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Act now to prevent training crisis, govts told

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The AMA has called on the nation’s Health Ministers to act immediately to head off a looming critical shortage of medical training places that threatens to derail the careers of hundreds of aspiring doctors and undermine efforts to improve access to health care.

AMA President Dr Steven Hambleton and Chair of the AMA Council of Doctors in Training Dr Will Milford have written to the nation’s Federal, State and Territory Health Ministers urging them to begin work on a national medical training plan when they meet later this month.

Dr Hambleton and Dr Milford said that the plight of around 20 Tasmanian interns and resident medical officers (RMOs), who have failed to secure training places next year to continue their studies, highlighted increasingly severe shortcomings in the medical training pipeline that threaten to derail efforts to boost doctor numbers and prematurely snuff out the careers of dozens, if not hundreds, of medical graduates.

The senior AMA officials warned of a “growing bulge” of RMOs seeking registrar positions, and said the potential for locally-trained doctors to miss out on a training position was “extremely troubling”.

In their letter, Dr Hambleton and Dr Milford said that although each Government was working to provide more prevocational and specialist training places, “this is being done in a very unplanned and uncoordinated way that is not necessarily matched to community need”.

The AMA Council of Doctors in Training, which met late last month, said the forthcoming Standing Council on Health meeting was a critical opportunity to immediately begin work on a national medical training plan.

Speaking following the Council meeting, AMA Vice President Professor Geoffrey Dobb said the crisis in medical training was not only a tragedy for those graduates denied the opportunity to complete their studies, but was a serious problem for the country as it tried to address shortages and gaps in the medical workforce, now and in the future.

“The Health Workforce Australia Health Workforce 2025 report last year warned that Australia needed to increase prevocational and specialist training places for doctors if the medical workforce is to meet future community need,” Professor Dobb said.

In its report, HWA warned the nation was facing a shortage of 2700 doctors by 2025 unless there was nationally co-ordinated reform of the medical training system.

The pressure on prevocational and specialty training places has intensified sharply in the past nine years as the number of medical graduates has soared, from just 1287 in 2004 to more 3100 last year, and is expected to reach 3970 in 2016.

Federal, State and Territory governments reached a temporary, last-minute deal late last year to avert a critical shortage in training places for 2013 that potentially would have left more than 100 medical graduates stranded, and Dr Milford has urged against a repeat of such ad hoc solutions.

Both he and Dr Hambleton have written to the Australian Health Ministers’ Advisory Committee seeking details on the number of RMO and registrar positions that each State and Territory will offer next year.

The AMA officials also questioned the continued influx of junior doctors from overseas, with currently around 1550 RMOs employed on 457 visas.

“Given the growing number of Australian-trained doctors seeking RMO and registrar positions, it is very difficult to understand why so many temporary resident doctors are still being used to fill local vacancies,” they wrote.

The AMA has backed proposals from HWA for the establishment of a National Medical Training Advisory Network to improve the coordination of the medical training pipeline, and wants this month’s meeting of Health Ministers to agree to commence work on a five-year nation medical training program.

“We understand these proposals will be on the agenda at the Health Ministers’ meeting, and the AMA and the AMACDT urge all governments to adopt both proposals and start work on them straight away,” Professor Dobb said, adding that a national training plan was first promised by the end of 2011, “and we are still waiting”.

“The Australian community cannot afford any more delays with this important work,” he said.

Adrian Rollins