Currently in Australia we are facing an intern crisis which has culminated in a series of talks over the past couple of weeks. Contrary to popular belief this is not something new but has been steadily growing each year. Governments (both at a State & Federal level) along with the AMA, AMSA and other interest groups have been trying to formulate a solution that works for them.
Just recently, the Federal Health Minister Tanya Plibersek made a $10 million commitment to address the medical internship shortfall. This comes at the expense of the Government’s Prevocational General Practice Placements Program (PGPPP - a program which encourages and supports GP Placements).
While some parties in particular AMSA were happy about this announcement, they were concerned with some of the conditions and consequences. Notably, Dr Hambleton from the AMA outlined that the current proposal is more like a short term fix then a long term solution.
“The AMA urges all the Health Ministers to look beyond band aid solutions and the Commonwealth-State argy-bargy to instead address the long-term need to fund and build greater capacity across the whole medical training pipeline,” Dr Hambleton said.
How I see things
Editors Note: Opinion at time of writing - 20/9/12. As more data has come to light I've slightly altered my opinions, but feel free to call me out on anything you disagree with. 16/10/12While I normally try to avoid politically charged topics on this blog, I feel like there are a couple key points to raise.
- One-off funding: This to me highlights the quick-fix nature of the current solution. Yes there are now 100 more intern places for this years graduates, but what happens next year when more medical students are expected to graduate.
- Drawing funding from other Training Programs: Redistributing the funding away from a program like PGPPP, which encourages junior doctors to work in General Practice, disrupts training opportunities further down the line. The government should be advocating and encouraging junior doctors to consider becoming General Practitioners, as one of the key front-line groups of the healthcare system. Improvement in the delivery of primary care is beneficial in minimising or preventing acute healthcare crises and the cost to the hospital system.
- International Medical Students need to be aware: Here's where I may come across a bit harsh, but I feel that international medical students also need to take personal responsibility for being aware of a country's health system. If I was going to apply to a medical school in the United States I would investigate not only the medical school, but my job prospects after graduation. This intern crisis while reaching a new high this year is not new, and as far as I'm aware medical schools do not guarantee international students internships upon completion of training. Therefore, you took a risk in accepting a place in an Australian medical school.
- Don't complain about conditions: I seen several international students I know, already complain about the fact that these places come with conditions. Again most of you are educated people, so I would hope that you could make an educated choice. If you do not like the new alternative option that exists, then don't choose it. As someone who is bonded to carry out a return of service, I find it insulting that you think the government is not entitled to get some form of remuneration for providing extra intern places. (Supporting these people appropriately down the track however, is another matter.)
- Unregulated Medical Schools: Medical schools are one of the driving forces leading up to this intern crisis. In my opinion, some medical schools have been taking more international medical students than the current health system can handle (for what I can only guess is a profiteering exercise). Fortunately the medical deans have recently stated that they will limit the intake of international full fee paying students in 2013, and to look at how the future intake of international students can be more closely linked to workforce need. This can only be a good thing for all parties concerned in the long run.
For a rundown of what's been taken place (courtesy of AMSA).
- 26.09.2012 Health Ministers meet but fail to reach agreement on a solution
- 26.09.2012 AMSA President quoted in 'International students miss out on internships', The Age
- 24.09.2012 AMSA writes to each State Health Minister, urging action on internships before time runs out
- 18.09.2012 AMSA President quoted in 'Wasted degrees: hundreds of students may miss internships', Medical Observer
- 17.09.2012 AMSA President quoted in 'Med students set to miss out on training places', Medical Observer
- 12.09.2012 Media Release: Time running out for internships: AMSA
- 29.08.2012 DoHA Medical Training Review Panel meeting, featuring a discussion on the current state of internship allocation
- 21.08.2012 Media Release: All talk and no action on internships: AMSA
- 21.08.2012 Health Minister Plibersek and Mr Mark Cormack, CEO of Health Workforce Australia, recognise issue during addresses to AMSA National Leadership Development Seminar
- 08.08.2012 Media Release: Internship places still lacking as second round offers released
- 30.07.2012 MJA InSight publishes opinion piece by AMSA President, 'Internship uncertainty'
- 23.07.2012 AMSA President interviewed on ABC News 24 television, 'Medical graduates missing out'
- 23.07.2012 AMSA President interviewed on ABC World Today, 'Lack of hospital internships threaten future doctor numbers'
- 23.07.2012 AMA President interviewed on ABC AM, 'Not enough internships for medical graduates'
- 23.07.2012 Media Release: Medical students face internship uncertainty
- 05.07.2012 AMSA President quoted in 'Med student glut a problem for hospitals', The West Australian (page 8)
- 05.07.2012 Media Release: Students gather to address medical education threats
- 05.07.2012 AMSA President holds press conference at National Convention, prior to annual 'Big Issues' session