Trainees with the Royal Australasian College of Physicians (RACP) specialist program have given a mostly positive feedback in the Medical Training Survey 2019 conducted by the Medical Board of Australia and AHPRA.
Survey data was obtained from 1333 doctors in training with the RACP between July and October 2019. Of those surveyed, 58% were female, 56% were in their 30s and 78% were working as registrars. The average number of postgraduate years was 6.4 years and trainees had spent an average of 3.8 years in the specialist training program
In terms of overall satisfaction, 79% of RACP trainees said they would recommend their current training position to other doctors (similar to the 78% response rate provided by all 9917 doctors in training who were surveyed).
While most trainees rated the quality of teaching (81%) and clinical supervision (85%) as good/excellent, there were lower ratings for communication and engagement with the RACP. Only 63% believed the College clearly communicated the requirements of the training program and 35% thought the College sought the views of trainees on the training program. Likewise only 29% of trainees thought the College provided access to psychological and/or mental health support services.
Most trainees thought they had a range of opportunities to develop their clinical skills, but 37% said they had to compete with other doctors for access to opportunities and 14% said they lacked opportunities to develop their procedural skills. A high proportion of RACP trainees (29%) said they did not have access to protected study time/leave and 12% said they were not able participate in research activities.
Educational activities that rated highest with trainees were bedside teaching (97%), simulation teaching (91%) and team/unit-based activities (90%). In contrast, online modules were rated as useful by only 71% of trainees, while multidisciplinary meetings and hospital wide meetings were rated as useful by 79% of trainees.
Surprisingly, given the 2018 fiasco with the computer-based RACP Divisional Written Exam, 55% of trainees said their RACP exam always ran smoothly on the day, while 35% disagreed. Only a minority (37%) believed the RACP exams always reflected the college training curriculum and 31% of trainees did not believe they were conducted fairly. More than a third (35%) of trainees said they did not receive useful feedback about their performance in the exam and 37% said they had not received support from the College when needed.
High workload and long hours were cited as the main factors having an adverse impact on trainee wellbeing. Most said they had a heavy workload, with RACP trainees working an average of 47.9 hours per week. Half of all RACP trainees said they did not have a good work-life balance,
Working unrostered overtime was another sore point, with 65% of RACP trainees saying they got paid only sometimes or never (vs 53% for all doctors in training). And 31% said working unrostered overtime had a negative impact on their training .
Other factors cited by trainees as having an adverse impact on wellbeing included having to relocate for work (28%), lack of appreciation (23%) and dealing with patient expectations (19%).
In terms of workplace culture, only two thirds of trainees said they would feel confident about raising concerns about bullying, harassment and discrimination (including racism) in workplace.
When asked about future career intentions, only 37% of trainee physicians said they were interested in rural practice compared to 47% of all specialist trainees . Conversely, 69% of physician trainees said they were interested in getting involved in medical research compared to 57% of all trainees.
Medical Board of Australia Dr Anne Tonkin, said the survey results provide an evidence base that educators, employers and stakeholders across the health sector can use to improve the culture of medicine and further strengthen medical training.
‘The 2019 survey results tell the start of an important and emerging national story about the culture and quality of medical training, from trainees’ perspectives. We hope the results trigger ideas and discussion about what we can all do to keep improving it,’ she said.