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 Dr Andrew Singer, Principal Medical Adviser, Acute Care and Health Workforce Divisions
  • Dr Singer is an Emergency and Retrieval specialist based in Canberra. For the last 6 years he has been the Principal Medical Advisor in the Department of Health.
  • Dr Singer holds an Adjunct Appointment with ANU. He has worked with the AMC on medical school accreditation and is currently involved with specialist training accreditation. Dr Singer has a broad knowledge of what is happening in the specialist colleges.
  • There are a number of gaps in the training pipeline that need to be filled in rural areas.
  • To get the workforce numbers needed in rural / regional Australia a reverse hub and spoke model will be required with training for a rural career occurring as much as possible in rural areas.
  • At the Commonwealth level there are only 2 tools – funding and regulation. The Federation White Paper may affect funding.       Section 19AB Health Act has been an effective tool getting doctors to work in rural environments but the challenge is to get local graduates to work in rural areas.
Discussion included the following issues:
Teaching, Training and Research Activity Based Funding and accreditation of training posts
  • The role of the Commonwealth in ABF depends on the outcomes of the white paper.
  • There is quite a lot of work to be done around accreditation of training posts - Flexible arrangements, distance supervision, tele supervision etc.       The biggest limitation on accreditation as a tool in rural areas is supervision.
  • Colleges ensure standards are focussed on what is required for the training.
  • The HWA principle for hospital based accreditation was to focus on what’s required for training. If there are no supervisors, they cannot provide training.
The future of internship
  • If internship is removed, it has to be replaced with something else.       Graduates need supervision
  • There is debate about the compulsory elements of internship. For example some are for, some against a compulsory emergency rotation.
The quality of clinical supervision
  • Balance is needed. Supervisors are part of the normal curve. Medical schools are good at pushing requirements for training for supervisors and raising standards. The same clinicians are supervising students, interns and vocational trainees.
Continuous curriculum
  • Encouraging innovation allows for different approaches. Continuity of pedagogy is important - graduates are expected to be good clinicians and good educators.
  • Colleges no longer only offer Fellowship. There is now greater expectation of training for directors of training and supervisors, leveraging off what universities are doing or do it themselves.
Final Comments
  • RCSs will receive a much better hearing if they’re the solution rather than the problem.
  • Don’t wait to be asked to do something. If you can see a solution to a problem, bring it forward.