Action on training crisis needed now

A RECENT joint summit of doctors and medical educators has called for urgent action to fix the crisis in the training of interns and specialists in Australia.

The crisis summit, which included the AMA, the Australian Medical Students’ Association (AMSA), the Medical Deans Australia and New Zealand and the Confederation of Postgraduate Medical Education Councils, also called for a more coordinated long-term approach to match training resources with the health needs of the population.

The summit was told Australia faced a shortfall of 6300 medical practitioners largely as a result of policy decisions and inadequate workforce planning.

Since 2004, the number of medical schools has increased and places in existing schools have been expanded.

This had led to a big jump in the numbers of medical students graduating, which continues to increase by about 300 medical graduates per year, according to AMSA president Ross Roberts-Thomson.

As well, since 2002, international full-fee-paying medical students have been allowed to stay in Australia to become interns and registered medical practitioners.

However, hospital internship places have failed to keep pace with the rise in numbers of medical students.

Last year, there were about 2280 medical graduates but only 2243 internships available — and the trend is continuing. Next year’s shortfall could be 80–90 intern positions.

Shortages of training positions are also affecting the specialties, with an additional 1200 specialist training places needed by 2015, the summit was told.

While the federal government has significantly expanded prevocational and vocational general practitioner training positions — doubling the number from 600 to 1200 by 2014 — this will not be enough to address the expected shortfall.

Hence Australia faces a widespread doctor shortage over the next 15 years, the summit heard.

In a combined position statement, the summit called on the federal government to inject more funding into hospitals, so all graduates are guaranteed an internship.

The statement said there should be no new medical schools or places in medical schools offered until there are enough training posts and clinical supervisors to provide adequate training for those already enrolled.

Other recommendations included reducing Australia’s reliance on international full-fee-paying medical students, allowing states to share information on intern applications to avoid graduates applying for positions in multiple states, continuing development and funding of innovative training programs, and improved training programs outside public hospitals.

The full version of this story will be published in MJA Careers on 1 November 2010.

Posted 18 October 2010