicine
45.2
23.7
16.9
6.8
4.0
2.3
0.6
0.6
Sexual health medicine
40.0
20.0
0.0
30.0
10.0
0.0
0.0
0.0
Sport and exercise medicine
32.1
46.4
3.6
0.0
10.7
0.0
3.6
3.6
Surgery
34.8
28.7
17.4
7.8
8.0
1.2
0.6
1.5
Total
32.6
25.2
20.4
8.1
8.9
2.2
1.6
1.4
Population proportion (%)(b)
32.2
24.8
20.1
7.3
10.7
2.3
1.0
1.7

First–year Advanced Trainees

In 2012, there were 3,114 first-year advanced vocational training positions/trainees (Table 4.15). The specialty with the most first-year advanced vocational training places was general practice (1,006), followed by adult medicine (418).

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Table 4.15: First-year advanced vocational positions/trainees by medical specialty and state/territory, 2012

(a) Trainees are included in ACEM total.
(b) Based on Dec 2011 data.
(c) ACT data are included in NSW figures.
(d) Total number of 1st year registrars across all states is 1012 (including double counting of registrars).
(e) Excludes one trainee currently living overseas.
(f) Psychiatry includes 71 trainees in subspecialty training.
(g) Total number of first year registrars across all states (excluding double counting of registrars and one registrar from overseas).

Source: Medical colleges and GPET

Medical specialtyNSWVicQldSAWATasNTACTAust
Addiction medicine
3
0
1
0
2
0
0
0
6
Adult medicine
138
136
69
25
24
14
4
8
418
Anaesthesia
56
46
47
17
16
5
1
8
196
Anaesthesia - Pain medicine
8
9
2
2
4
1
0
0
26
Dermatology
11
7
8
2
0
0
0
0
28
Emergency medicine - ACEM
84
68
83
19
23
8
4
4
293
Emergency medicine - RACP(a)
3
1
7
1
2
0
0
0
14
General practice - GPET
(c)343
235
227
78
79
29
21
..
(d)1,006
General practice - ACRRM
13
5
16
3
5
0
1
0
(e)43
Intensive care
21
23
19
6
9
2
2
0
82
Medical administration
4
5
10
0
4
0
0
1
24
Obstetrics and Gynaecology
24
15
17
4
4
1
1
0
66
Occupational and Environmental medicine
8
2
7
1
3
1
0
1
23
Ophthalmology
10
8
2
2
3
1
1
0
27
Paediatrics
54
35
19
11
18
1
3
0
141
Palliative medicine
2
0
3
3
0
1
0
0
9
Pathology
18
14
9
3
5
0
1
1
51
Pathology and RACP (jointly)
15
13
7
7
4
1
0
2
49
Psychiatry
72
68
35
12
23
2
1
3
(f)216
Public health medicine
1
3
0
2
2
0
1
3
12
Radiation oncology
12
4
3
2
1
2
0
0
24
Radiodiagnosis
21
16
16
5
8
1
0
3
70
Rehabilitation medicine
25
16
9
6
0
1
0
0
57
Sexual health medicine
0
0
0
0
0
0
0
0
0
Sport and exercise medicine
1
0
0
0
0
0
0
0
1
Surgery(b)
90
60
48
12
20
6
3
7
246
Total
1034
788
657
222
257
77
44
41
(g)3,114

Female Trainees

Half (5,536 or 50.3%) of all advanced vocational trainees were female (Table 4.16). This proportion was far higher in some specialties, with females comprising three-fifths or more of advanced vocational trainees in sexual health medicine, dermatology, rehabilitation medicine, public health medicine, obstetrics and gynaecology, paediatrics, general practice, palliative medicine and pathology (80.0%, 73.7%, 68.9%, 67.2%, 65.4%, 65.3%, 63.5%, 62.5% and 60.8% respectively).

A number of smaller specialties showed relatively low proportions of females, but of the larger specialties, ophthalmology and surgery were notable for the low proportions of female advanced trainees (23.8% and 25.4% respectively).

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Table 4.16: Female advanced vocational trainees by medical specialty and state/territory, 2012

(a) Trainees are included in ACEM total.
(b) Based on Dec 2011 data. Includes 15 female Australian trainees on approved extended leave.
(c) ACT data is included in NSW figures.
(d) Total number of female registrars across all states is 2,165, this includes double counting of registrars.
(e) RANZCO advanced training comprises years 3, 4 and 5. The figure of 19 is female trainees in years 3 and 4. These trainees must be 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.

Source: Medical colleges and GPET

Medical specialtyNSWVicQldSAWATasNTACTAust
Addiction medicine
3
1
2
0
1
0
1
0
8
Adult medicine
221
214
97
59
44
15
6
14
670
Anaesthesia
88
78
45
22
25
5
2
3
268
Anaesthesia - Pain medicine
9
7
2
2
2
1
0
0
23
Dermatology
18
12
8
3
1
0
0
0
42
Emergency medicine - ACEM
136
124
120
34
58
9
10
2
493
Emergency medicine - RACP(a)
8
6
8
1
2
0
0
0
25
General practice - GPET
(c)742
467
434
183
205
75
59
..
(d)2,142
General practice - ACRRM
9
3
14
2
8
5
3
0
44
Intensive care
33
22
22
5
6
0
2
2
92
Medical administration
9
7
11
1
8
0
1
2
39
Obstetrics and Gynaecology
31
21
20
7
6
0
1
1
87
Occupational and Environmental medicine
7
1
3
1
3
0
0
2
17
Ophthalmology
10
5
1
3
0
0
0
0
(e)19
Paediatrics
136
105
63
27
40
3
10
3
387
Palliative medicine
1
4
4
5
0
1
0
0
15
Pathology
71
47
33
13
16
4
2
5
191
Pathology and RACP (jointly)
34
30
17
10
9
3
0
3
106
Psychiatry
72
73
48
12
24
0
0
3
232
Public health medicine
14
7
2
4
4
0
7
3
41
Radiation oncology
42
15
12
4
5
0
0
2
80
Radiodiagnosis
46
29
24
13
9
1
0
3
125
Rehabilitation medicine
57
32
16
11
4
1
1
0
122
Sexual health medicine
3
1
0
3
1
0
0
0
8
Sport and exercise medicine
3
2
0
0
1
0
0
1
7
Surgery(b)
91
93
45
21
18
3
2
5
278
Total
1,886
1,406
1,051
446
500
126
107
54
5,536

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 2012, there were 1,379 part-time advanced trainees across specialties. This represents one-eighth (12.5%) of all advanced trainees (Table 4.17).

Part-time training was most common in sexual health medicine (50.0%), general practice (25.4%) and public health medicine (26.2%).

A number of other specialties were notable for 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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Table 4.17: Advanced vocational trainees undertaking part-time training by medical specialty and state/territory, 2012

(a) Trainees are included in ACEM total.
(b) Palliative Medicine only denotes Chapter trainees.
(c) Based on Dec 2011 data.
(d) ACT data are included in NSW figures.
(e) Total number of part-time registrars across states is 881 (including double counting of registrars).

Source: Medical colleges and GPET

Medical specialtyNSWVicQldSAWATasNTACTAust
Addiction medicine
1
0
1
1
1
0
0
0
4
Adult medicine
16
15
9
9
2
2
0
2
55
Anaesthesia
15
15
8
2
3
0
0
2
45
Anaesthesia - Pain medicine
4
2
2
0
0
0
0
0
8
Dermatology
1
1
3
2
0
0
0
0
7
Emergency medicine - ACEM
42
30
9
9
10
1
2
2
105
Emergency medicine - RACP(a)
2
0
2
1
0
0
0
0
5
General practice - GPET
(d)361
148
169
76
62
38
27
..
(e)874
General practice - ACRRM
0
0
0
0
0
0
0
0
0
Intensive care
2
1
2
0
0
0
0
0
5
Medical administration
1
0
2
0
1
0
0
0
4
Obstetrics and Gynaecology
3
1
2
0
0
0
0
0
6
Occupational and Environmental medicine
0
0
0
0
0
0
0
0
0
Ophthalmology
1
2
0
0
0
0
0
0
3
Paediatrics
22
31
8
3
7
0
2
1
74
Palliative medicine(b)
0
0
0
4
0
0
0
0
4
Pathology
10
9
5
0
3
1
0
0
28
Pathology and RACP (jointly)
2
2
0
0
0
1
0
0
5
Psychiatry
28
24
19
3
6
2
0
0
82
Public health medicine
4
4
2
1
4
0
1
0
16
Radiation oncology
3
0
0
0
0
0
0
2
5
Radiodiagnosis
4
1
1
2
0
0
0
0
8
Rehabilitation medicine
11
9
8
1
2
0
0
0
31
Sexual health medicine
2
1
0
1
1
0
0
0
5
Sport and exercise medicine
0
1
1
0
0
0
1
0
3
Surgery(c)
1
0
0
0
1
0
0
0
2
Total
534
297
253
115
103
45
33
9
1,379

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.

In 2012, there were 103 advanced trainees who discontinued training (Table 4.18). This is considerably less than in 2010 and more in line with the numbers in 2008 and 2009.

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Table 4.18: Advanced vocational trainee discontinuations by state/territory, 2008-2012

(a) ACT data are included in NSW figures for general practice.
(b) Total Advanced vocational trainee discontinuations by state/territory, 2008-2012 (excluding one trainee from overseas).

Source: Medical colleges and GPET

NSWVicQldSAWATasNTACTAust
2008
37
29
29
6
7
2
1
1
112
2009
40
36
28
7
15
2
0
1
129
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