The Impact on Training Future Psychiatrists 

February 2025

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Key Messages:

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1. Psychiatrists are in critical shortage in Australia, especially in outer metropolitan, regional and rural Australia where very few private services exist.

2. NSW is responsible for training 32% of new psychiatrists in Australia (2023).

3. Training occurs almost exclusively in the public sector (>90%).

4. Collapse of the training pipeline is imminent.

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Key Facts:

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• Psychiatrists have been in critically short supply Australia-wide since at least 2020 and are disproportionately distributed in urban centres.[1], [2]

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• 206 NSW staff specialist psychiatrists have expressed an intention to resign in December 2024.

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• This is 2/3 of the NSW Staff Specialist Psychiatrist workforce.

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• The NSW Government has framed this as a pay dispute and referred the matter to a full bench of the NSW Industrial Relations Commission (IRC) to be heard in March 2025.

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• Staff Specialist vacancies in NSW were at 30% of funded positions before January 2025. No other group medical specialists had a vacancy rate approaching 1/3 within NSW Health.

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• This vacancy rate and failure to recruit is comparable to that which affected Emergency Staff Specialists in NSW in 2010-2011, which led to a 25% recruitment and retention bonus.[3]

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• 80% of new psychiatrists in NSW are entering private practice or going interstate instead of remaining in NSW public sector practice. This cycle of understaffing contributes to unsafe services for patients and staff, deficiencies in training, and leads to further staff losses.

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• NSW Staff Specialist pay is 30% lower than Queensland and Victoria, and 52% lower than WA.[4]

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[1] Mental Health Workforce – Labour Market Analysis Final Report To Commonwealth Department of Health, ACIL Allen (2022)

[2] Hayter C, Allison S, Bastaiampillai T, Kisely S, Looi J. The changing psychiatry workforce in Australia: Still lacking in rural and remote regions. Aust J Rural Health. 2024 Apr;32(2):332-342. doi: 10.1111/ajr.13092. Epub 2024 Feb 28.

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Training impact

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• A core responsibility of Staff Specialists is the training of psychiatry registrars (doctors in training to qualify as specialist psychiatrists).

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• The vast majority of training terms (> 90%) are in the public sector.

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• There is negligible Federal funding for psychiatrist training in the private sector.

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• Training is not a core responsibly of VMO or Locum Psychiatrists, which NSW Government are relying upon to fill gaps. Training cannot be delivered by a temporary or casual workforce.

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• Training standards are set and monitored by the RANZCP. A critical non-negotiable standard is the trainee to supervisor ratio, which must be less than 2:1 (i.e., two trainees per supervisor), and a minimum number of hours for each trainee working under direct supervision of a psychiatrist.

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• A loss of over >200 specialists, leaving only 60, will result in the collapse of training within NSW.

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Psychiatry Training and Workforce Snapshot 2023-2023 

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Source: https://www.ranzcp.org/college-committees/annual-reports-plans-and-evaluations/annual-reports-and-strategy

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• Australia wide, the whole psychiatry workforce increased by 17.7%, but NSW only grew by 12.6%.

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• NSW consistently accounts for 28-30% of the Australian trainee workforce 2020-23.

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• NSW graduated 31.7% of new psychiatrists in 2023, after a brief reduction due to COVID-19.

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• New trainees in NSW fell by 7% in 2023 but increased by 18.2% in Australia, compared to 2020.

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• There is no spare capacity to absorb NSW trainees to positions interstate or in New Zealand.

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