Dr Nimisha Aithal Paediatric advanced trainee , lecturer at Griffith University school of medicine , and associate lecturer at the University of Queensland .

referred to as a non-trainee registrar , service registrar or principal house officer — is a doctor who performs all the duties of a registrar but does not have a college training position .

in those that have large registrar cohorts ( emergency medicine ) or those with highly competitive entry ( surgical specialties ).

Unaccredited positions primarily exist to ensure adequate service

experience in a specialty before applying for a training position .

They also allow juniors to ‘ try before they buy ’ without having to commit to a

Unaccredited registrars are so vulnerable in the public hospital system .

supervision of a consultant . There is a 20 % likelihood that this doctor was in fact an unaccredited registrar .

An unaccredited registrar — also

These ‘ service registrar ’ jobs are unique to and ubiquitous in Australia .

They are available in almost all specialties but predominate

delivery within public hospitals . Without them , the system could not function .

These roles are viewed by doctors-in-training as a way to gain

specialty .

But those who accept them can end up inhabiting a training no-man ’ s-land exposed to working conditions and

uncertain career progression

given the intensive competition

for specialty training .

They lack protection by the

colleges and so depend on the

goodwill of individual hos-

Write-off here and ideally three lines if possible please , thankyou Obitius molupienime quat im num nume sust , simus doluptas

pital departments and workforces , which are not famed for prioritising the needs of junior doctors .

So they work excessive and unsafe hours to fill rosters and on-call shifts , while accredited

trainees benefit from

college-mandated protected

teaching and skill acquisition .

Accredited registrars are

protected from prolonged

stretches of after-hours work

as colleges stipulate they cannot

exceed a certain number

in a calendar year .

No such cap exists for their

colleagues .

The fact that they do not

advocate for themselves for

better conditions reflects

their dependency on the

goodwill of superiors to

secure those coveted training

spots .

It is no secret that medical

training is a marathon . It

will take me at least 10 years

after finishing medical school

to attain the fellowships I am

pursuing .

But as a paediatric

advanced trainee , I am still

one of the lucky ones — my

future has some degree of

certainty . There is no limit to

the number of years doctors

can work as an unaccredited

Pull Quote here Si odi totatiatem faccusa erovid magnimus , sitatum asitiis eariatio es qui cuptiorDolupid quam , sunt . Nis ne as recto et facia qui ut quiam , quis ma nullorest inctum ligendaerum

registrar .

There is that deeper question of what happens to those doctors who have dedicated years of their lives and never find refuge in a training position .

What does that do to a person ? What does it do when the bright ambitions fail in such

an environment ? What kind

of disenchantment can that

breed ?

To me , any system that

insists on fair working conditions

for one group , while completely ignoring the needs

of another , is broken .

After all , if there is such a

clinical need for unaccredited

registrars to keep the public

hospital system lights on ,

then there is a moral imperative

to create an environment

that also serves to protect and

support them .

That is very far from happening

.

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