Improving the medical scientist workforce Overview The medical scientist workforce has been an issue which the Government and the pathology sector has been grappling with for more than five years. This proposal is aimed at building a consensus plan to address the issues identified and recommendations made in work already undertaken. These were projects endorsed by the Quality Use of Pathology Committee and funded by the Department of Health and Ageing. The intention would be to have those directly involved in this work come together with the other stakeholders to build a practical plan able to be implemented by those in the room. To initiate discussion and clarify the current status it is proposed that the following statement be tested with stakeholders in a workshop. A sustainable and appropriately skilled medical scientist workforce is critical to the maintenance of quality and efficiency of the Australian pathology sector. It can only be achieved by: 1. A better understanding of the current and future pathology workforce through improved data on existing workforce, labour demand and market analysis 2. Deployment of competency based standards to improve allocation of human resources 3. Structured and funded training programs for medical scientists that may include attainment of the Fellowship of the RCPA Faculty of Science for senior scientists. 4. Integration of the VET sector into pathology workforce planning including improved training of technicians and technical assistants Initial steps have been taken for some of these initiatives but all need to be resourced to either start and/or ensure their continuation. It is emphasised that the above statement is up for discussion and for amendment as part of reaching a consensus. Below is a briefing paper which highlights the issues and activities that have taken place in this area and which are relevant to all stakeholders reaching a consensus. A briefing paper Purpose This briefing paper provides background for the establishment of a consensus plan to be progressed at a Workshop on the Medical Scientist Workforce will be held in Sydney on June 15, 2012 (to be confirmed). The Workshop is sponsored by the Pathology Associations Council (PAC) and organised through one of its member societies, the Australasian Association of Clinical Biochemists (AACB).. The AACB is seeking support from the Quality 1
Use of Pathology Program (QUPP) to progress the recommendations made in the reports on Scientist workforce already commissioned by DoHA through QUPP. To build consensus and understanding those assembled to build the plan will be briefed by those directly associated with the research and initiatives already undertaken to address the recognised issues around the medical scientist workforce. What is wrong with the Medical Scientist workforce? A number of problems face the medical or clinical scientist workforce within the pathology sector. One of the more significant problems is that many senior scientists are expected to retire soon and there is uncertainty about whether there are sufficiently trained and experienced people to replace them. While the problem is in part due to demographics, other factors may be that medical science as a career is not seen as attractive and there is the lack of a structured training program for scientists. Over the last 5 or so years, these problems have been discussed within the various professional societies and colleges, at the Pathology Associations Council and at NPAAC. To address the issues the Department of Health and Ageing funded through the Quality Use of Pathology Program two studies. One by Urbis addressed issues related to workforce statistics since there were major information gaps in this area. A second project carried out by Human Capital Alliance examined the career structures and pathways for medical scientists in pathology. From both these reports, but particularly the HCA one, and continuing discussions at the PAC and its constituent professional bodies, have come a number of suggested actions which would address many of the identified issues with the medical scientist workforce. Why do we need to address issues related to the medical science workforce? The major arguments in favour of improvements to the medical scientist workforce are as follows: 1. Address the potential lack of senior scientists due to impending retirements 2. Appropriately qualified and senior scientists could extend their practice into areas where there are shortages of medically qualified staff 3. The opportunity to use larger number of vocationally trained technicians or those with associate diploma qualifications to perform technical roles rather than overqualified junior scientists 4. Addressing all of the above would result in a more attractive and satisfying career for medical scientists. 2
Can it wait? It is hard to think of any arguments to ignore the present problems, risk a major shortage of trained and experienced scientific and technical staff and jeopardise the quality of pathology practice in Australia. While there are potential costs associated with the creation of training positions there could also be savings resulting from mapping job positions to appropriate competency standards. What needs to be put in place? There is very poor information about who works in pathology laboratories, other than pathologists. The lack of information is partly due to poor definition of the term medical scientist and consequently the relative numbers of graduate and non graduate staff is unclear. Adding to the confusion are variable state based industrial awards. To address these issues a better understanding of the pathology labour market is required including staff numbers, qualifications and vacancy rates. Across Australia there is considerable variation in the proportions of graduate and nongraduate staff such as technicians working in laboratories. What is well described is the situation of graduate scientists often carrying out tasks that are more fitted to vocationally trained staff such as technicians. This has arisen because in some pathology disciplines, work previously performed by scientists has been automated and requires less supervision but workforce planning and recruitment has not changed to reflect the effect of technology. The use of competency based standards would ensure that positions are mapped to the appropriate level of qualification and experience. There are a number of issues with training which require resolution. Firstly there appears to be an underutilisation of vocationally trained people in laboratories and there are few examples of traineeships or apprenticeships at this level. This could be addressed by discussions with the VET sector around pathology placements. Second problems have been identified with graduates from medical science courses that have no practical component included in the curriculum. These graduates have to occupy traineeship posts with their first employee but such posts are becoming more difficult to find with the economic constraints in the pathology industry. Some courses are already addressing this issue by including practical components. Third is the issue of training posts and career paths for scientists to reach senior positions. The lack of posts and what is perceived by some to be absence of a defined career path is seen as contributing to the shortage of senior scientists. Discussions have taken place on defining a career path, including the role of the RCPA Faculty of Science and on identifying scientist training positions within pathology departments and practices. What is happening in the Medical Scientist Workforce in Australia? 3
Following the highlighting of potential shortages amongst the scientific and technical workforce, two studies were commissioned by the Department of Health and Ageing. The Urbis survey provided data about the workforce but it is acknowledged that doubts remain and further work needs to be done in this area, possibly enlisting the help of NATA. The HCA report into Career structures and Pathways has provided much useful information, together with feedback from the workforce and some key actions; following up these is the main purpose of the Workshop. The PAC Workforce Committee has spent a considerable time on many of these issues and have made progress on a number of fronts. They resurrected a project started in the 1990s of defining competencies at all scientific and technical levels in the laboratory and have defined new standards which reflect current practice in all disciplines. These standards could be deployed widely and ultimately would go some way to ensuring that positions are mapped to the appropriately level of experience. In addition they have defined a possible career pathway for senior scientists with an associated training program which could lead to one of the existing professional Fellowships or in a Fellowship awarded by the newly established RCPA Faculty of Science. To this end the College recently contacted all their members to see which institutions would be interested in creating training positions for trainee scientists. A background but possible relevant discussion has also taken place amongst the profession about registration or certification for all or some medical scientists. Medical Science was not in the group of allied health professions selected for registration, possibly because the level of risk was seen as low and the legal liability within laboratories rests with the pathologist and senior scientist, as defined in the NPAAC supervisory arrangements. What is happening with Medical Scientists elsewhere? Comparison is made most often to the medical scientist workforce in the USA and UK. There is concern in both about shortages due to the same demographic features as in Australia. A key feature of the USA workforce is that the majority of laboratory directors are PhD scientists, and the entry point into a senior scientist career is a PhD. The UK provides perhaps the most interest because for some time it has had well defined career paths for senior scientists including training positions and similar examinations for both trainee scientists and pathologists conducted by the Royal College of Pathologists. The PAC Workforce Committee sees the UK model as the one Australia should more closely emulate. The aim of the Workshop A number of solutions have been offered to resolve the present problems with the medical science workforce. These need to be rejected, accepted or modified as necessary by the profession at large. Employers in both public and private sectors need to be made aware of 4
the issues and potential solutions and then their acceptance or otherwise sought. Finally the solutions need to be developed further and deployed with appropriate resources. 5