Governing the reform of the medical internship

We appreciate the letter by Mack and colleagues regarding our article,1 and agree that continuing professional development (CPD) is an important phase of the medical training continuum, where clinical skills are consolidated and updated resulting in the clinical mastery of the practising doctor. We note that the Medical Board of Australia has recently released a revised registration standard regarding CPD, which will be implemented from 1 October 2016.2 This revised standard sets out CPD requirements for practitioners with specialist registration, for those with provisional registration undertaking an intern year, and for international medical graduates undertaking supervised practice.

The standard also sets out CPD requirements for practitioners with only general registration, which may include doctors who, after completing their internship, are not working in accredited pre-vocational or vocational training positions, or may be working as locums or surgical assistants, or are preparing for vocational program examinations or undertaking a research period. From October 2016, such practitioners must complete a minimum of 50 hours of CPD per year via a self-directed program (including specific elements), or meet the CPD requirements of a specialist medical college that is relevant to their scope of practice.

For a number of these doctors who do not have candidacy with or fellowship of a vocational college, the access to appropriate or specialist CPD programs may be difficult and dependent on local opportunities and support.3 We note recent efforts to assist with this, such as the Hospital Skills Program, which is a professional development program for non-specialist doctors in New South Wales.4 However, this is a problem that requires the support and action of the leading medical organisations, including the Medical Board of Australia, specialist colleges, and education and training providers.

The development of a national integrated governance structure across all phases of medical training, including CPD, would enable the inclusion of all practicing clinicians within an overarching educational framework aimed at achieving optimal clinical care.