Issues in training in clinical psychology in Australia: Interplay between training goals and legal standards of practice

Training models in clinical psychology vary across regions, as do the laws that regulate professional practice in psychology. Standards for practice and for entry into professional practice may endure past the point of utility in the face of changing health-care systems and evolving international considerations. Herein the authors review aspects of the Australian 4-year training model, including qualifications for entry to the profession, supervision, and the influence of the profession and the universities in maintaining and in changing to a new training model. Aspects of training in clinical psychology in Australia are also discussed, and the Australian and New Zealand accreditation models are contrasted. Suggestions on ways to move forward are offered.

Deregulation, competition policy and intra-professional contests in medical education

This paper investigates how government policy directions embracing deregulation and market liberalism, together with significant pre-existing tensions within the Australian medical profession, produced ground breaking change in the funding and delivery of medical education for general practitioners. From an initial view between and within the medical profession, and government, about the goal of improving the standards of general practice education and training, segments of the general practice community, particularly those located in rural and remote settings, displayed increasingly vocal concerns about the approach and solutions proffered by the predominantly urban-influenced Royal Australian College of General Practitioners (RACGP). The extent of dissatisfaction culminated in the establishment of the Australian College of Rural and Remote Medicine (ACRRM) in 1997 and the development of an alternative curriculum for general practice. This paper focuses on two decades of changes in general practice training and how competition policy acted as a justificatory mechanism for putting general practice education out to competitive tender against a background of significant intra-professional conflict. The government's interest in increasing efficiency and deregulating the 'closed shop' practices of professions, as expressed through national competition policy, ultimately exposed the existing antagonisms within the profession to public view and allowed the government some influence on the sacred cow of professional training. Government policy has acted as a mechanism of resolution for long standing grievances of the rural GPs and propelled professional training towards an open competition model. The findings have implications for future research looking at the unanticipated outcomes of competition and internal markets.