Training costs should not price graduates out of entering or advancing through specialist medical training, the AMA says.
The AMA’s first-ever position statement on specialist medical training fees has confirmed what doctors in training have long raised concerns about: unpredictable and opaque college fees extend well beyond annual training and membership costs.
Developed by the AMA’s Council of Doctors in Training (CDT), the AMA’s position statement, published today, outlined five guiding principles that build on the CDT’s long-standing advocacy.
It was put together in response to 2025 Medical Training Survey data, which found 66% of specialist non-GP trainees experienced stress due to the financial cost of their training, with 13% citing cost as a barrier to their training progression.
Moreover, 57% of specialist non-GP trainees disagreed when asked whether their college provided clear, accessible information on fee spending – a finding the AMA said pointed to a broader trust deficit that could hinder trainees’ ability to assess value or plan their training pathway.
AMA president Dr Danielle McMullen said college-provided specialist medical training was crucial to Australia’s medical workforce pipeline, but transparent, predictable fees that supported diversity and wellbeing were equally essential.
“The position statement we are releasing today supports constructive engagement with specialist medical colleges to find a balanced approach that recognises both trainee needs and system sustainability,” she said.
This included financial transparency for applications, membership, examinations, standard annual fees, and any other associated expenses.
AMA council of doctors in training chair Dr Sanjay Hettige said the costs were already compounded by insufficient capacity for specialist training places, highlighted in this year’s whole of workforce compendium report.
“There still exists the misconception that trainee doctors come from privileged backgrounds,” he said.
“On top of that, when training costs put whole specialties out of reach or make it harder to attract doctors to rural and regional communities, it is not only unfair to individual trainees – it is a workforce problem,” Dr Hettige said.
It’s a sentiment both the New South Wales Medical Students’ Council and the Australian Medical Students Association had recently expressed.
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There were several asks in the AMA’s position statement.
Namely, a federally funded independent health workforce planning and analysis body to provide data-driven decision making.
The Medical Workforce Advisory Collaboration (MWAC), which was not mentioned in the AMA’s position statement despite its membership, was inaugurated in August 2024 and meets four times a year.
Dr Hettige told The Medical Republic that, while MWAC existed, there was a lack of “real transparency” or accountability about which initiatives were being undertaken or how the current bottlenecks in the medical workforce training pipeline were being addressed.
“We do get to see some of the stuff that’s going on, but I do feel like our voice is more there just to comment on things, not to be properly consulted, to cause changes, and to meaningfully contribute,” he said.
While the Australian Medical Council’s Standards mandated transparency and communication about training fee changes, the AMA went further, urging “predictability and justification” as critical to fairness.
It stipulated any training fee increases beyond inflation, with the Consumer Price Index currently at 4.2%, be justified and communicated promptly, and that trainees be given a seat at the governance decision-making table.
“Fee structures should not disproportionately impact trainees from underrepresented backgrounds, including women, rural trainees, First Nations trainees, trainees from low socioeconomic backgrounds, trainees with disabilities, and trainees with caring responsibilities,” the statement read.
The AMA said colleges should also share IT and examination system resources to improve training efficiency and establish formal, publicly available college policies on financial distress, including deferred payments and hardship-based fee waivers, for students who require flexible payment options.
Dr Hettige told TMR the position statement had been in the works for almost two years, but that its timing could not have been more apt.
The AMA had written to all the major colleges and to the Council of Presidents of Medical Colleges, and aimed to meet with them to collaborate on improving transparency, he said.
“[Colleges] can no longer hide from this. Their members are really quite angry about this issue, and otherwise they may not have the volunteer workforce they need to carry out their functions,” he said.
“How are they going to get the new body of trainees coming through as young fellows to actually contribute back to their college when they’ve been treating them, in some ways, quite abysmally?”
Dr Hettige told TMR the upcoming AMA specialist trainee experience health check, based on annual Medical Training Survey data, would be released in the next few weeks.
