This one-day workshop on 22 June 2011 sought to inform stakeholders of recent research and developments relating to the pathology workforce, and to provide an opportunity for discussion of key issues for the specialist and scientific workforce. Both medical and scientific professionals attended with key issues raised including limited career opportunities, increased demands on the workforce and a forecast decrease in both specialist and scientific workforce numbers. The Australian Association of Pathology Practices (AAPP) was not represented at the workshop, and asked that their decision not to attend be noted.
(The number of delegates available to attend this workshop was substantially reduced at short notice due to the closure of Sydney Airport related to an ash cloud from a volcanic eruption in Chile.)
Grant Recipient
URBIS
Aims
to provide a representative forum for discussion of pathology workforce issues
to consider the findings of research related to the pathology workforce
to identify information gaps requiring further research or investigation.
Objective
to stimulate discussion and debate regarding current and projected workforce challenges and solutions.
These aims and objective were achieved by this workshop.
Findings
Workforce Issues
There is a declining proportion of working age population and an ageing population with increasing demands for pathology services.
There are cultural changes across generations which are predicted to impact on workforce choices in the future, with many younger people choosing lifestyle choices over career advancement.
The career framework is less well defined for the scientific workforce than it is for the specialist pathologist workforce.
Influences on the future pathology workforce identified include:
the need for more flexible workplace environments
increasing and changing demands for technologies
the growing move within Australia towards nationally consistent accreditation and standards.
limited career opportunities, particularly for the scientific workforce
insufficient rewards, particularly for the scientific workforce
stress/burnout
a desire for improved work-life balance.
The current workforce levels, which have increased (particularly in rural areas) for Anatomical Pathologists, represent a threat to the health and well being of pathologists, and on the quality and safety of pathology services.
There needs to be recognition that participating pathologists perform other duties in addition to reporting on patient-related activities.
Segmenting the workforce in discrete roles with different training pathways, accreditation requirements and career pathways, and with different industrial arrangements across States/Territories, has not been conducive to developing clear and consistent career frameworks.
Issues relating to the specialist workforce include:
a perceived need for flexibility across pathology sub-disciplines
workforce shortages and the proposal for increased recruitment of medical graduates into pathology, including the creation of more training positions
the creation of more specialist pathologist positions to cope with the increase in the demand for services
increasing service demand and the impact of workload pressures on pathologists’ health and wellbeing, as well as quality and safety
changing technologies and the proposal for enhanced training including support for training while still working
flexible work practices and the development of a career framework which could provide new options for pathologists to move into and out of pathology specialties over a lifetime’s career.
There is a critical need to recruit and retain senior scientists.
There is no dedicated pathway for Aboriginal and Torres Strait Islander medical graduates, which may be addressed in the future.
There is a large amount of data to support action to address key workforce challenges and no pressing need for new research.
The increase in the demand and complexity of pathology services will require innovative, long-term planning in order to respond to the changing technological environment and ensure the capacity of the workforce to adapt to changing market needs.
The number of pathology trainees has increased from 406 in 2008 to 474 in 2010.
The increasing drive towards sub-specialisation may require even more pathologists than otherwise to provide for both generalist and sub-specialty pathology demands.
General Findings
The Pathology Associations Council (PAC) Competency Based Standards (CBS) framework for Medical Scientists provides a structure for creating a scope of practice and developing a career pathway which could be formalised in industrial reward structures.
New technologies, such as decision support and point of care testing, will require a flexible and responsive workforce to adapt to changing work practices and service demands. In some cases technology may increase workloads, while it may decrease workloads and increase capacity for other tasks.
It is important for the pathology sector and government to work together to ensure the workforce is able to meet the demands for future services.
There is a trend towards concentrating services in urban areas which is reducing the opportunities for rural careers. Innovative packaging or incentives and professional opportunities, as well as strategies such as creating generalist positions for anatomical pathology trainees based in regional or rural locations, could encourage more practitioners to work in rural areas.
Recommendations
A better training and career framework for senior scientists should be explored which also considered the drive to sub-specialisation, and the potential for professionals (including pathologists) to move in or out of sub-specialties over the course of their career.
Explore options to promote the value of pathology services to the broader health system and within universities to gain the cooperation of those in a position to assist with addressing recruitment, training and workload needs.
Existing studies and data could be further mined and an annual survey on employment and data trends would be useful.
Explore the option of implementing comprehensive national workforce planning.
Quality measures for anatomical pathology need to be given more priority.
Possible future actions to recruit and retain senior scientists include:
remuneration relative to qualifications and specialisation
support to undertake a professional fellowship.
A career framework, supported by greater flexibility within the workplace, is essential to ensure the future pathology workforce was able to meet the demands for services. This may need to be coordinated with undergraduate and postgraduate training, and offer options for ongoing professional development supported while retaining specialists in employment.
Explore one accurate method to collect workforce data for both the specialist and scientific workforce.
Forecast the number of pathology specialists required in the future to ensure there is capacity within the training pipeline to accommodate an increased number of pathology trainees, including defining a full-time workload.
Identify the gaps in the available data on the demand for pathology services.
Develop guidelines on safe pathologist workloads.
Profile the workforce differences between private and public laboratories.
Compare the attrition rates to those in other professions to assess the extent of the problem.
Follow on Initiatives and Projects
Further possible work through the Workforce Advisory Committee under the Pathology Funding Agreement.
Areas for Future Consideration
Explore the issue of pathology training and specialty opportunities for Aboriginal and Torres Strait Islander medical graduates.
Explore the possibility of guidelines on safe pathologist workloads.
