A horde of untrained doctors is no good for our health
A crisis looms. Before November 2012, 181 trained medical students would find themselves without a graduate placement. Without this last step, they cannot practice as doctors in Australia.
A medical degree sees a student spend up to six years at university, where they gather a general education in medicine. Once complete, the student must find a graduate internship in a hospital, where they can then move from students to become actual doctors.
According to an audit by the Confederation of Postgraduate Medical Education Councils, 3326 Australian-trained medical graduates applied for 3080 internships in 2013. That leaves 181 graduating students - who have spent between $51,000 and $300,000 - without any option to further their barely-started career.
It’s being labelled the National Internship Crisis, and James Churchill, the president of the Australian Medical Students’ Association says it’s a significant problem over the long term.
“There’s a lot of money that goes into training. It’s a waste of an investment the public makes. A waste of medical professionals to meet our future needs.”
These future doctors are particularly crucial for providing desperately needed healthcare in rural regions. Mr Churchill points out that the rural system is almost in crisis mode itself.
Dr Sean Fabri is International Medical Graduates Subcommittee Chair at the Postgraduate Medical Council of Victoria. He agrees that rural doctoring is important, but is concerned that the flood of students and a lack of appropriate mechanisms to process them is increasing the strain.
“One potential way it could affect patients is the dilution of training. If we just have to find more places for this large number of interns – and the numbers are just going to go up and up with the current government policy – we might end up sharing the jobs or workload against a larger number of people. While some will get the sufficient amount of experience, there’s going to be gaps.”
Dr Fabri and Mr Churchill both say the solution is, like a lot of complex issues that involve state, federal and local co-operation, a long-term, consistent approach. The fact that a cycle of medical education transcends a politician’s elected term doesn’t help.
The breakthrough 116 positions that have been produced by planning between federal Health Minister Tanya Plibersek, and Health Ministers from Western Australia, Queensland, the ACT and the Northern Territory are useful for now, but it’s the lack of plans for further training that makes Dr Fabri and Mr Churchill’s AMSA concerned.
Dr Fabri says there is good data on providing solutions. “There’s actually a World Health Organisation recommendation that was made in 2010 which suggested that first world countries like Australia need to develop a sustainable workforce in medicine, and as part of that we have an organisation called Health Workforce Australia. They’ve released a document called Health Workforce 2025.”
Mr Churchill says that Health Workforce 2025 “is the best workforce planning data we have.” The difficulty to overcome is implementing the data, requiring “coordination of different arms of the medical training pipeline. No one body is clearly responsible for that aspect.”
Mr Churchill suggests that using the Health Workforce 2025 data to estimate numbers is key, making sure the students who enter courses have relatively assured internships ready at the end. An understanding between the public and private hospitals, and universities that supply them with students is necessary to make such numbers useful.
“Hospitals are now inundated with applications, by people desperate for positions,” Dr Fabri admits. His role as part of the team processing these applications has put him in the eye of the storm. “You’d think that initially that would be a good thing, but in fact it’s created a tremendous burden of sorting and shortlisting applicants. When you have nine hundred people who’ve applied, that’s just not a number you can realistically interview. Especially given the short timeframe.”
A study in Queensland has identified a shortfall in ongoing training and positions for doctors, with reports that as many as 400 doctors in postgraduate years will not be offered work in the state in 2013. Meanwhile, the Australian Nursing Federation predicts a “shortage of more than 109,000 nurses by 2025.” (Link) Clearly, Australia’s medical community is in trouble.
Governments are finally at the table, discussing these problems with stakeholders. The 116 new positions extend the lifeline, but only for now. Further investment from governments in required, but that will be tough given the economic climate.
AMSA is pushing for implementation of the Health Workforce 2025 data, and government and private hospitals to engage with universities on the matter. The importance of the issue is not one that is front and centre in the public’s mind, but if adequate achievements aren’t met, and soon, patients will be the ones in crisis.
Comments on this post will close at 8pm AEDT.
Read all about it
Up to the minute Twitter chatter
The latest and greatest
Good morning Punchers. After four years of excellent fun and great conversation, this is the final post…
I have had some close calls, one that involved what looked to me like an AK47 pointed my way, followed…
In a world in which there are still people who subscribe to the vile notion that certain victims of sexual…