States Continue To Hold Back Surgical Training Numbers

It was reported in The Australian Financial Review today that the health ministers want to set ACCC Chair Graeme Samuel loose on the Royal Australasian College of Surgeons (RACS) to end what they claim is a 'monopoly' on surgical training.

Dr Haikerwal said the only monopolies are the States' combined monopoly of ignorance about how surgical training numbers are established and their monopoly in providing training places.

"The number of surgical training places can only be increased if the States fund the appropriate number of Advanced Surgical Training (AST) places, which must include jobs where surgeons actually operate," Dr Haikerwal said.

"In its draft surgical workforce report - THE SURGICAL WORKFORCE IN AUSTRALIA - An Overview of Supply and Requirements 2004 to 2015 - the Australian Medical Workforce Advisory Committee (AMWAC) calls for between 231 and 278 first-year Advanced Surgical Training (AST) posts to be made available annually.

"In 2004, 197 first year AST places were available nationally across all States and Territories - all funded by the respective State and Territory Governments. This number has hardly shifted since then. Meanwhile, RACS has increased basic surgical training (BST) numbers significantly - from 164 in 2003 to 231 in 2006.

"So we now have a larger number of trainees coming out of BST but there are fewer AST places for them to all continue their training. The States prefer 'apprentice surgeons', not 'master surgeons', and this is wrong.

"There is a bottleneck, which means trainees are missing out - and this means that hospitals and patients are missing out on vital surgical capacity. Put simply, RACS is not blocking the supply of surgeons, the States are.

"The equation is simple - surgical training numbers can only be increased further if the States provide and fund the appropriate number of AST places. Otherwise, highly trained doctors will be left in limbo, unable to finish their training, and unable to treat the patients who so desperately need their skills.

"To date, the State health departments have refused to sign off on the AMWAC recommendations. Perhaps they should take note of the AMWAC recommendation that reads: '…the coordination of the advanced surgical training program continue to be overseen by the Royal Australasian College of Surgeons, in consultation with State and Territory health departments.'"