Private Hospital training, mind the gap

Abstract

Background: Australasian vocational training traditionally occurs within the public hospital domain. Early studies and a Commonwealth funded program, suggested private sector training as a feasible option with implementation across multiple specialties. This is the first Australian study that examines the vocational trainees’ experience in private hospital rotations, focusing on procedural exposure and predictors of an effective learning experience. Methods: General surgical trainees were surveyed. Trainees that had completed at least six months were eligible. A 15 item questionnaire was used to assess five domains: operative, clinical teaching, trainees’ recommendations: clinic and on-call exposure. Results: Nine private hospitals with accredited rotations provided 95 eligible trainees, with 45 respondents (response rate 47%). 22% performed major procedures as the primary proceduralist and 13% performed any endoscopy. Over half of respondents rated the teaching in private hospitals as ‘average’ or below, whilst the majority (58%) were not satisfied with the overall training experience and would not recommend it to their peers. Conclusion: Whilst private sector training has been implemented by 13 specialist colleges, our survey suggests a gap remains between private and public vocational training. Limited trainee primary procedure exposure and difficulties with access to private outpatient clinics are major criteria that require review.