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Blocking overseas practitioners won’t solve rural doctor shortage

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The nation needs to do more to encourage medical practitioners to work in under-served rural areas rather than simply seek to choke off the supply of overseas-trained doctors by tightening visa rules, AMA President Dr Michael Gannon has said.

Responding to a report in The Australian that the Health Department wants to axe visas for imported doctors to make room for a growing number of domestic medical graduates, Dr Gannon said the real issue was to improve the attractiveness of rural practice for doctors, regardless of where they come from.

A surge in the number of medical graduates in recent years has eased fears of a doctor shortage, leading some to argue the country no longer needs to rely on the recruitment of doctors from overseas to plug gaps in the medical workforce.

But, while acknowledging the big jump in medical graduates had altered the landscape, Dr Gannon said the Health Department’s proposal to remove 41 health jobs from the Skilled Occupations List was misdirected.

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Dr Gannon said for several decades overseas-trained doctors had been a valued part of the health system, helping ameliorate the effects of a long period of under-investment in medical training.

He said it was important that those with special skills or talent continued to have the opportunity to work in Australia.

Instead of blocking doctors from overseas, the focus should be on addressing the misallocation that sees most doctors, whether locally trained or from overseas, congregating in practices in the major cities rather than moving into rural areas where they were most needed, Dr Gannon told ABC radio.

“We just have to look at a system which is not delivering on its stated intention, which is to get doctors where they’re really needed,” the AMA President said. “What we’ve seen now is that we’ve got a reasonable oversupply of GPs and other specialists in inner-metropolitan Australia, and I think what we need to work harder on is investing in incentives to get doctors to work in rural areas.”

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Dr Gannon said country practice was a “very, very rewarding professional career”, and evidence showed that junior doctors given opportunities to train in rural areas were far more likely to work there.

The AMA has urged increased Commonwealth investment in rural training, and late last year the Government announced the establishment of a $93.8 million Integrated Rural Training Pipeline to improve the retention of postgraduate prevocational doctors in country areas.

Dr Gannon said that while the funding was welcome, it did not come close to replacing the Prevocational General Practice Placements Program (PGPPP) scrapped in the 2014 Budget, and much more effort was needed, particularly to encourage more procedural GPs to set up in the bush.

The AMA has proposed a Community Residency Program which would allow doctors in training to undertake rotations of up to 13 weeks to give them a good experience of life as a rural GP and to enhance their clinical experience.

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“The abolition of the PGPPP has left general practice in a position where it is the only major medical specialty unable to offer doctors in training a structured prevocational training experience before they make a career choice,” Dr Gannon said.

“The Community Residency Program would provide them with opportunities to undertake important general practice prevocational training in an effort to encourage more young doctors to choose a career in general practice.”

The AMA President said it would complement the Government’s plan to establish a National Rural Generalist Pathway as a way to address rural workforce issues.

Adrian Rollins

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