Australian Medical Association

The AMA believes that Health Workforce Australia (HWA) can play a significant role in providing funding support to increase available resources for teaching and training prevocational doctors and vocational trainees.  The attached AMA paper Supporting prevocational and vocational training through Health Workforce Australia puts forward specific proposals regarding how this can be achieved.

The Confederation of Postgraduate Medical Education Councils (CPMEC) has prepared a discussion paper on the structure and content of the internship - the year of supervised clinical training completed by graduates of an Australian Medical Council-accredited medical school.

The AMA Council of Doctors-in-Training has written to CPMEC and given broad support to the discussion paper’s recommendations as they align with the AMA’s position on the duration of the intern year, its core terms and the role of placements in community settings.

Findings of the AMA Junior Doctor Training, Education and Supervision Survey

The consortium of eleven graduate medical schools is seeking the ACCC’s permission to continue its policies and practices for selecting applicants to graduate medical schools. These include the preference policy where applicants submit a single application to the Graduate Australian Medical Schools Admission Centre, and the one interview policy whereby applicants receive only one offer for an interview.

In its submission the AMA has said that, on balance, the public benefits from authorising the graduate medical school consortium to continue these polices and practices outweighs any potential drawbacks;  however, the AMA has noted that where a graduate medical school uses the interview process to look for certain qualities in an applicant, there is the potential for the applicant to be disadvantaged by the interview process in some circumstances. The AMA has encouraged the ACCC to address these issues in the authorisation process.

AMA Position Statement: Workplace Bullying and Harassment - 2009

There is good evidence that bullying and harassment of doctors occurs in the workplace. One Australian study found that 50% of Australian junior doctors had been bullied in their workplace, and a New Zealand study reported that 50% of doctors had experienced at least one episode of bullying behaviour during their previous three or sixth-month clinical attachment.

Workplace bullying of members of the medical workforce can occur between colleagues students and employees, and any contractors, patients, and family members with whom they are dealing.

The evidence is clear that workplace bullying contributes to poor employee health including the physical and psychological manifestations of stress and depression. Workplace bullying may affect medical students, junior doctors or senior specialists. Workplace bullying and harassment may impact on the training and education of doctors. It creates a poor learning environment due to the continued erosion of confidence, skills and initiative of the doctor, thereby creating a negative attitude towards their chosen specialty.

The AMA has prepared this position statement on workplace bullying and harassment in order to:

• to provide a guide for all doctors, hospital and practice managers to identify and manage workplace bullying and harassment;
• to raise awareness and reduce the exposure of doctors to workplace bullying and harassment; and
• to assist the medical profession in combating its perpetuation.

The AMA Position Statement on Electronic Prescription Transfer Systems – 2009 supports the development of an electronic prescription transfer system as a fundamental building block for a broader eHealth system in Australia. It sets out the high level principles that should underpin an electronic prescription transfer system.

The development of an e system in Australia is supported by:

1. the National eHealth Strategy
2. the KPMG Consultancy in Electronic Prescribing and Dispensing Final Report (commissioned by the Department of Health and Ageing);
3. the National Health and Hospital Reform Commission (NHHRC) Interim Report, including the supplementary paper on person-controlled electronic health records; and
4. commercial vendors actively promoting their prescribing systems.

The AMA position on other aspects of eHealth are set out in the following position statements:

AMA Position Statement – Unique Healthcare Identifiers – 2008
AMA Position Statement – Connectivity – 2007
AMA Position Statement – Safety and Quality of E-Health Systems – 2006

The Federal Parliament's Senate Community Affairs Committee is conducting an Inquiry into the Health Workforce Australia Bill 2009 (the "Bill"). The Commonwealth agreed to establish a new health workforce agency at the November 2008 Council of Australian Governments (COAG) meeting and this Bill seeks to implement that commitment.

The AMA has provided a submission to the Senate Inquiry.

AMA Position Statement: Clinical support time for public hospital doctors - 2009

The AMA defines clinical support time as protected time for duties that are not directly related to individual patient care. Clinical support duties encompass most aspects of the teaching, continuing professional development, clinical governance, administration and research activities undertaken by clinicians in the public health sector.

The purpose of this position statement is to specify a minimum benchmark of remunerated time for clinical support duties for senior and junior clinicians. It includes a comprehensive list of the roles and responsibilities that constitute clinical support time to assist with developing job descriptions and work schedules.

The Confederation of Postgraduate Medical Education Councils is developing an accreditation framework covering prevocational training positions across the country. While generally supportive of the concept, the AMA Council of Doctors in Training has expressed concerns at the current draft document that has been released for comment. In particular, the AMACDT believes that the draft PMAF focuses too heavily on general principles and procedures. While there are references to governance and supervisory standards, the document does not outline the applicable standards, and associated criteria and indicators, by which hospitals should be assessed in order to gain accreditation for their clinical training.

The AMACDT has encouraged the CMPEC to involve AMACDT representatives in preparing a revised draft to ensure that the input of junior doctors is properly taken into account.

ANZCA is undertaking a review of its curriculum. Based on trainee feedback, the AMA provided a submission to the review. The submission notes that trainees have reported that the College maintains a strong focus on trainee issues and are supportive of the current curriculum. The primary exam and the module-structure curriculum are noted as particular College strengths. The submission provides specific feedback on:

• Access to specialty terms
• Recognition of prior learning
• College fees
• Teaching and supervisory skills
• Educational material
• Final exam syllabus
• Basic training
• Level 1 supervision

AMA Submission to National Health Workforce Taskforce on understanding demand and capacity for undergraduate clinical placements.

AMA Position Statement: Hospitalists - 2008

The AMA Survey Report on Junior Doctor Health and Wellbeing presents the findings of the AMA's survey of the health and wellbeing of 914 junior doctors at the postgraduate year 2 level and above across Australia and New Zealand.

To read the full report click here AMA Survey Report on Junior Doctor Health and Wellbeing

The medical profession has a strong commitment to high quality patient care. This commitment often translates to working patterns that may leave you exposed to higher than acceptable risks of fatigue.

AMA Work-life flexibility survey report

AMA Position Statement Medical Training in Expanded Settings Including the Private Sector - 2007

AMA Position Statement: Accommodation And Appointment Standards For Community Placements - 2007

A guide for prospective medical students on the steps to becoming a doctor and the bonded medical places that are offered by the Australian Government.

AMA Position Statement: Core Terms in Internship - 2007

AMA Position Statement Pre-Internships In Medical School - 2007

AMA Position Statement Recognising Medical Teaching and Training in Private Practice - 2007

In this paper the AMA comments on the recent Australian Commission on Safety and Quality in Health Care (ACSQHC) paper titled Review of National Safety and Quality Accreditation Standards. The paper considers the concept of national safety and quality accreditation standards within the context of the broader, changing and evolving health care system. In preparing its comments the AMA reviewed the ACSQHC Work Plan for the period 2006/2007-2010/2011 as endorsed by Federal and State health ministers.

Safe Handover: Safe Patients

GP Registrars in their basic and advanced terms are employed by the supervising practices in which they work.

AMA Position Statement: Early Streaming Into Specialty Training - 2006

AMA Position Statement: Quality and Safety in Public Hospitals - 2006

AMA Position Statement: Health and Wellbeing of Medical Students and Practitioners - 2006

AMA Position Statement: Safety and Quality of E-Health Systems - 2006

AMA Safe Hours Audit 2006

AMA Position Statement Employment of Medical Students in Hospitals - 2006