Case Study: Royal Darwin Hospital
The Royal Darwin Hospital (RDH) has many excellent facilities and positions for RACP trainees with 20 to 30 doctors appointed to Basic Physician Training roles per year. Basic Trainees occupy a diverse number of roles across the Top End Health Services. Having chosen to undertake training in a non-conventional training environment, they are often better placed to adapt to challenging resource limitations and complex patient needs.
The demand for skilled doctors continually outstrips the supply of applicants who aspire to physician training. There has been some improvement with the advent of a Northern Territory based medical school, which began supplying graduates to Top End Health Services in 2016.
As is the case in many rural and regional areas, the lure of accredited training positions has in the past been used as a key recruitment tool for RDH. This has led to situations where doctors who have a low likelihood of completing RACP training spend many years employed as a Basic Physician trainee with little hope of career progression.
The Director of Physician Education (DPE) reviewed the system of appointments of Basic Trainees at RDH and discussed it with administration, Human Resources and the clinician body. The result was an increased emphasis on the assessment of clinical expertise, sound clinical process, professionalism and trainability as key criteria for DPE endorsed registration as a Basic Physician Trainee with the RACP. This has meant that some doctors are employed by RDH and work in accreditable positions but are not appointed as Basic Trainees. There is a recognition that a doctor may be entrustable in a particular role but that this does not necessarily make them appropriate for a physician training pathway. This understanding also allows for trainees from other specialties, such as intensive care or emergency medicine, to access excellent training opportunities leading to reciprocal gains.
Doctors are interviewed throughout the year for Basic Trainee positions using a standard process, including standard questions, and an insistence on rigorous verbal reference checks from physicians willing to specifically endorse the applicant in their suitability for training. The candidate is at liberty to choose their own referees but must provide two current practitioners with whom they have worked closely. The idea that merit will form the basis of the best physician training opportunities is openly stated to all prospective candidates.
The revised process at RDH helps to ensure that those appointed to Basic Trainee positions are both able to work in the RDH environment and progress through training, upholding the RACP principle of striving for excellence.