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17 Jun 2013

Medical groups have condemned controversial proposals for the establishment of two new medical schools as irresponsible given unresolved concerns about a looming shortage of internships in coming years.

Charles Sturt University and La Trobe University have launched a joint bid for $46 million from the Federal Government to help fund a rural medical school operating three campuses across rural New South Wales and Victoria.

The proposal calls for the establishment of the Murray-Darling Medical School, which would operate from CSU’s Orange and Wagga Wagga campuses, as well as La Trobe University’s Bendigo campus, with an initial complement of 120 training places when it opens in 2015, rising to 180 positions by 2017.

But the plans, and a similar proposal by Western Australia’s Curtin University, have fallen foul of medical groups concerned that governments are struggling to provide sufficient internships for medical graduates from existing medical schools, let alone meeting the extra demand created by more medical schools.

Last year, only a last-minute political deal between the Commonwealth and several State and Territory governments averted a disastrous shortfall in the number of internships offered to medical graduates.

There are mounting fears that, with the number of medical graduates set to build every year, the placement crisis will become progressively worse unless there is a clear commitment by the nation’s governments to resolve the issue.

Health Workforce Australia estimates that the nation’s universities will be producing almost 4000 medical graduates every year by 2016, and has warned that the number of intern places was not growing quickly enough to meet expected demand.

In a report released late last year, HWA said that unless there was significant investment in extra prevocational and vocational training places, the nation faced an annual shortage of 451 specialist training positions by 2016.

Chair of the AMA Council of Doctors in Training (AMACDT) Dr Will Milford said it would be “criminal” if governments allowed a repeat of last year’s near-disastrous events.

“It would be criminal of we learnt nothing from the chaos and confusion of last year’s internship crisis, and patients miss out on the quality medical care they desperately need,” Dr Milford said. “Governments have a responsibility to ensure that all medical graduates can access an internship to complete their training and become registered as independent medical practitioners.”

AMACDT has convened a coalition of peak medical student and junior doctor groups comprising the Australian Medical Students’ Association (AMSA), Medical Student Action on Training, the General Practice Students Network and the National Rural Health Students’ Network, to jointly campaign for a boost in medical internships.

Dr Milford said the coalition would work together to convince all governments to fund their share of internships.

AMSA President Ben Veness said that in such a situation it made no sense to be opening more medical schools.

“Increasing the number of medical students at a time when we are already short of training positions is irresponsible,” Mr Veness said. “No new medical schools should be opened without a guaranteed commensurate increase in the number of internships and subsequent training positions.”

In addition, he said, there were already accredited medical schools in each of the towns where the proposed Murray-Darling Medical School would have a campus.

Health Minister Tanya Plibersek said recently that resolving the internship crisis and ensuring there were adequate places in future was a priority for the Government, and she has written to the AMA assuring it that she will not approve any new medical schools until the current problems are resolved.

A report in The Australian suggested Opposition leader Tony Abbott had given a similar assurance to medical school deans.

But National MPs have thrown their support behind the joint CUS-La Trobe University plan.

Regional education spokeswoman Senator Fiona Nash told The Australian said the proposal was cost-effective and reflected international experience about effective rural training.

“In my view it deserves the Government’s strong consideration,” Senator Nash told The Australian.

CSU Vice Chancellor Andrew Vann told The Australian that current medical schools were producing too many city-based specialists, and not enough practitioners who stayed in regional areas.

He said that too often students trained in regional settings returned to their social networks in the cities, and the CSU-La Trobe University plan provided a “new solution” to the problem.

While the universities are pushing ahead with their proposal, Ms Plibersek told the AMA National Conference late last month that she had ordered work to begin immediately on an “end-to-end rural pathway” for medical students, which was one of the recommendations of the Mason Review of Australian Government Health Workforce Programs.

AMA President Dr Steve Hambleton said the pathway had the potential to improve the recruitment and retention of medical graduates in rural areas, as well as expanding critical medical training opportunities in these regions.



Published: 17 Jun 2013