To the Editor: I was recently amazed to learn that the solution to the educational needs of prevocational doctors was more teaching from registrars.1 My understanding was that registrars were themselves in a predominantly learning position, desperately hoping to glean some scraps of wisdom from consultant doctors. Often, the registrar, this supposed demi-god of all knowledge, is only 1 or 2 years ahead of the prevocational doctor and permanently juggling yet another postgraduate examination and the rigours of clinical duties. Then, with Australian medical schools springing up here and there, there are the inevitable hordes of medical students. So, registrars have an inherent and significant conflict of interest, namely, self-education to be able to continue climbing the slippery slope of postgraduate vocational education versus the altruistic provision of education for others.

Perhaps graduating medical students need to take personal responsibility for their own education. Continuing medical education (CME) is a lifelong process that requires individual initiative. Support from the various specialist Colleges is welcome but not essential. Weaning prevocational doctors from their dependency on “formal education” is an essential first step towards independent clinical practice. This is not to say that CME for prevocational doctors should not be supported, but rather that it is unrealistic to demand that it should all be spoon-fed from registrars. An informal verbal survey of my registrar colleagues unanimously showed that we would all like to expand our teaching load, but not at the expense of clinical care.

So what can the system do to support the beginners? Nurses have clinical nurse educators, and soldiers have drill sergeants. The nursing education system and the army have both recognised the value of employing personnel purely for educational purposes. The medical profession could do likewise.

The pretence that service is educational for prevocational doctors should be denounced. Routine tasks performed by prevocational doctors that do not require medical expertise, but consume much time, could perhaps be delegated to non-medical professionals. This would free up time for medical education on the job. However, protected time for teaching by adequately remunerated clinical teachers requires workforce expansion and, ultimately, public funding and political will.

Finally, from within a profession that often subscribes to the view that good resident staff are seen but not heard (that is, work hard and don’t complain), recognition by consultants that they too were once beginners may lead to positive cultural changes.