By Dr Isabel Hanson (she/her) BSc BA MBBS MSc DCH FRACGP, DPhil candidate
Published also in The Mandarin
Doctors and public servants have a lot in common.
Both work in complex systems to solve problems. Both must diagnose causes, come up with responses, communicate clearly, and guide the implementation of change. Both need not only technical skills, but also judgment, leadership, and the ability to navigate ambiguity.
Medicine builds this capacity through apprenticeship. The Australian Public Service could apply the same approach to grow its own expertise.
Expertise cannot be learned from a book. Professions that value analytic capability often lean heavily on academic achievement, overlooking the importance of apprenticeship and learning on-the-job. In medicine, the scientific foundations are built at university. But the craft of medicine is developed over a lifetime, through supervision, observation, peer reflection, and repeated exposure to complexity.
Medicine has invested in understanding how professionals learn on-the-job. The APS could do the same, not by replicating medical training, but by building a culture of apprenticeship that turns capable staff into experts.
Why Expertise Requires More Than Formal Education
Medical training is structured as an apprenticeship. Doctors learn in teams, from peers, and through formal and informal teaching from senior colleagues. The standard must be high because even minor errors can harm our patients.
Doctors move through a series of stages: from novice to advanced beginner, to competent, to proficient, and finally to expert. This framework, known as the Dreyfus model of skill acquisition, reminds us that examinations and formal coursework can assess competence, but they cannot produce proficiency or expertise on their own.
After graduating from university, new doctors enter clinical environments where they deliver services and provide advice under supervision. This early phase is comparable to APS grade employees. As doctors gain confidence and experience, they move into registrar roles. Registrars are comparable to EL1 and EL2 levels, where they manage complexity, teach juniors, and take increasing responsibility. Senior consultants, equivalent to the Senior Executive Service, are expected to lead not only by delivering outcomes but also by mentoring and contributing to system improvement.
The 2020 Review of the APSC Centre for Leadership and Learning highlights the importance of on-the-job learning, noting that consolidation through experience, supported by mobility and mentoring, is essential for building capability. Medical training shows how this approach can be embedded successfully across a complex system spanning multiple regions, specialties, and career stages.
Developing Judgment Through Practice
As a General Practice registrar, I was being observed by my supervisor during a consultation for a patient with back pain. I followed national guidelines, screened for complications, and arranged follow-up. After the patient left, my supervisor asked me: “What do you think was really going on?”.
She pointed to a moment when the patient mentioned taking codeine, then quickly changed the subject. I had missed it. She also noted the patient’s trembling hands, clasped tightly together in their lap. I had been so focused on doing the ‘right’ thing by the textbook, I had overlooked the deeper reason the patient was in my office: chronic pain had led to codeine dependency, and they were asking for help.
We called the patient back. I asked better questions, listened more closely, and uncovered an addiction that was affecting every part of their life. Addressing it changed the course of their care. Asking “what is really going on?” marks the shift from rule-following to seeing the whole picture. Now, as an experienced GP, I have countless examples where that question has improved the care I offer my patients. This is part of the craft of medicine, and I would not have learned it without the insight of a mentor.
Competence means the ability to apply learned rules and procedures. Proficiency means knowing when to apply them, when to adapt, and how to lead others through complexity. It requires judgment built from experience and mentorship, not abstract knowledge alone. As proficiency develops, through time and mentorship, expertise in the craft of the profession begins to take shape.
Clear Communication as a Marker of Expertise
Expertise often defies easy description, yet it is recognisable in practice: the quiet confidence, the ability to grasp complexity quickly, and the fluency of action that comes from deep experience. Experts still draw on analysis when needed, especially in unfamiliar situations. Their strength lies in recognising patterns quickly, condensing vast amounts of information into a simple (but not simplistic) formulation, communicating with clarity, and responding decisively.
Communication is one of the clearest examples of how professional expertise is developed through apprenticeship. In medicine, junior doctors learn to distil complex information into short, targeted briefings suited to the audience. A patient’s full history, test results, diagnoses, and treatments must be summarised in under a minute, whether briefing a specialist surgeon, consulting physician, or transfer team. The story must be clear, precise, and adapted to the listener’s needs.
This skill can take years of practice to master. It demands an understanding of what matters, what can be left unsaid, how to pitch advice at the right level of technical detail, and how to best convince the listener of your plan. It is learned not through theory alone, but through repeated observation, practice, and feedback.
Public service communication shares the same demands. Subho Banerjee, Deputy Commissioner of the APSC, recently recalled in The Mandarin one of the most impressive displays of public service craft he had witnessed: Peter Shergold, then head of the Department of the Prime Minister and Cabinet, delivering a five-minute briefing to the Prime Minister on Indigenous welfare reform.
The day before, Banerjee had been grilled by Shergold for an hour to prepare. He was peppered with detailed questions about risks, benefits, and practical implementation challenges. The next day, Shergold drew together everything he had absorbed from multiple sources and delivered a short, careful, practical, and deeply knowledgeable briefing to the Prime Minister, without notes.
Banerjee described it as a “virtuoso performance” of public service communication. It was not a matter of having memorised facts, but of having internalised the issue well enough to speak fluently, think on his feet, and advise with judgment. Banerjee was witnessing expertise at the highest level of the APS.
This is the same craft that case presentations teach in medicine. It is the art of selecting relevant information, structuring advice logically, and framing it practically for decision-makers. It requires deep understanding, not just content knowledge.
Building this kind of capability is slow, deliberate work. It demands exposure to good models, opportunities to practise under pressure, and honest feedback from those further along the path.
The APS Academy has recognised this need through its focus on “APS craft,” aiming to provide opportunities for public servants to learn through practice, mentoring, and peer conversation, as well as through formal courses. This is a positive step, reflecting some of the lessons medicine has long embedded in its training culture.
Building a Culture That Invests in Expertise
Expertise is a collective asset, not a personal achievement. Medical culture expects all staff to contribute to teaching and mentoring. The Australian Public Service should do the same. Building a culture of apprenticeship would support the development of expertise across the service.
By investing not only in formal education, but also in deliberate apprenticeship and learning on-the-job, the APS can build a workforce capable of leading, innovating and delivering for Australia.
Dr Isabel Hanson worked for the Department of the Prime Minister and Cabinet and the Department of Human Services before retraining as a medical doctor. She is now a General Practitioner and a General Sir John Monash Scholar, completing her Doctor of Philosophy (DPhil) in Primary Care at the University of Oxford.