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

3 thoughts on “Action on training crisis needed now

  1. Anonymous says:

    Guys,
    you are forgetting one more aspect to the exploitation of IMGs apart from it being unethical to drain the doctors from poor countries.This is the AMC. These people pay an enormous amount of money to sit and pass these exams. Then there may be no internship place – so you don’t get registration as no job.
    In spite of knowing this, the AMC continues to open new MCQ exam centres overseas with a waiting time of 18 months before doctors can sit the part 2 examination. It then takes another 2-3 months to issue the computer print out called a certifcate. But you can actually work here after passing only part 1 because that suits the current requirement/shortage in Australia.
    Does anyone know where all this money is going? Does anyone know how much money is being generated through this channel? Just like how selling education to these third world countries has become a business in Australia.
    In my opinion, anyone who is saying there is no discrimination in Australia is fooling themselves. Just look at the different pathways AMC has to let doctors from certain countries [who might be failures in their own country] to come here and take on jobs without any examinations just because their training system is similar to ours. They can just walk in without any screening examinations and take up the jobs.

  2. Anonymous says:

    Was this not an obvious outcome of the increased medical student places? Why don’t we think outside the square on this and make solutions that can benefit our profession?

    Many junior doctors would like increased flexibility of work hours for various reasons (most commonly to have families). Could we not restructure to some extent to allow the option of part-time work in the intern and resident years (outside of just the emergency department)? This would allow a better work/family balance for those of us with young children and also ensure more individuals could be employed. Not only does this benefit us personally but also may work to encourage young doctors to stay in the hospital longer. It would allow doctors wanting that balance to consider specialist training options other than General Practice.

  3. Vikki says:

    It is essential that Australia become self-sufficient in terms of training doctors and specialists, thereby reducing the need for employing doctors from overseas. It is unethical to continue to drain developing countries of their doctors, not only because their need is greater than ours, but also because, unlike in Australia, the cost of medical training in many less affluent countries is borne totally by the state.

    The medical fraternity is a very strong group with enormous power in Australia; this power should be used to ensure that every medical graduate is offered a training position.

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