Five years data from the Medical Training Survey (MTS) are generating rich insights, with important headline results from the 2023 survey of Australia’s doctors in training.
More than half (54.5 per cent) of Australia’s doctors in training did the 2023 MTS, an annual profession-wide longitudinal survey that tracks the quality of medical training.
Results this year are broadly consistent with previous years, with some small but statistically significant variations.
‘There is a lot going well in medical training and clear signs for optimism’, Dr Anne Tonkin AO, Chair of the Medical Board of Australia, which leads the MTS.
The 2023 MTS results show that the quality of supervision, orientation, education and training and patient safety training has improved. Trainees report that their workload and hours of work have reduced. Fewer trainees are considering leaving the profession. New questions this year about flexible training and work options set a new baseline for future analysis.
‘The upticks from last year’s results, although small, are statistically significant and encouraging,’ Dr Tonkin said.
But she invited caution, given what is statistically significant may not always be practically meaningful with such a large sample size.
‘It will also be interesting to learn over time how much and what parts of trainee experiences relate to the easing of pandemic-related pressures and what changes are flowing from both specific and systemic improvements,’ Dr Tonkin said.
Again this year, 2023 MTS results flag an ongoing fault-line in the culture of medicine.
‘There is an urgent need for ongoing commitment to building a culture of respect in medicine and medical training’, Dr Tonkin said.
It is totally unacceptable that 54% of Aboriginal and Torres Strait Islander trainees experienced and/or witnessed bullying, harassment, discrimination and racism. It is inexcusable that 35% of all trainees did. The longitudinal MTS data makes clear that this area is yet to improve and shows a critical and urgent need for action.
There is nuance beneath the headline numbers and variation in the results across medical disciplines, jurisdictions and health services. Year on year comparisons shine a light on where good things are happening and specific initiatives are making a difference. It also spotlights areas where focus and action are needed.
Five years of legitimising trainees’ experience, through MTS questions about culture and behaviour, may in itself be encouraging doctors in training to speak up about these issues. Close longitudinal analysis is key.
With an established link between culture and patient safety, only collaboration between frontline organisations will enable lasting cultural change that will benefit doctors and patients, Dr Tonkin said.
‘In our complex health system of shared accountabilities and responsibilities, there is no quick fix. There is also no excuse for inaction,’ she said.
‘Ready public access to rich, longitudinal MTS data creates opportunities for shared learning that can support the cultural transformation our system needs’.
The MTS again received strong participation from Aboriginal and Torres Strait Islander trainees with 176 responses.
‘We value the feedback from Aboriginal and Torres Strait Islander trainees about their experience of medical training. These important data can support our journey towards providing culturally safe and appropriate medical training, and more broadly, culturally safe healthcare’, Dr Tonkin said.
New questions on flexible training and working arrangements provide an important baseline to monitor future trends. Trainees report that their specialist colleges generally support (access to) flexible training, but this support is not replicated in the workplace. Nearly one in five trainees considered accessing flexible working arrangements, but were unable or chose not to access it.
‘Organisations across the health sector owe it to current doctors in training, and our future medical workforce, to harness the value of MTS data and use it to drive ongoing improvements in training that will keep our doctors among the best in the world’, Dr Tonkin said.