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The universal truths of medical training

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It is a truth universally acknowledged that a Government in possession of a valued health care system must be in want of a sustainable, locally-trained medical workforce. 

A truth so universally acknowledged that, in 2006, the states and territories were granted extra medical school places by the Commonwealth on the condition they guaranteed to provide intern-training places for domestic medical graduates. Of course, everyone happily agreed.

As medical graduate numbers continued to rise, this agreement became harder and harder to uphold.

Bound to the agreement, the states and territories continue to provide internships to their local graduates in the hopes of securing that ever-coveted sustainable workforce. 

But, as time goes on, truths change. 

Last month, we saw reports from South Australia suggesting that up to 22 locally-trained domestic graduates will miss out on an internship from 2017. These numbers look set to rise in 2018, up to 39.

Perhaps most worryingly, rather than scrambling to ensure the ongoing development of a robust medical workforce, it appears that South Australia is instead going to breach the COAG agreement, leaving 22 graduates without jobs.

While we may be speaking about small number in the greater scheme of medical training we, as a profession and a society, have made a significant investment in the training of these 22 graduates. Without the ability to complete an internship, these individuals will be unable to join our workforce and serve our community.

Not only is this a waste of incredible talent, but would also be short-changing the Australian people. We cannot afford to waste the significant investment we make in any of our nearly 4000 medical graduates each year.

Logically, a shortage in intern places is merely a precursor of what is to come further along the medical training pipeline.

Work by the now-disbanded Health Workforce Australia projected a shortfall of 569 vocational training places by 2018, rising to 1011 places by 2030.

This means that doctors in training will be soon be without the opportunity to progress to specialist practitioners, leaving the Australian people without access to doctors in the areas and specialities that they need the most.

In short: the training crisis is not coming, it is already here.  We seem to be in the middle of it before we even knew it had begun.

The South Australian Government needs to be held to account over its failure to commit to providing medical internships to domestic graduates from local medical schools.

Additionally, the AMA calls on all states and territories to re-affirm past COAG commitments.

We know that there are a sufficient number of graduates making their way through the training pipeline.

However, graduates require vocational training to progress and, without adequate investment into training places, we will never build the health workforce we need.

 There needs to be Federal leadership regarding the expansion of vocational training.

We call on all Health Ministers to work closely together in the funding, planning, and coordination of medical training places.  Medical training needs to be a priority agenda item not only for our Federal leaders, but also for all states and territories.  

Not only is Australia in want of a well-trained and sustainable medical workforce, we deserve one – and are within reach of establishing one.

Now, we just need to separate the universal truths from the politics.

To view the letter the AMA has sent to Health Minister Sussan Ley on the issue, visit: media/medical-training-must-be-priority-health-ministers