AMA push for a female-friendlier medical sector

An updated position statement looks at the importance of flexible training and work arrangements in supporting a diverse workforce.

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Reforming the way general practice registrars accumulate and carry leave entitlements is one step in making medical training more manageable for women and people with caring responsibilities, according to an updated AMA position statement.

With medical students graduating later in life, junior doctors are commonly entering and completing training programs while trying to juggle children and family commitments.

General practice trainees in particular, the association said, face additional challenges like a lack of entitlements and no portability of leave between training practices.

Government-funded reform is the only way to ensure GP registrars have access to paid leave entitlements equivalent to that of hospital-based trainees.

“GP trainees should be empowered to negotiate their employment contracts and flexible training needs with their employer and supervisor without fear of financial, employment or cultural repercussion,” the AMA said.

“This can be achieved though employment reform to create a separation between training and employment that does not exist under current arrangements.”

One way to support female and minority doctors more broadly, the AMA contends, is to provide greater flexibility of working conditions.

“Access to flexible work is important for both men and women who want to be able to share the parenting load,” AMA president Professor Steve Robson said.

“Caring duties disproportionately fall to women, and men find they are discriminated against when asking for access to flexible work.”

The association defines this as not just flexible working hours – e.g. reduced hours, split shifts, etc. – but as also including flexible working places and practices.

Examples of the latter two include working from home or remotely, as well as purchasing leave or job sharing.

Although medical colleges have adopted various policies supporting flexible work, the AMA said these were often challenging to translate into practice due to various employer concerns, like staffing and funding.

In answer to this, the AMA argues that labour forces can and will eventually force employers to compete to attract and retain clinicians, and that improved flexibility of work is an “intrinsic quality” of an employer of choice.

“Most training programs in Australia provide opportunities for trainees to complete their training in a flexible manner, but unfortunately there’s evidence that shows trainees find it hard to request flexible training and work due to structural and cultural issues,” Professor Robson said.

“The burden is often placed on the trainees to negotiate their own terms of flexibility and support, resulting in poor uptake of flexible training.”

Ideally, employers, administrators and training providers would work together to not just make a commitment to offer flexible work and training arrangements, but to provide clear and accessible policies about flexible arrangements for registrars and to actively support doctors to take up those arrangements.

Examples of flexible provisions that could be implemented include creating designated lactation room facilities within reasonable proximity of clinical areas, support for career breaks and investigating technology that could allow clinicians to work remotely.

To assist registrars who want to work flexibly to progress through training in a timely manner, concessions might include reducing the instance of high-stakes barrier exams in favour of competency-based education, as well as allowing trainees to sit fellowship exams while on extended leave.