The Council of Presidents of Medical Colleges (CPMC) convened its quarterly Stakeholder Meetings on 2 and 3 September on the lands of the Wurundjeri Woi Wurrung and Boon Wurrung peoples of the Kulin Nation bringing together leaders from Australia’s 16 specialist medical colleges to meet with the Department of Health, Disability and Ageing, regulators – Ahpra, the Medical Board of Australia and the Australian Medical Council as well as other key health sector stakeholders including the Australian Medical Association.
The Minister for Health, Disability and Ageing, the Hon Mark Butler MP, and Dr Mike Freelander MP, Chair of the House Standing Committee on Health, Aged Care and Disability, also addressed the meeting.
Inquiry into Access to and Affordability of Medical Specialists
Dr Mike Freelander MP, Chair of the House Standing Committee on Health, Aged Care and Disability, provided an update on the current Inquiry into Access to and Affordability of Medical Specialists.
Discussion highlighted the range of interconnected factors affecting access to specialist care, including workforce availability and distribution, specialist training capacity, public outpatient services, affordability and the particular challenges experienced in rural and regional communities as well as First Nations’ peoples.
Opportunities to improve access by training specialists in areas of community need and creating stronger pathways between metropolitan and regional settings through bi-directional training and appointments was discussed. The role of telehealth and improved referral pathways to support GPs to access specialist advice and connect patients with appropriate specialist care was also highlighted.
The discussion reinforced the importance of considering access and affordability as broad health system issues requiring coordinated action across workforce, training and service delivery.
Accreditation and Training Standards
The Australian Medical Council (AMC) provided an update on the revised Accreditation Standards for Specialist Medical Programs and work underway to support their implementation. The AMC is in final stages of review and approval of the new standards which will come into effect in 2027. AMC is currently developing guidance material to support the implementation of revised standards and is planning a series of implementation workshops during 2026 to support colleges in preparing for the introduction of the revised standards. The revised standards strengthen the focus on trainee voice and wellbeing, cultural safety, community and consumer engagement and continuous improvement, while supporting greater flexibility and innovation in specialist training.
The Australian Medical Council also provided an update on the development of the NHPO Recommendation 13 Framework for assessing and managing concerns and complaints about accredited specialist medical training settings. The Framework seeks to support clearer and more consistent approaches to communication, coordination and collaboration between specialist medical colleges, training sites and other relevant parties when concerns arise, including in relation to workplace health and safety responsibilities and has been based on WHS laws and applies to all training settings. Discussion highlighted the importance of clear responsibilities and effective collaboration, communication and between colleges, health services and other stakeholders in supporting safe and high-quality training environments.
The AMC is undertaking further consultation on the Framework, with specialist medical colleges continuing to contribute to its development.
Ministerial Remarks
The Minister for Health, Disability and Ageing, the Hon Mark Butler MP, provided an update on the Australian Government’s health reform priorities and the next phase of reform across the health system. The Minister highlighted the continued implementation of the Strengthening Medicare agenda, growth in general practice and Rural Generalist training, and the role of the new National Health Reform Agreement in supporting broader workforce reform.
The focus is now on the increasing pressures across the private health sector, access to and affordability of specialist care, informed financial consent and current work to improve transparency for patients about the cost of care. Workforce pressures were also discussed, including the need to address bottlenecks across specialist training and medical workforce pathways.
The discussion reinforced the importance of continued collaboration between government and specialist medical colleges as reforms affecting access, affordability, training and workforce progress.
Regulation and Specialist Pathways
Ahpra and the Medical Board of Australia provided an update on regulatory priorities affecting the medical profession, including work to improve regulatory processes and strengthen practitioner and patient safety.
A significant focus of the discussion was Ahpra’s adoption of the International Holocaust Remembrance Alliance (IHRA) Working Definition of Antisemitism as a reference tool within its regulatory framework. Discussion considered how the definition will operate alongside existing professional standards and obligations, and the importance of providing clarity for medical practitioners about its application within the regulatory environment.
An update was also provided on reforms to specialist pathways for Specialist International Medical Graduates (SIMGs), including the expedited specialist pathway and proposed changes to streamline the standard pathway. The expedited pathway introduced on 21 October 2024 has accelerated workforce entry for eligible UK, Irish and New Zealand graduates. An evaluation has reported that 88% are practising in priority and districts of workforce shortage areas and 11% in regional, rural and remote locations.
Ahpra and the Medical Board also discussed continuing professional development requirements for practitioners in non-clinical roles as well as emerging regulatory issues associated with the compassionate release of superannuation for medical treatment.
The session reinforced the importance of ongoing engagement between regulators and specialist medical colleges on regulatory reforms and emerging issues affecting the profession.
National Accreditation Portal
Miller Blue Group provided an update on the National Accreditation Portal project, overseen by CPMC and RACMA. The project was established in response to recommendations identifying duplication and is exploring the feasibility and requirements for a national technology-enabled platform.
A national portal has the potential to reduce duplication and administrative burden for health services, improve consistency across accreditation processes and provide greater visibility of specialist training across the health system which could assist with workforce planning as well as communication between sites and colleges. The next phase will focus on an Expression of Interest and assessing potential implementation costs, considering the governance, ownership and funding arrangements that would be required to support a future national platform.
Specialist Training, Workforce Reform and Access to Affordable Care
The Department of Health, Disability and Ageing provided an update on a range of national reforms relating to specialist access and affordability, health workforce planning and specialist training.
Discussion covered current work to improve access to affordable specialist care and transparency for patients, including the Medical Costs Finder with CPMC and colleges contributing to the development of the underlying fee‑presentation methodology. The Department’s Specialist Affordability Working Group is advising on practical reforms to improve access to affordable specialist care, including referral processes, informed financial consent and approaches to addressing very high fees. A range of policy approaches and reform options will continue to be discussed as the department engages with the medical profession and other stakeholders. It was noted that these affordability reforms are being considered alongside broader workforce and private health sector reforms.
The session also considered the 2026–2031 National Health Reform Agreement and its health workforce priorities, including national workforce planning, workforce distribution, training and supervision, First Nations workforce, cultural safety and new models of care.
Work underway to review workforce distribution arrangements, including District of Workforce Shortage and Distribution Priority Area classifications, was also discussed, with a focus on better identifying and responding to areas of workforce need.
The Department presented national workforce modelling. Discussion reinforced the importance of a more coordinated, needs-based approach to workforce planning that considers where future specialists are needed, the training pathways required and the needs of communities.
An update on the Specialist Training Program and FATES was provided and their role in supporting specialist training pathways, workforce distribution and improved access to care.
Exploring Innovative Models to Streamline and Shorten Training Pathways
Professor Mel Miller from Griffith University presented the draft report and recommendations from the Exploring Innovative Models to Streamline and Shorten the Training Pathway for Specialists project, commissioned by the Department of Health, Disability and Ageing.
The report draws on extensive national consultation with specialist medical colleges, trainees, supervisors and other stakeholders and identifies opportunities to make specialist training more flexible and efficient while maintaining quality and safety. A key finding is that the greatest opportunities are not simply in shortening the formal duration of specialist training, but in addressing bottlenecks across the training pipeline and reducing unnecessary duplication across colleges and training settings.
The presentation provided an opportunity for CPMC members to consider the draft report and recommendations and provide feedback ahead of further refinement and engagement with the Department.
Access and Affordability
The AMA led discussions on the recent media coverage that has highlighted rising specialist fees and long wait times in public outpatient clinics. The discussion considered a range of factors influencing access to specialist care, including Medicare rebates, public hospital and outpatient capacity, private health arrangements, specialist workforce availability and distribution, specialist fees, fee transparency and informed financial consent. There was a strong focus on ensuring that affordability is considered as a whole-of-system issue rather than through any single measure in isolation.
The session also considered issues affecting doctors in training, including the financial burden associated with specialist medical training. These issues were then considered further by colleges in a dedicated discussion on the cost of specialist medical training.
Medical Students and Specialist Training
The NSW Medical Students’ Council joined the meeting to discuss the transition of Australian medical graduates into specialist training and the growing pressures across the medical training pipeline. They presented their proposal for giving greater priority to Australian-trained medical graduates in access to specialist training through UK style legislation, alongside increasing training capacity and better targeting internationally trained doctors to areas of genuine workforce need.
The discussion considered the relationship between increasing numbers of medical graduates, the availability of accredited specialist training places and future specialist workforce requirements. Participants also considered the potential consequences of training bottlenecks, including longer periods in prevocational roles, increasing competition for training positions and uncertainty for doctors seeking to enter specialist training.
Rural and Regional Care – Cross-College Collaboration
Participants discussed cross-college initiatives aimed at strengthening access to care in rural and regional communities, with ACRRM leading the discussion.
ACRRM outlined their work with RACGP and RANZCO to support appropriately trained GPs and Rural Generalists to deliver intravitreal injections safely in communities where ophthalmology service is limited or unavailable, supported by specialist ophthalmology training, supervision and referral pathways.
ACRRM and RACGP also provided an update on their Joint Consultative Committee on Rural Generalist Medicine and opportunities to strengthen collaboration across standards, curriculum and advanced skills training.
Discussion highlighted the value of colleges working together to develop practical training and workforce approaches that support multidisciplinary care, strengthen connections between generalist and specialist services and improve access to high-quality care closer to home.
Dual Training Recognition – Cross-College Collaboration
Participants discussed opportunities to improve flexibility and reduce unnecessary duplication for doctors undertaking training across related specialties, with ANZCA and CICM outlining their new Dual Training Recognition Process.
The initiative provides a more coordinated approach to recognising eligible training, assessments and courses completed across anaesthesia and intensive care medicine, while maintaining the standards and requirements of both specialties which supports trainees seeking both FANZCA and FCICM qualifications through a more streamlined and shorter recognition process.
Discussion explored the potential for greater collaboration between colleges to improve recognition across training programs, support more flexible training pathways and reduce unnecessary duplication for trainees.
Principles of good college governance
Specialist medical college leaders participated in a workshop exploring contemporary principles of good governance and the changing governance, legal and regulatory environment in which colleges operate.
The session considered a range of issues relevant to effective college governance, including governance structures and Board composition, the roles and responsibilities of directors, leadership and succession, remuneration and resourcing, and the importance of ensuring governance arrangements remain appropriate as organisations evolve.
Participants shared experiences and approaches across colleges, recognising that while governance models differ, there is value in continued cross-college discussion and sharing of good practice to support well-governed, sustainable and high-performing specialist medical colleges.
Thank you
The CPMC warmly thanks all stakeholders and meeting attendees for their active participation and valued contribution to these discussions
