Even before they learn their scalpel skills, Australia's trainee surgeons will have to pass a test on the basics of hand hygiene.

The Royal Australasian College of Surgeons will introduce the online test that all trainees must complete before beginning their five-year surgical courses.

Experts say it is a significant advance in the campaign to get more doctors to clean their hands before and after seeing each patient - a practice that has been shown to reduce the rate of hospital-acquired infections like drug-resistant golden staph. While surgeons are well-known for their ''scrub-up'' before surgery, they have a reputation for not being so rigorous when inspecting patients on their ward rounds before and after surgery.

Recent national surveys have shown that in hospitals doctors trail other health professionals like nurses in rates of hand cleaning. However, there has been a significant improvement since a national campaign began three years ago, the director of Hand Hygiene Australia, Lindsay Grayson, says.

Nearly 60 per cent of doctors meet hand-cleaning standards, compared with about 70 per cent of nurses, but Professor Grayson says the important development is that doctors are improving rapidly, from fewer than half making the grade a few years ago.

The surgeons' lead in hand cleaning was significant in bringing behaviour change of the kind that Australians made in learning to wear seat belts. ''It makes sense but we must get into the habit,'' Professor Grayson said.

What made the habit easier was provision of alcohol-based hand cleansers that include a moisturiser, making it a quick option that does not ruin the skin like repeated use of soap and water. Intensive-care nurses may have to clean their hands 20-30 times an hour.

Professor Grayson said research showed improved hand hygiene was earning dividends by reducing the incidence of prolonged hospital stays caused by avoidable infections, saving millions of dollars.