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JMO Charter 2009

3. Prevocational Training

Postgraduate Medical Council of Western Australia

The Western Australian Minister for Health established the Postgraduate Medical Council of Western Australia (PMCWA) in August 2003, to provide leadership for early postgraduate medical education and training in WA. The Postgraduate Medical Council is primarily funded by the Department of Health Western Australia.

Aims of the PMCWA

Development of guidelines and protocols for the education and training of pre-vocational doctors and other medical practitioners not in vocational training programs.
Setting standards for pre-vocational training positions within health services.
Accrediting and monitoring medical training positions for pre-vocational doctors: postgraduate years 1, 2 and 3/plus (PGY1, PGY2 and PGY3/+).
Monitoring and advising on the supply and demand for the pre-vocational workforce in Western Australia.
Supporting clinicians and other professionals involved in the education and training of pre-vocational and other non-vocational doctors.
Identifying and advising on matters that impact on the health and welfare of pre-vocational and other non-vocational doctors.

Committee and structure

Members of the Postgraduate Medical Council are representatives of the stakeholder organisations involved in the support, training, supervision and administration of pre-vocational doctors and other non-vocational medical officers. Membership to the Postgraduate Medical Council is via Ministerial appointment. The Council reports to the Minister for Health via the Director General of the Department of Health. There is a representative from the JMO Forum on the PMC Executive, as well as the subcommittees of Accreditation, Education, and Workforce.

Accreditation

The aim of prevocational training is to further the professional and personal development of medical graduates in their early postgraduate years. The accreditation program sets out to establish and monitor standards for prevocational medical positions with the emphasis on the first two postgraduate years, and to assist in the attainment of a universally high standard of general clinical training. Accreditation helps to ensure that health services employing pre-vocational doctors offer sufficient experience, education, training, supervision, assessment, evaluation, support (including resources) and a safe working environment to enable pre-vocational doctors to meet the objectives of their training. Through the process of accreditation, hospitals and other training organisations which employ prevocational doctors are formally evaluated by a survey team using clearly defined and established standards.

Interested in becoming a surveyor? It’s a good way to see what posts are available at other hospitals and how they are run, as well as being the voice for junior doctors in ongoing accreditation for new posts. Email PMCWA@health.wa.gov.au to register your interest.

Workforce

Currently there is a well-described shortage of medical practitioners in Western Australia. The Postgraduate Medical Council recognises that workforce planning is fundamental to the delivery of good health care. The PMCWA through its Workforce Sub-committee aims to monitor the supply, demand and needs of pre-vocational doctors in Western Australia.

The Workforce Committee is accountable to Council for the monitoring of supply, demand and needs of pre-vocational medical officers and other non-vocational doctors in Western Australia. A member of the JMO Forum sits on the Workforce Committee.

Projects:

WA Intern Online Recruitment – commenced in 2005, to provide a streamlined process for intern application in Western Australia.
Increased training positions for internship in WA: The number of medical graduates in Western Australia is increasing from 144 in 2006 to over 300 in 2009. The Council has commenced, in collaboration with the Department of Health of Western Australia and other key stakeholders, a project to identify the issues and strategies for increasing the number of intern training positions in Western Australia.

Education

he Education Committee is responsible for the identification, evaluation and monitoring of education and training programs for pre-vocational medical officers and other non-vocational doctors. The Education Committee will report to the Council on strategies and outcomes.

The JMO education representative sits on both the JMO forum meetings and the quarterly education committee meetings. The role of the representative is to be an advocate for junior medical officers on all educational issues including teaching, training support, educational accreditation, senior supervision, site issues, research and career development. They are also responsible for providing feedback on the activities of the education committee to JMO forum members for further discussion. In addition to this, the representative is also responsible for undertaking or assisting in education projects with the support of the JMO forum and education committee. Previous projects run by the education representative include the handover project, junior medical officer curriculum, and the assessment and appraisal form for junior doctors.

Australian Curriculum Framework for Junior Doctors

The Confederation of Postgraduate Medical Education Councils (CPMEC) launched the Australian Curriculum Framework for Junior Doctors in October 2006.

The curriculum framework outlines the knowledge, skills and behaviours required of prevocational doctors (PGY1, PGY2 and above) in order to work safely in Australian hospitals and other healthcare settings. It provides a bridge between undergraduate curricula and the curricula that underpin college training programs. It provides junior doctors with an educational template that clearly identifies the core competencies and capabilities that are required to provide quality health care
The framework is built around three learning areas: Clinical management, Communication and Professionalism. These areas have been divided into a total of eleven categories. Each category is further subdivided into four to seven learning topics. Each topic includes three competencies or capabilities. While it is expected that most of the competencies will be mastered by the end of internship, it is anticipated that a trainee will become more proficient and skilful in these competencies in subsequent postgraduate years. For more information, please refer to the website for the Australian Curriculum Framework for Junior Doctors.

Education and Training Tips for Interns

Intubations / laryngeal masks are a requirement of RPH, but not the other hospitals or PMCWA / Medical Board. Best to get the experience on rural rotations. Don’t stress about this.
Teaching (once or twice a week) is compulsory and is protected time from your pager. Divert your pager to your Resident/ Registrar for this hour. It is a good break from the ward and the topics are useful.
Be proactive – there are a wide range of skills you can learn in your intern year such as chest drains, ascitic taps, nerve blocks, lumbar puncture, suturing, tying, cutting, central lines… to list a few.

Education and Training Tips for RMOs

Resident teaching will be introduced to some hospital sites in 2009. Support this as it is useful to refresh a wide range of topics that may be away from your area of interest.
Think about attending courses (EMST, CRISP, ASSET, CLEAR etc) which may be relevant to your area of interest. They provide a good opportunity to acquire skills in a non-clinical setting, and may assist you within training program applications.

JMO Forum

he WA JMO Forum is an initiative of the JMO Committee to promote better communication between Junior Medical Officers and the PMCWA. It is used to inform JMOs of initiatives and strategies of the PMCWA and to gather information from the JMOs to inform the PMCWA.

The terms of reference for the committee include:

To focus on the participation and involvement of JMOs in the decision making and planning functions of the Postgraduate Medical Council of WA and its committees.
To provide advice to PMCWA and its Committees on issues of relevance to JMOs.
To report to PMCWA Committees on relevant issues and where appropriate, forward issues to Council through the Committee reports.
To assist in the development and evaluation of resources developed by the PMCWA and its Committees.
To educate and inform key stakeholders of the goals of PMCWA Council.
To provide representation on PMCWA Committees to support their work in achieving the goals of Council.
To support members of Council, Executive and Secretariat attending the JMO Forum as a resource on specific issues, when appropriate.

The JMO Committee meets every second month in the Nurses Conferences Room at SCGH. Any JMO may attend. Interested in coming along? See calendar for details of the next meeting.

Links with AMA DIT, RMO Societies

The AMA Doctors in Training (DIT) Committee is closely allied with the PMCWA Junior Medical Officers Committee. Whilst the JMO Committee focuses upon the educational, supervisory and training aspects of prevocational doctors, the AMA DIT primarily looks at the industrial side of being a junior doctor. This can include issues with lockers, security, or on-site hospital facilities as they arise. DIT also concentrates on the AMA Metropolitan Health Services Agreement and how this is being applied to the work done by junior doctors. Whilst you might think the payment of doctors should be relatively straightforward given such a prescriptive document, it really isn’t – in many areas the AMA needs to ensure fair payment of doctors for the work we perform and ensure safeguards in terms of hours and workload in protecting patient safety.

As you might imagine – these things often overlap between AMA DIT, PMCWA JMO and the hospital-based RMO societies. Each of the five tertiary hospitals in Perth have their own RMO society with an annually-appointed President, and other committee members depending on the hospital. There has been considerable support between groups on issues that affect a group of junior doctors including parking at PMH, the upcoming Fiona Stanley Hospital development, and the proposed expansion of country health rotations for junior doctors. The alliance of all of these groups, including the two medical student bodies (WAMSS and MSAND) create a very powerful voice for the younger generation of doctors in our hospitals.

Resolutions of 2008 National JMO Forum

The 13th National Prevocational Medical Education Forum was held in Tasmania in November 2008. At the National JMO Forum, the following consensus opinions were reached:

Education and Training

To establish a National JMO Committee to address arising issues and to steer the annual National JMO Forum and resolutions
JMO Forums are to work towards a guarantee from jurisdictions for high quality (rather than simply quantity) jobs for interns
Further resources be invested to improve education and support for junior doctors, particularly in less well established sites
Ongoing support of the national rollout of the Intern Welfare Study

Workforce

JMO Forums are broadly supportive of national registration
The implementation of a National Accreditation Network requires increased JMO representation

PMCWA JMO Forum Goals for 2009 and how to get involved

2008 has created some great challenges, and as we move forward we will need to focus on the following:

Assisting the PMC and WACHS by providing junior doctor feedback into WACHS request to become a primary allocation centre (PAC)

Providing realistic expectations of what is required from a junior doctor country term
Ensuring that patients and junior doctors will not be disadvantaged by any change to the current system
Encouraging the utilization of country terms through the current PACs in the mean time

Attendance at the national JMO forum and national prevocational training forum
Preparing ourselves for the Fiona Stanley Hospital, ensuring a safe and effective working environment with appropriate amenities

How to get involved?

Representatives from PMCWA will give a talk during the intern orientation sessions at your hospital in 2009. At this time there will be an opportunity to give us your name and email address so that we can contact you about upcoming meetings. Alternatively you can email PMCWA with your details and the relevant information will be forwarded to you.

The first JMO Forum Meeting is generally held in February each year and subsequent meetings occur every two months.

JMO Welfare Study

The JMO Welfare Study was the first of its kind in WA to investigate various aspects of intern life. Key indicators included preparedness to practice, health and wellbeing, education and training, supervision, job satisfaction, work-related stress and burnout. This was carried out in the form of a questionnaire sent to all WA interns in 2006-07.

The study indicated that a significant proportion of interns experienced both high levels of work-related stress and low levels of job satisfaction that cannot simply be blamed on their role as carers of the sick.

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