The Ides of March

9 Mar 2018

In 44BC during the Ides of March, Julius Caesar was murdered by the Roman Senate. This is generally what the Ides of March are remembered for, due mostly to Shakespeare. However, the Ides of March (March 15th) were traditionally a deadline for settling one’s debts. The AMA National Conference is coming up in May and it is an election year for the AMA. Every two years, we re-elect office holders to all representative positions in the AMA, including the CDT Chair. Luckily for us, May is not March and no-one will be stabbed to death for the privilege of serving the profession and our patients. The Ides do mark a period a couple of months before the end of my term as CDT Chair however, and a deadline for settling debts seems as good a time as any to think about what we’ve achieved in this time. Did we deliver?

I want to frame these achievements as a function of the profession. Who benefits from them? What would have happened had the AMA not campaigned and lobbied for these changes? So with that in mind, let’s begin:

  • We’ve worked with Federal government, State government and stakeholders across Australia on the issue of doctor mental health. We’ve lobbied for changes to mandatory reporting laws and we’re seeing the fruits of that labour now. We continue to work on a national framework for doctor mental health across Australia. Why? Because the mental health of our profession has to be a top priority if we are to survive.
  • We lobbied for and saw the start of the development of a National Training Survey. Why? Because our workforce and training data is piecemeal and hard to come by. We need good data to fix bad training.
  • We conducted our Safe Hours Audit, which we’ve been doing since the mid-90s. Why? Because fatigue harms doctors and patients, and the answer to failing training practices is not simply more hours of bad training. It’s a re-think of how we teach.
  • We’ve hosted a Medical Workforce and Training Summit, calling for changes to the medical workforce to enable more open and fair training for trainees, and for a medical workforce that best suits Australians no matter where they live. Why? Because workforce maldistribution is resulting in poor training opportunities and progression, and harming the health of Australians.
  • We’ve passed high-level standards on what we think are best practices in assessment and we’ve lobbied colleges directly when there are issues that affect all trainees, such as the recent issue with the RACP fellowship exam or the changes to assessment in RANZCP. Why? Because trainees need meaningful training programs that support them in developing the skills needed for specialty practice, and these programs need to be open, fair and transparent.
  • We’re in the process of developing a standardised “National Hospital Health Check”. What began as a very successful program in a single state in 2013 is now almost a complete national program run by AMA branches across the nation. Why? Because we need to call out the state of training and culture in all of our hospitals, and also promote the good practices so that we can learn across the country, not just within our silos.
  • We worked with AIDA (Australian Indigenous Doctors Association) to focus efforts across the nation on supporting Indigenous trainees through to fellowship. Why? To remove inequity and to develop stable workforce for Indigenous Australia
  • We developed a National Code of Practice for Flexible Work Arrangements. Why? To stop employers from placing flexible work in the “too hard” basket
  • We lobbied and worked with the Department of Health to re-develop the BMP and MRBS programs and we are optimistic that we will see sensible reforms. Why? To remove excessively onerous conditions on bonded doctors and students, to develop a sustainable workforce for rural and regional Australia
  • We made multiple submissions to, and helped to influence the COAG Medical Intern Review. Why? Because while it could be better, internship isn’t broken, and we risked throwing the baby out with the bath water.
  • We’ve started work to reshape mandatory training across the country. Why? Because mandatory training is a fundamentally broken system that isn’t fit for purpose, it wastes your precious time and it doesn’t make you a safer doctor.

This is the short list, believe it or not. And this list is focused on the Council of Doctors in Training. It doesn’t list the broader achievements of the wider AMA family, such as the easing of the Medicare MBS freeze, or the tireless industrial representation from your State AMA branches.

The AMA’s biggest failure is in our communication back to members. We’re doing more to tell members what we are doing on a regular basis. We’ve recently changed the way we use our social media platforms, and we are continuing to look at ways to change e-mail communications with members. We’ve changed the way CDT works to bring more members into our public health working groups and to get a closer interface between our State doctor-in-training committees and with the Training Representatives from the colleges.

So back to the Ides of March and the upcoming election in May. Caesar was assassinated because of the tensions between his dictatorial aspirations and the democratic ideals of the Senate. I have no such ambition, and I’m a firm believer that sustainable leadership change is necessary to the evolution of representative organisations like CDT and the broader AMA. So it is with great pleasure that I announce that Dr Tessa Kennedy will be taking over my role in May. Tessa is an advanced paediatric and intensive care trainee, who has been an exceptional leader on both a NSW and a Federal stage. I can think of no greater doctor to be handing over the reins to, and I look forward to the transition over the next few months.

In the meantime, it’s back to work as usual. There’s more than 30,000 doctors-in-training across the country and the work is never done. I hope this list helps to provide more insight into what we do as an organisation and helps to explain exactly why your membership is so important to the improvement of the profession. There’s a lot that I don’t know, but on this I am certain: if the AMA wasn’t standing up for you and your patients, there’d be no-one else to do it with the same drive and impact.

Until next time,
Z

Dr John Zorbas
Chair AMA Council of Doctors in Training