This is how I feel about the current state of the Victorian Health system: (posted on doctors4hospitals)

Many interesting comments, all of which I agree with.  I too am a disillusioned senior registrar about to finish my Emergency specialty training and upon completion, abandon the public health system for good.  I can't in good conscience support a system that has abused me and my peers in such a systematic and degrading way for so many years.  The $20K CME allowance isn't enough to entice me back and is really an affront to registrars, who can buy 3 textbooks with their $1000, while watching their consultants jet off overseas (business class) to conferences that they don't even show up to, while we have to fight (and often lose) to get our 5 hours a week paid training time. My consultants spend their CME money on flash new computers for their kids, overseas holidays and new i-phones, none of which are used for work. What do I get as someone who actually has to go home each night and study? A couple of free textbooks. What a load of BS.  Maybe if everyone was treated better as a registrar they wouldn't think about leaving and they wouldn't need the $20K CME carrot to keep people in the system.

As far as hoping to change the system what everyone needs to keep in mind are the following facts:
1) Nothing mentioned on this page is "new" information to the AMA, the government or the Colleges.
2) All of these organisations have a vested interest in maintaining the status quo, and no amount of whining about how bad it all is, to anyone, will change it.  They know IT ALL, and could change it anytime they want, they just won't because it will simply cost too much, and could lose the government the next election.
3) This system has evolved because our predecessors (read "bosses") have allowed it to and we have them to thank for being such pushovers and creating a culture of compliance and dependence on hospitals for our bastardising training system.
4) The reason they haven't fought to change the system earlier is that as you learn more about it, you come to realise that YOU CANNOT CHANGE THE SYSTEM.  No amount of letter writing, petitions, campaigns, haggling, arguing, lobbying or meetings will ever change the system. Why? Because WE CAN'T STRIKE. WE HAVE NOTHING TO BARGAIN WITH. WE NEED THE SYSTEM MORE THAN IT NEEDS US. The only thing yo can do is LEAVE. (As seen recently when ALL the Emergency Physicians in Adelaide RESIGNED, and their demands were miraculously and instantly met). Did the AMA achieve this for them...? No.
5) When you need the hospital more than they need you (ie for training positions) they will always have the power to dictate pitiful working conditions and YOU ARE POWERLESS TO CHANGE IT.
6) When the situation is reversed (ie when they need to fill a shift) you have the power.  Next time you're called by a HMO manager to fill a shift demand $200/hour. Or just say "no". When they laugh at your outrageous request for higher pay, tell them to get stuffed and hang up.  You still have your day off, and they still have an empty roster. (I did this once and they called back a few hours later and paid me the $200/hour as they couldn't get anyone to do the shift).  Or tell them to get the locum agency to call you.  Why accept the lowest locum rates in the country (Victoria) to help a system that won't help you?  Screw the HMO manager, they're earning double what you are and the biggest challenge they'll ever face is filling an empty box on an Excel spreadsheet.  Compare that to your usual day at work. 
7) VOTE WITH YOUR FEET.  Why risk being driven to suicide (as some of our colleagues have been) or depression, or hypertension, or tears, or realtionship breakups? (Heard of any HMO managers or CEO's killing themselves recently because of their job stress?) Why not just pick up and move interstate? Wouldn't you rather have better conditions, better pay, less ill-effects on your health and realtionships, plus better weather, and then fly back to Melbourne once a month to see your friends and family? Do you really see them that often anyway?  Get Skype and you can video-chat with them every night, for free!
8) THE PATIENTS WILL BE FINE.  Don't ever let the guilt of the "but what about the patients?" lobby guilt trip you into accepting substandard conditions. While the public wants free healthcare, then they will get a crap system.  If they want to pay more, then they will get a better system.  It's no use whining about how little you're getting paid - the money has to come from somewhere, and as long as the public refuses to pay more for public healthcare, then your salary will NEVER go up. I can't stand to hear people say "patients are consumers these days" and they "have the same rights as consumers".  I'm sorry but that is bullshit.  If they are consumers then let them pay market rates for my services.  And make them pay for proper equipment and facilities for me to treat them in.  As long as we live in a society where healthcare is seen as a "right", but where people aren't willing to pay for it, then YOUR SALARY WILL NEVER GO UP, AND YOUR WORK CONDITIONS WILL NEVER IMPROVE.
9) "I can't leave as it will just increase the stress on my colleagues".  Don't let the fact that your colleagues are too apathetic to get out make you feel bad for leaving.  If they had any brains they'd be doing it as well.  YOU OWE THEM NOTHING as it's their continued acceptance of piss-poor working conditions that continues to make your work so difficult. Just look after "number 1" (ie yourself) and let the system fall down around the fools who choose to stay.  Or let your boss (who I guarantee earns a least $250-500K p.a.) come in on their day off to write discharge summaries. After all, they created this mess.
10)No private company would treat equivalently educated, trained and skillful employees as badly as public hospital doctors are treated.  Anyone else with equivalent qualifications in the private sector would start on a 6-figure salary, with a phone and a car, and as they progressed they'd get a designated car-park, a personal assistant, a laptop, their own office, free lunches & dinners, and overseas trips for professional development, as well as performance and end-of-year bonuses and if they didn't I'm sure they'd at least be able to, oh I don't know, maybe go to the toilet or eat something during their day at work.  Unfortunately we don't even get these basic food and toilet privileges as public hospital doctors.  Do you think prisoners in Victoria's (privately run) prisons would accept it if they weren't fed and weren't allowed to go to the toilet for 10-14 hours?  There'd be riots...  If patients want professional service THEN START TREATING AND PAYING US LIKE PROFESSIONALS (which as I've clearly explained, will never happen in our lifetimes...sigh). And on this point here's an anecdote: my sister is a corporate lawyer, last year her CHRISTMAS BONUS was more than my after-tax salary for the year... She writes contracts and I save lives...
11) IT IS ONLY GOING TO GET WORSE.  Demand is going up and up, doctor number are going down... hmm I wonder why.  How do they plan to fix it? By improving my conditions? Paying me what I'm worth and treating me like a valued employee so I'll stay? No.  DHS has spent millions concocting plans to massively increase intern numbers (yet is providing no infrastructure to help supervise and train them... more cannon fodder) and is enticing foreign doctors with incentive packages including free health insurance, rent assistance and spousal employment assistance, (which I assume is cheaper than my currently unpaid overtime) yet most of us would actually stay in the system if they just improve a few of the conditions. Instead they intend to send more lambs to the slaughter, put more kerosene on the fire... pick your own analogy, it's all bad.  For this DHS can go to hell, and so can the Victorian  public for not supporting us.  And they'll all get what they deserve, a crappily designed, dangerous system, run by incompetents, supervised and controlled by morons. Good luck.

My advice? VOTE WITH YOUR FEET.  LET THE VICTORIAN PUBLIC HEALTH SYSTEM COLLAPSE. Your primary responsibility is to YOURSELF, NOT THE PATIENTS, NOT THE AMA, NOT YOUR COLLEAGUES AND CERTAINLY NOT THE HOSPITAL. Anyone that tries to convince you otherwise is either an agent of the system, or a delusional do-gooder who's too blinded by their "ethical duty" or some other crap to see what's really going on.

If you really want to stay then choose a specialty like Emergency (or even Anaesthetics) that lets you walk straight out of the public system as a consultant and start charging $200-$300 per hour as a locum or private ED specialist.  You can earn $200,000-300,000 per year working 2 to 3 days a week, 8am til 6pm and never be on call. The system does not, has not and will never support you in the public system so why are you sacrificing so much of yourself for it?.  Don't hold your breath for the EBA, because at the end of the day the AMA is a useless organisation, with no leverage and nothing to bargain with.  Cancel your membership and with the money buy a few bottles of nice wine, you'll get more joy out of it, and it might make you feel better after a crap day at work (or you can use it to help with moving expenses, or to buy a new hammock in Darwin, Cairns, Perth, or wherever else you end up). GOOD LUCK!