Interns arrive at their teaching hospital knowing they must do five rotations including three core rotations. In some cases they have a fair choice; in others the experience might seem a bit haphazard. Yet there should be no such thing as a bad rotation.

"Each time I had finished a term as an intern I decided that I wanted to take that on as my future,'' says Dr John Ferguson, Chief Medical Officer at The Austin hospital.

"It was a positive reflection on the experience gained, which is the way it should be. We are looking at establishing a series of 'model years' which allow interns to get the best mix and match possible to make the internship a truly worthwhile year.''

Part of this is a new plan for the fifth rotation. "This is where interns begin establishing a career path and get the feel of what they might like to do,'' says Dr Ferguson. "We want this non-core term to be as broad and meaningful an experience as possible.''

Austin Health has the biggest intake in Victoria _ together with Northern Health it will take more than 90 interns next year _ and the widest choice of rotations. The Austin hopes to plan intern rotations which will establish future career paths in a wide range of possible areas.

"We are constantly looking at new and innovative roles to offer interns for their non-core terms,'' says HMO Manager Sarah McConchie. "We expect to provide the first term for an intern based at the Victorian Institute for Forensic Medicine, and an opportunity in psychiatry _ rarely offered at intern level.''

Austin Health is also a major provider of unique services in specialist areas. These including liver transplant, spinal services and respiratory support. It is also the only hospital doing percutaneous aortic valve replacement, which transforms major heart surgery into an overnight stay.

The hospital continues to grow and evolve with the Olivia Newton-John Cancer and Wellness Centre opening in 2010. The new elective surgical centre has enabled the hospital to do over 1000 more operations this year. The Austin knows that HMOs need looking after. Their new quarters include common rooms and leisure facilities.

"The Austin has an extremely friendly and positive culture with an attitude of support,'' says Ms McConchie. "A system has evolved in which volunteers from HMO2, 3 and registrar level `buddy' with interns and mentor them.''

Resolution of issues between interns and the hospital is the responsibility of a special registrar who serves as an impartial intermediary, strengthening communication between consultants, HMOs and the hospital. There are also meetings with HMO representatives so that dialogue is kept fully open. It is vital for all interns to feel the support, to know that their voice is being heard in such a big hospital.