Prevocational medical training and the Australian Curriculum Framework for Junior Doctors: a junior doctor perspective

Abstract

The current system of prevocational training does not meet the needs of junior doctors because of a high administrative workload, insufficient funding for education, and a lack of centralised guidance for trainees, teachers and hospitals. The Australian Curriculum Framework for Junior Doctors is designed to identify the training objectives for the prevocational years. The Framework has the potential to improve the quality of training of junior doctors, but this depends on how well it is implemented and resourced. It is imperative that any group responsible for implementing or assessing the Framework have a representative junior doctor, among others, on its decision‐making committee. Stringent accreditation of training institutions is vital to the effective implementation of the Framework. The Framework should be used to promote teaching and learning, not as a barrier to vocational training or as a check‐list to complete.

Interns reflect: the effect of formative assessment with feedback during pre-internship

“…It is generally assumed that interns are able to perform basic core skills, such as U/C under supervision when first entering the workplace 17. However, our previous study found that immediately prior to the commencement of internship, almost one-third (29%) of Pre-Intern (PrInt) students had never performed male U/C 18.…”

The capacity of Australian ED to absorb the projected increase in intern numbers

“…The role of junior medical staff in public hospitals is often characterized by a dichotomy between service provision and training 7 . Rather than simply being service providers, junior doctors are acknowledged as ‘doctors in training’ whose learning needs and responsibilities deserve consideration 9,10 . In Australia, State Medical Boards and Postgraduate Medical Councils are responsible for stipulating the training and supervision requirements for interns, the nature of rotations that can and must be taken, and the settings in which they can be undertaken 11–13 .…”

“…7 Rather than simply being service providers, junior doctors are acknowledged as 'doctors in training' whose learning needs and responsibilities deserve consideration. 9,10 In Australia, State Medical Boards and Postgraduate Medical Councils are responsible for stipulating the training and supervision requirements for interns, the nature of rotations that can and must be taken, and the settings in which they can be undertaken. [11][12][13] There has, however, been concern regarding lack of uniformity across States, difficulty in identifying common education goals, and inconsistencies in supervision and assessment/feedback.…”

Training our prevocational doctors

“…However, will the Framework make any difference to the educational experience in those transitional years? This is a point of concern for JMOs, as discussed by https://doi.org/10.5694/j.1326-5377.2007.tb00831.x in this issue 7 …”

“…Assessment may be even harder. Although the JMOs are not keen for assessment to be used for registration, 7 registration is a recognition of a level of competence and needs to involve some form of assessment. How can we be sure that doctors have reached a level of competence where they can be left to care for patients independently or are ready to move to the next stage of training?…”