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1Executive SummaryThe framework was commissioned by the Committee of Presidents of MedicalColleges (CPMC) in Australia to guide its commitment to close the gap in healthstatus between Indigenous and other Australians by specifically supporting thetraining of Indigenous medical specialists. This report does indeed take a‘recruitment to specialisation’ approach, recommending initiatives to recruit andsupport Indigenous medical students in their pathway from junior doctors toFellows.Three streams of action have been identified: recruitment and retention—andsuccessful completion—of Indigenous medical graduates in their chosen specialisttraining; reform of the curricula to incorporate Indigenous health perspectives,experiences and opportunities into core training; and the pragmatics of ensuringchange and implementation of strategies in these areas.The central legitimacy of this report rests on the contributions of 15 Indigenousmedical specialists, or specialists‐in‐training, from around Australia who generouslyshared their insights in interviews. Also, a literature review was undertaken lookingat the scope of published information related to mentoring in medicine as well ascultural competency and safety in specialist medical training. Key approaches weredrawn from the Medical Deans of Australia and New Zealand (MDANZ) andAustralian Indigenous Doctors Association (AIDA) collaboration agreement, whichaims to increase the number of Indigenous medical students, as well as ensure thatIndigenous perspectives are integrated into basic medical education.Australia has a poor record in the recruitment and retention of Indigenous people inmedicine. In contrast to other settler colonial nations such as New Zealand, theUnited States and Canada, who all graduated their first Indigenous doctors in thelate 1880s, Australia’s first Indigenous medical doctor graduated in 1983, andcurrent numbers represent only approximately 0.2 per cent of the medicalworkforce in Australia (but Indigenous Australians represent 2.3 per cent of the totalpopulation). The reality of these relatively small numbers of Indigenous medicalgraduates provide an opportunity for Colleges to address needs on an individualbasis in the short term, whilst putting in place a systemic approach for the future. Itis anticipated that Indigenous medical graduates will increase from current numbers(an estimated 137 doctors in training) by 10 and 20 per year for the three years from2010, with nearly double that in the following years (possibly up to 40).In framing the recommendations of this report, consideration has been given to thespecific factors that impact on Indigenous doctors’ decision to specialise. Whilementors play a significant role, an awareness of the poor state of Aboriginal healthwithin their own families and communities and the ability to improve this withspecialty skills also has an influence. The scope of impact in general practice wasanother emergent theme.The report discusses pathways into specialties, support, retention and mentoring,curriculum reform and pathways for change and concludes that existing expertise,goodwill and good intent alone do not ensure the successful execution of the