In this edition: Spotlight on Medical Training
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SA MET Newsletter
Issue 28
| April 2015
Latest News - Spotlight on Medical Training

Associate Professor Alison Jones, Manager, South Australian Medical Education
and Training
(SA MET) Unit, Office for Professional Leadership

In the past 50 years, the delivery of health care has undergone substantial changes. This has resulted in improved outcomes of medical care and contributed to improved quality of life. With these changes, there have been significant transformations to the Australian health system and subsequently to the roles and expectations of junior doctors.  The significant changes include:
  • Shorter, more intensive stays in hospital
  • Changing inpatient profile - older patients with multiple co-morbidities
  • Higher proportion of health services being provided outside of the hospital system
  • Increasing specialisation within the medical workforce

There has been an increased focus on patient safety and quality of health care services. This has resulted in health service management placing more requirements on the level of supervision of junior doctors and the activities that they can perform.  In South Australia, the Health System is currently undergoing transformation through the Transforming Health initiative. At present, junior doctors are working in an environment requiring them to be adaptive and to work with systems which are constantly changing.  Traditional medical career pathways are rapidly changing and this is demonstrated in the upcoming reviews and consultations (see below). The junior doctors graduating from university will have to negotiate ever increasing pressures and demands to develop the skills and competencies required for their career advancements.  We need to be open to change, promote innovation and provide extensive support to junior doctors in regards to further training, career pathways and development.

From the Chair - Professor Kevin Forsyth, Chair, SA MET Health Advisory Council
The National Review of Intern Training is well overdue. Internship, necessary for medical registration, has remained relatively unaltered for many years. Our health service and the way health is delivered has changed, as has the way interns work in the health service.
The Australian Medical Council (AMC) has recently defined a range of expected outcomes from internship. This addition is welcome. However the requirements for medical registration as set by Australian Health Practitioner Regulation Agency (AHPRA), defined a few years back, have not kept pace with the developments from the AMC, or indeed the greater definition of competencies and skills from medical school training. A systematic examination of these factors is likely to lead to greater clarity on what defines internship and hopefully greater precision and flexibility to components of medical registration. In South Australia, we are hopeful that there can be greater flexibility in the types of experience and the settings where these experiences are obtained in defining internship and hence registration.

Latest news in Medical Education

National Review of Medical Intern Training
In April 2014, the Council of Australian Governments (COAG) Health Council commissioned the National Review of Medical Intern Training (discussion paper). The Review is examining the current medical internship model and possible reforms to support medical graduate transition into practice, as well as further training.
Internship is the first year of postgraduate medical practice; it builds general skills and supports career decisions. Junior doctors require significant further training and supervision before they are considered proficient and safe for independent practice. 

The National Review of Medical Intern Training focuses on specifically four main areas including:

  • The purpose of internship
  • The effectiveness of the internship year
  • The role of the internship, in supporting career decision making by doctors
  • Models to support expansion of intern training settings

For further information, visit the COAG Health Council website.

The Royal Australasian College of Surgeons (RACS) has recognised that the increased numbers of medical graduates and limited training places have resulted in junior doctors spending more time in non-accredited positions.  To assist junior doctors and to help guide them in their career development during the early prevocational years, RACS has established JDocs a competency framework supported by a suite of learning and assessment resources.  JDocs is available for doctors including internship and beyond, registered in Australia and New Zealand.
The level of input from the doctor is entirely up to them.  It is important to understand that utilising JDocs framework does not guarantee selection into any procedural specialty training program.  However, this framework and the supporting resources will assist the junior doctor recognise the skills and performance standards, prior to applying to vocational specialist training.   

Selection into Training Policy - Royal Australasian College of Physicians
Recently the Royal Australasian College of Physicians (RACP) commenced seeking feedback from a wide range of stakeholders on their Selection into Training Policy.  This policy defines the principles, selection criteria and standards that underpin entry and selection into RACP training programs.  The Department of Health provided feedback on this Policy.  RACP is now exploring how best to standardise selection into physician training and are currently exploring best practice selection methods.

Latest news in Medical Workforce

Intern and Basic/Prevocational (PGY2+) Trainee Medical Officer (TMO) applications for 2016
Application dates for intern and PGY2+ for 2016 positions have been finalised. For important dates regarding intern and PGY2+ applications, visit the SA Health website.
Intern and PGY2+ applications will be received through the SA Health eRecruitment system for the first time in 2015.

Intern preference data
A total of 779 applications for internship were commenced in 2014, for the 2015 intern year. Of the applications 717 of these were submitted by the specified closing date. Following the verification of all applications, 663 were determined to have completed their application, met the eligibility criteria and were marked as validated.

Over 78% of applicants received their first preference, with 15% receiving their second preference and 5% receiving their third preference.

Eligible applicants were allocated to available intern positions using a computer‐based algorithm that took into consideration:

  • intern category;
  • applicants’ Local Health Network (LHN) preferences; and
  • number of available positions at each LHN.

Further information is available in the 2014 SA MET Unit Intern and PGY2+ Application & Allocations Report.

Workforce snapshot - Medical specialty
Utilising publicly available medical data and information, such as the Medical Training Review Panel Reports and the Health Workforce 2025 Report, can prove useful for medical students and trainees in guiding them to make an informed decision about which medical specialty to pursue.

The Health Workforce 2025 report indicates that there were current perceived workforce shortages in the specialty areas of general practice, general medicine, medical oncology, psychiatry and radiation oncology.
  The table below details the number of specialist trainees and fellows who were employed within South Australia in 2013.

Applying for vacancies
Applying for job vacancies can sometimes feel like a daunting task, however with preparation, practice and motivation, you can develop a successful application and be confident when attending interviews.  The Medical Education Officers in the Medical Education Units can support you in constructing your Curriculum Vitae (CV).  Get in contact with them and ask about how they can provide assistance. The articles below contain simple tips for creating a successful CV and also some helpful tips on preparing for interviews.

Five tips for creating a successful curriculum vitae (CV)
Keep your CV concise

  • A CV should be set out properly and easy to read. Ideally, your CV should be about two pages long, plus a page for your referees.
Layout and format
  • To ensure your CV is appealing to potential employers, it should have a simple layout and format. Keep your format consistent, for example: all headings could be bold and you could use bullet points, for brief information.
Include a personal statement and career objectives
  • In order for your CV to stand out, you should include a personal statement. This could include information about your experiences. It is also very important to outline your career objectives, as this will catch the employer’s attention.
Keep your CV up to date
  • Your CV should always be kept up to date and include correct information. When a significant event occurs in your career or when studying, ensure you record it. You can add this to your CV later on. Proof read your CV carefully, to avoid spelling and grammar errors.
Chronological order
  • Present your study and career history with the most recent first. Set out your career history in a series of positions (for example: sales assistant, administration officer) with achievements listed below. With more recent positions, include high level of detail of your achievements.
For further information, the SA MET website has a CV template. This template can be used as a guide, or for ideas to assist you with your CV.
Tips to nail that job
Preparing for that interview:
  • Dress in smart business style.
  • Arrive 10-15 minutes early – ensure you have time to relax prior to the interview.
  • Appear friendly and outgoing to all you meet (including staff on reception).
  • Come prepared for key questions - e.g. ‘tell me about yourself’, ‘why are you interested in this position’, ‘when have you managed a conflict situation?’. 
    You will need to provide examples of when you have utilised your skills (use examples within the workplace, the community or your personal life).
  • Acknowledge and greet everyone in the interview room and shake hands with them.
  • Maintain good eye contact and show you are interested.

Getting into a Training Program

sapmea and the Australian Medical Association (AMA) South Australia (SA), are inviting all junior doctors and medical students to attend a practical session on gaining entry into post-graduate training.  This workshop will include interview tips, CV development and an opportunity to discuss College specific training with representatives from colleges. View the full program details on the sapmea website.

Medical Careers Information night
The Queen Elizabeth Hospital (TQEH) will be holding a Medical Careers information night on 12 May 2015. The night will focus on applying for junior doctor positions and specialties. For more information, click here.

Professional Development Program for Registrars (PDPR)
  • 22-23 July 2015 (CALHN only)
  • 24-25 September 2015
  • 19-20 November 2015
Visit the SA MET website for further information.

Managing Workplace Stress
  • 17 June 2015 (SALHN)
  • 18 June 2015 (MGDHS)
Visit the SA MET website for further information.

Managing Workplace Conflict
  • 24 June 2015 (SALHN)
Visit the SA MET website for further information.
In A moment with… We interviewed two junior doctors and asked them to describe their medical career pathways and explain what influenced their decisions. 
A moment with…
Dr Thomas Crowhurst

Dr Thomas Crowhurst (PGY2), is the Chair of the Australian Medical Association (AMA) South Australia Doctors in Training (DiT) Committee.

Tell us about your chosen career pathway in medicine. I've started Basic Physician Training (BPT) at the Royal Adelaide Hospital (RAH) this year, after completing my internship here last year. I don't yet have a fixed intention for my advanced training, but I'm looking forward to
working in a range of areas as a basic trainee and this will undoubtedly help with my career decision-making.

When you decided on your career pathway, what information and resources assisted you in your decision?  After some early indecisiveness in my pre-clinical years, I finished Medical School with the firm goal to become a physician. In making this decision, I think the most informative experiences occurred while working on various teams during my clinical years of Medical School. As an intern; the opportunities to talk trainees and explore their desires/experiences were extremely helpful. Advice I would offer to medical students, would be to make time to talk with their seniors about their career goals and to explore their underlying reasoning.

Was there anything else that influenced your choice of pathways? I conducted some research early during my time at Medical School which was actually in emergency medicine. This was a very useful experience in that it consolidated my interest in clinical research, even if my ultimate vocational training pathway was not in critical care; after that project, I knew that I would need to find a pathway that would enable participation in clinical research in combination with clinical practice.

What tips would you offer to junior doctors to assist them in making their decision of future career pathway? As mentioned above, I think the key is to speak to as many people as possible. There is a great deal to be learned from seniors, both a few years above through to the very senior levels. 
A moment with…
Dr Heng Chong

Dr Heng Chong (PGY5), is the Chair of the South Australian (SA) Junior Medical Officers (JMO) Forum.

What are you currently doing? I'm currently in the final year of my PhD program. I'm also a Resident Medical Officer (RMO) at the Noarlunga Hospital on a casual basis.

What have you considered or undertaken to lead you to where you are now? As a career, I'm interested in becoming an academic dermatologist. I knew since medical school that I wanted to undertake a PhD because of my interest and experience in research, although back then I couldn't pick which field. Once I decided on Dermatology, the next reasonable step in my career plan was to embark on a further 3-4 years of research. To apply for specialty training, I've looked at information from the college and talked to the head of units in the hospitals (to understand what the college is looking for in a trainee). I have also experienced teaching, accreditation and medical leadership. I've really enjoyed these different, yet all relevant, aspects of medicine to prepare me for my goal of being an academic clinician.

So far in your medical career, what or who have influenced you? During medical school, I did three summer research projects and was regularly exposed to clinician-scientists in most specialties during my rotations in Christchurch. I was inspired very early on to be involved with research and teaching. Up until my first RMO year, I had always kept an open mind regarding my chosen field of medicine, yet frequently thought about the clinical practice I enjoyed and was good at. It has been the cumulative experience and a thoughtful consideration that helped me decide on my chosen pathway. My
supportive wife is also a big factor in helping me to decide and continue on this pathway.

What tips would you offer to junior doctors to assist them in making decisions regarding possible future career pathways? For those who haven't decided on a pathway, speak to registrars and consultants during your rotations and ask them about their views about the specialty. Unfortunately, not many junior doctors have the opportunity to fully experience a variety of medicine. General practice or Emergency Medicine offers a small taste in most areas of medicine. As soon as you realise which specialty interests you, I would encourage you to engage with the department or college. Arranging experiences through a rotation, elective or observership would also help you to decide on your pathways.

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