Medical education in Australia

Medical education in Australia is concerned with both the basic training of medical practitioners and with the post-graduate training of medical specialists.

Medical school
Various models of medical education exist in Australia. Undergraduate-entry program typically last 5-6 years, and permit entry from secondary school matriculation. Applicants are usually assessed by a combination of high school leaving certificate performance, UMAT (Undergraduate Medicine and Health Sciences Admission Test) score and interview. Graduate medical programs typically last 4 years, and require the entrant to have attained a previous bachelor degree qualification at a certain level of achievement in addition to aptitude tests and interviews. The most common selection test used is the GAMSAT (Graduate Australian Medical Schools Admission Test).

In early years, theoretical domains of study predominate, with increasing clinical focus during the program. However, early clinical exposure — in which students commence clinical skills from very early in the course, concurrently with theoretical study — is a component of many degrees, most notably the graduate medical programs. In recent years medical school learning and teaching in Australia has taken on a new direction. At most universities there has been a move away from the more traditional methods of teaching with a shift towards the Problem Based Learning (PBL) pedagogy including the use of Objective Structured Clinical Examinations (OSCEs).

Depending on the program undertaken, students graduate as Bachelor of Medicine / Bachelor of Surgery (MBBS), (BMBS), or simply a Bachelor of Medicine (BMed), in addition to any other degrees attained during study.

Internship
All States and Territories require recently qualified medical practitioners to successfully undertake and complete at least one year of supervised practice, generally known as an internship. Internship is undertaken in hospital positions accredited for this purpose. Interns in Australia are 'undifferentiated', meaning that they undertake rotations through many different specialties. Rotations differ from hospital to hospital and state to state. However, most states require three core terms to be completed - a medical term (general or subspecialty internal medicine), general or subspecialty surgery, and emergency medicine. In some states, a general practice term is offered instead of the Emergency Medicine term.

Historically the intern year was the only postgraduate training required to obtain a Provider Number. However, since 1996 the Commonwealth Government no longer issues Provider Numbers to doctors who have not completed postgraduate training (with some notable exceptions). A Provider Number is required to bill Medicare or issue prescriptions under the Pharmaceutical Benefits Scheme.

Aside from experience gained through working, formal educational opportunities are required to be provided by hospitals for junior doctors. Accreditation and oversight of this phase of medical education is by each State's postgraduate medical council. There has been some movement towards a national set of standards for internship.

Residency
Upon successful conclusion of the intern year, doctors qualify for a full registration in the Medical Board of their State or Territory, and are licensed to engage in independent medical practice. Because Provider Numbers are not issued to doctors who have not completed postgraduate studies, practically all doctors continue their training as Resident Medical Officers (RMOs) in hospitals, which typically last two years.

Some states (e.g. New South Wales) also require junior doctors to undertake a second generalist year, that is their first RMO year. Other states permit streaming from the first RMO year.

Specialist training
Specialist training varies considerably from specialist college to college. In some specialist college training programs (e.g. surgery) a trainee continues as a RMO in their early training, whilst in others trainees begin at registrar level.

At the same time as working in hospitals, registrars also prepare for examinations for admission into specialist medical colleges, such as the Royal Australian College of General Practitioners, the Royal Australasian College of Surgeons, etc.

Those successful in completing the requirements of their college program become fellows of that college. They are now specialists in the case of most areas of medicine (and typically work in specialist private practice and/or as a consultant in a hospital); an exception are fellows of the Royal Australian College of General Practitioners, who are general practitioners, not specialists.

Continuing medical education
All professional colleges require their members to undertake continuing medical education; the requirements of each college vary.