Australia's Intern Crisis

Original article: http://www.mjainsight.com.au/view?post=james-churchill-an-intern-crisis&post_id=9436&cat=comment

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An intern crisis

Written by James Churchill

HUNDREDS of students graduating from Australian medical schools this year may not get an internship in 2013.

The Australian Medical Students’ Association has been concerned for years that the rapid and sustained increases in medical student numbers would, at some point, lead to the clinical training system failing to provide sufficient internships for graduates.

The number of medical graduates has rapidly doubled from 1633 in 2006 to this year’s predicted 3512. With the lack of adequate workforce planning over a number of years, it’s no wonder that our health systems are struggling to keep up with graduate numbers.

In 2006, and again in 2010, the Council of Australian Governments (COAG) guaranteed “to provide high-quality clinical placements and intern training for Commonwealth-funded medical” students.

Despite these guarantees, it is concerning that many state agencies have advertised fewer internship positions than the estimated number of domestic applicants. In these states, the job prospects for Australian-trained international students are even more alarming.

International students, who make up about 15% of graduate numbers, are not guaranteed an internship in any state or territory, and are generally prioritised after domestic students in the allocation systems.

Our estimates show that, overall, 456 medical graduates will not gain an internship that is required for full medical registration, and will therefore not be able to work as doctors in Australia. As domestic students get first allocation, it will be international students who will bear the brunt of this lack of places.

Many of these students will be forced to seek internships overseas after being trained specifically for the Australian health care system and the complex medical needs of its ageing population.

The prospect of medical graduates not being able to continue training in Australia represents an appalling lack of workforce planning by governments and universities. It is concerning on a number of levels.

First, producing medical graduates without jobs will not solve the shortage and maldistribution of Australia’s medical workforce, and will leave graduates unable to serve communities in need.

The recent Health Workforce 2025 report predicts a modest undersupply of doctors by 2025 in a range of likely scenarios. It also highlights that Australia’s current reliance on overseas-trained doctors goes against many conventions to which Australia is a signatory.

We are now in a ridiculous situation where, on the one hand, Australia produces more doctors than internship positions, forcing doctors to continue their internship training overseas, yet, on the other, we continue to rely on vast numbers of overseas-trained doctors to meet Australia’s health needs.

Second, significant federal, state, university and private financial resources go into training a medical graduate, all of which is wasted if that graduate cannot practise. The waste of immeasurable and valuable clinical resources is equally significant given the various pressures of increasing student numbers.

Third, this situation has significant implications for the sustainability of Australia’s medical education sector. As many of those students likely to miss out on internships are international full-fee paying students, a loss of confidence in graduates’ ability to continue training in Australia may precipitate a decline in demand for international full-fee places at Australian medical schools.

Many medical schools are significantly reliant on international student revenue, the loss of which may have severe consequences for the quality of medical education in Australia.

Progress on this issue in the coming weeks will be critical for those medical students concerned about their future careers.

Sufficient funding and support must be provided to health services to ensure that the maximum number of quality internship positions is available for Australia’s medical graduates.

It will not suffice for university medical schools, and state and federal governments to simply blame each other for the problem and hope that it will somehow resolve itself.

Governments and their agencies must recognise the significance of failing to provide medical graduates with internships and the ability to continue the training that is needed for Australian medical school graduates to fully participate in Australia’s future medical workforce.

Mr James Churchill is the president of the Australian Medical Students’ Association.

Updates on the internship crisis are available the Australian Medical Students’ Association website. AMSA has also started a petition — Health Ministers of Australia: Train the doctors Australia needs.

Posted 4 June 2012