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Medicine to become the preserve of the wealthiest, not brightest, if Govt pushes through $250,000 medical degrees

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The Federal Government’s plan to deregulate university fees will push the cost of medical degrees up to $250,000, discouraging low income students from becoming doctors and skewing the medical workforce toward higher paid specialties and city practices.

AMA President Associate Professor Brian Owler has accused the Abbott Government of failing to appreciate the full consequences of its deregulation policy, warning the skyrocketing cost of a medical degree would undermine efforts to end the shortage of rural doctors, intensify the concentration of practitioners in the most lucrative specialties and discourage people from a career in medical research.

The Federal Government is trying the win Senate support for the deregulation of university fees, which it argues will unshackle universities and allow them to fully compete in the international education market.

So far its way has been blocked by blocked by the Palmer United Party, which has joined Labor and Greens in opposing the measure, and A/Professor Owler was assured of the PUP’s continuing opposition when he met with the minor party’s Senate leader Glenn Lazarus earlier this month.

The AMA President said the Government’s policy was ill-considered and, by saddling medical graduates with crushing debt, would exacerbate existing problems regarding rural shortages of doctors and the difficulty of luring graduates into vital but less well remunerated areas of medicine such as general practice, paediatrics and rehabilitation.

Medical Deans Australia and New Zealand have estimated that students embarking on a graduate medical degree will already be carrying a HECS debt of about $55,656 from their undergraduate studies.

A/Professor Owler said that on top of this, domestic students were likely to incur an annual debt of $52,000 for their four-year degree, even taken into account a Commonwealth subsidy of $18,000 a year, leaving them with a total debt of more than $250,000.

He said that although medicine was a relatively well paid profession, making the degree so costly would have a number of undesirable consequences for patient access to quality care.

The AMA President said the threat of such heavy debts would be a significant deterrent for people from lower socio-economic backgrounds, including rural and Indigenous Australians, from considering a career in medicine.

A/Professor Owler said that, even without these big fee increases, the bulk of students studying medicine were from better off backgrounds.

A 2011 report commissioned by the Group of Eight universities found that 45 per cent of students applying to study medicine came from well off families, compared with 15 per cent from low socio-economic backgrounds.

The AMA President warned the deterrent effect for low-income students would be strong, regardless of any loan assistance offered, and was a serious problem for the profession.

“This is a real issue in medicine. We want the best and brightest, not the wealthiest,” he said. “We want the medical profession to have the same diversity as the communities it serves. Australia has gained significant benefit by attracting medical students from diverse backgrounds…[and] that is something that we should continue to value.”

In addition to deterring lower income people from entering medicine, high fees would also skew the career choices of graduates toward better remunerated areas of practice, he said.

A/Professor Owler said overseas evidence showed that students carrying big debts gravitated toward better paid specialities, and the deregulation of fees was likely to see more medical graduates seeking to become surgeons and procedural specialists rather than GPs, paediatricians and other less lucrative areas of medicine.

He warned there would also be a flow-on effect for rural areas.

“Areas of medicine that are better remunerated will become more attractive. Ultimately, these decisions will exacerbate doctor shortages in rural and regional areas,” he said.

Not only that, it would also make it much harder to encourage graduates to embark upon research.

“High debt levels among medical graduates will deter our best and brightest, our future leaders, from undertaking PhD programs,” A/Professor Owler warned. “As a medical graduate, already with significant debt, often at the stage of life of starting a family, it would not be surprising to see commitment to further research, to science, questioned. For all the talk of the Medical Research Future Fund, it is disappointing that implications such as these do not seem to have been considered.”

Adrian Rollins