Culture of medical training in the spotlight in 2022 Medical Training Survey

01 Feb 2023

Results of the 2022 Medical Training Survey (MTS) are broadly consistent with previous years, with some small but statistically significant variations in year-on-year results, including an increase in trainee workload, a dip in the quality of teaching, a drop in the number of trainees who would recommend their current training position or organisation and an increase in the number of trainees considering a future outside of medicine.

The MTS is a longitudinal survey, run by the Medical Board of Australia, that tracks feedback about the quality of medical training run in Australia. Stringent privacy controls make it safe and confidential for trainees to take part.

Each year, more than half Australia’s doctors in training share their insights in the MTS, with results signalling what’s going well in training and issues to watch.

With a 56% MTS response rate in 2022, the survey generated a robust evidence base to inform ongoing improvements in training. Trends are visible early, enabling close monitoring or swift action by agencies best placed to respond and effect positive change.

The participation rate for Aboriginal and Torres Strait Islander trainees increased from 158 in 2021 to 191 in 2022.

'The MTS has given us all an important opportunity to listen to and act on the feedback from these trainees, as we move towards providing culturally safe and appropriate medical training and more broadly, culturally safe medical care,' said Medical Board of Australia Chair, Dr Anne Tonkin.

Dr Tonkin said while there was still a lot going well in medical training, results show some important issues that require attention and some early trends to monitor closely.

'We can all be pleased that Australia continues to deliver high quality medical training, producing doctors who provide high quality medical care to patients in this country,' Dr Tonkin said.

'But MTS results suggest that in 2022, things were not quite as good in medical training as they have been in previous years,' Dr Tonkin said.

Qualitative research and analysis would be needed to definitively understand the reasons for this, but it is possible that broader, pandemic-related health system pressures are adversely affecting medical training, she said. 

'Through the MTS, the health sector has been given early warning about issues to address. We all owe it to trainees to act,' Dr Tonkin said.

Dr Tonkin said the MTS was proving an invaluable diagnostic tool, shining a light on the state of medical training in Australia. She singled out the culture of medical training as a continuing concern.

'The culture of medical training needs attention. It is totally unacceptable that 55% of Aboriginal and Torres Strait Islander trainees have experienced and/or witnessed bullying, harassment, discrimination and racism and inexcusable that 34% of all trainees did,' Dr Tonkin said. 

The source of bullying, harassment, discrimination and racism changed in 2022, with an increase in patients and or family/carers identified as the source of the incident (up from 38% in 2021 to 45% in 2022).

'This is an important issue to watch and may point to frustrations with a health system under pressure,' Dr Tonkin said. 

A new question about reasons for not reporting concerns about bullying, harassment, discrimination and racism proved its value. 

'We no longer have to speculate that trainees are concerned about the consequences of reporting, we know this is true,' Dr Tonkin said.

Of those who had experienced bullying, harassment, discrimination and/or racism, 70% did not report it. Of these trainees, 55% were concerned about the repercussions, and 51% said nothing would be done if they did make a report. 

Fault lines in the culture of medicine revealed by the MTS warrant ongoing, collaborative solutions from agencies across the health sector.

'The Board will continue the policy and professional standards work that will underpin sector wide action, in collaboration with the frontline organisations who hold the keys to lasting cultural change,' Dr Tonkin said. 

There was a 7% increase (to 53%) in the number of trainees who rated their workload as heavy/very heavy since the pandemic started in 2020. On the upside, this year’s results reveal an increase in the number of trainees getting paid for their overtime. 

The COVID-19 pandemic continued to impact on training in most areas, but slightly differently from the previous year. In 2022, workload and training progression were adversely affected, while exam preparation and training opportunities were largely impacted in 2021.

2022 results are published in static reports and accessible through an online reporting tool on the MTS website. 

The reporting tool enables users to compare results year on year, or compare hospital site or specialty with the national average. A short video includes tips on using the interactive data dashboard that helps you create your own reports. Watch the video or read the User guide and access the dashboard on the MedicalTrainingSurvey.gov.au website. 

About the MTS

The Medical Training Survey (MTS) is a national, annual, profession-wide survey of all doctors in training in Australia. It is safe and confidential for doctors in training to take part. 

The MTS is run by the Medical Board of Australia and Aphra and was developed collaboratively with doctors in training, specialist medical colleges, jurisdictions, postgraduate medical councils, Australian Indigenous Doctors' Association, Australian Medical Council, Australian Medical Association, NSW Medical Council, Doctors' Health Services and other stakeholders.

For more information

• Visit https://medicaltrainingsurvey.gov.au/ for access to the 2022 MTS questions or article on how stakeholders are using the MTS results
• Visit www.medicalboard.gov.au under 'Contact us' to lodge an online enquiry form
• For registration enquiries: 1300 419 495 (within Australia) +61 3 8708 9001 (overseas callers)
• For media enquiries: (03) 8708 9200