A meeting of more than 2,000 Victorian public hospital doctors recently voted to pursue industrial action following a breakdown in enterprise bargaining negotiations with the Allan Government. It is the first time in almost 20 years that doctors at Victorian public hospitals have taken this step.
When patients meet their specialists, either in their private rooms or at the public outpatient clinic, most do not realise that it took 15-20 years to reach that position. Becoming a specialist is a long and demanding journey. It includes years of training starting with internship, followed by residency, competing for a place on a highly competitive specialist training program, five or more years of accredited training, fellowship examinations and, for many, further subspecialty training before finally practising independently.
During those years, doctors in training work long hours, rotate between hospitals every six to twelve months, relocate cities, study for major examinations outside of work and take on increasing clinical responsibility. They also spend thousands of dollars on mandatory courses, examination fees, professional memberships, conferences and interview preparation whilst often carrying university debt.
For many, these years also coincide with the time they hope to buy a home, start a family or simply settle into one community. For women in particular, specialist training often overlaps with the years when fertility naturally declines, creating difficult decisions such as delaying family planning.
I would choose surgery again in a heartbeat. It is a fantastic career. Caring for patients is an extraordinary responsibility, and one I feel incredibly fortunate to have. But I also do not think we should have to hide the realities of the journey.
If we are asking doctors to accept increasing responsibility, continue years of training and adapt to changing expectations around training and working conditions, then we also need to ask whether the system recognises and values that commitment. This cannot be simply a conversation about doctors’ pay. It is about protected training time, safe working conditions, sustainable careers and ensuring that the next generation of doctors can continue to choose medicine without unnecessary barriers. We cannot expect doctors in training to shoulder the burden of workforce planning challenges alone.
This conversation also needs to acknowledge that Australia’s specialist training pipeline is complex. Universities train medical students. Governments fund hospitals. Hospitals employ doctors in training. Specialist colleges oversee training standards. Consultant positions depend on workforce planning and health service funding. When these parts of the system are not well aligned, it is often doctors in training who absorb the uncertainty.
None of this means lowering standards. Patients deserve exceptionally well-trained specialists, and maintaining those standards should always remain the priority. But high standards and a sustainable workforce are not mutually exclusive.
If we want talented Australians to continue choosing medicine, we need to be honest about the road ahead and equally willing to ask whether every part of that road still serves doctors, patients and the health system as well as it could. Because investing in doctors has never just been about doctors. It is about the patients who will one day depend on them.