In the early 2000s the Federal Government began funding new medical schools in response to reports of an increasing shortage of doctors in Australia.
This was the obvious policy response and, at the time, every new medical school (including several established while Tony Abbott was Health Minister) was lauded as a success. As a result, the number of medical graduates has nearly doubled in the past ten years.
Soon enough, the attention shifted from medical student numbers to the availability of internships and training positions at some undefined point in the future. There seemed to be little interest from decision makers in the problem, since a) it was poorly understood, b) it seemed some years away and c) it’s a difficult problem to solve – universities educate medical students with federal funding, but hospitals, colleges and state governments train the graduates. The Council of Australian Governments did, however, guarantee internship positions for all domestic medical graduates.
In late 2012, the problem seemed to come to a head, and pressure from AMSA, the AMA and other groups led to increases in training positions from State governments, as well as a $10 million commitment from the-then Labor Government, to find more positions.
The incoming Coalition government committed to a Commonwealth Medical Internship Initiative in 2013, to fund up to 100 extra internships each year for four years in non-traditional settings such as private hospitals and rural areas.
Despite the best efforts, the bureaucracy of the current system has been an issue.
While applications were submitted, in most instances, in May, and offers began to be released in July, there are still hundreds of students waiting for positions, with a significant number of positions still remaining.
The states have done their best to eliminate the confusion caused by students accepting offers in two places, and by the practice of taking students who have accepted offers in one State and placing them somewhere else. But, until there is a nationally co-ordinated system for internship allocation, we will continue to lose graduates overseas while they wait for the states to sort out their processes.
A new development occurred in South Australia this year. A ministry official from SA Health met with some student representatives to politely inform them that up to 10 per cent of the domestic graduates who had trained in South Australia would have to look to other states for internships. A subsequent bunch of questions from journalists to the South Australian Health Minister had Jack Snelling promising that there would be internships for South Australian graduates. But it isn’t clear how long that guarantee will last for, or if those jobs will be in South Australia.
The universities must share some of the blame. The only students to miss out on internships so far have been international students. These students had a medical degree promoted to them, and came out to this country with high hopes of starting a career. Their fees help fund medical education for universities as a whole. However, most of them were not aware that internships might not be available upon their graduation.
While the situation for those seeking internships is somewhat perilous, spare a thought for those prevocational doctors who are applying for specialist positions – not only are positions limited, but there is very little data to show what the state of affairs actually is.
Ultimately, something will have to give – either universities will need to be more tightly regulated regarding their student numbers; State governments, colleges and hospitals will have to make more training room, or students and young doctors will give up and work elsewhere.
We need leadership. The Council of Australian Governments needs to come together and work on a plan for medical training in Australia, and finish what was started more than a decade ago.