We cope by importing doctors from other counties. In fact, Australia has been the highest per capita importer in the world of foreign-trained doctors. Politicians have tried for many years to help. First increasing the output of doctors, but then realising that under fee for service, more doctors means more costs for Medicare. So medical student numbers were cut back More recently, about a decade ago, the federal government began a massive increase in the number of medical students.The first phase of this increase has nowgraduated. The average member of the public has only a hazy view of medical training.On graduation from a medical school, these doctors cannot practise independently but require graduated and supervised training.In round terms, one can double the length of training, so to producea fully fledged GP or specialist will be of the order of 12 years (sometimes longer) after leaving school. For the first year after graduating, these doctors have to work as interns. As interns they contribute to patient care.But they need close supervision, but the supervisiongradually becomes less as they become more senior.So the service provision at more junior levels is less, but increases with increasing level of seniority. But and a big but there wereinitially too few jobs for the graduating interns.Each state has then increasedthe number of intern positions (by 120 last year and this year in Queensland, for example).Next year, there is a need for a similar bulge in the numbers of slightly more senior doctors and this continues up the training scale. The increase in interns will flow on like global warming giving rise to increased numbers at each stage after graduation. Eventually, they will become advanced trainees, then finally fully fledged general practitioners or specialists.The process has begun, and will yield more GPs or specialists in 4-6 years from now. Training positions require salary and infrastructure.The states have to find money.But junior doctors do not treat as many patients as fully trained doctors. So the states spend more now, and hope for a dividend in 4-6 years from now with increased GPs and specialists. What will happen next?How about bedding down the increase of medical graduates?Well, um, no Two universities have applied fora new medical school Charles Sturt University in NSW and Curtin University in WA. There are strong lobbyists for each. A popular one is rural focus.They forget that each of the older Australian medical schools has a rural clinical school where students spend a full year studying in rural areas. Who is lobbying forCurtin University?Some well-connected people. Jim McGinty is chair of Health Workforce Australia, and former Minister of Health in the previous ALP governmentHealth Workforce Australiahas a budget of several billion to pay for undergraduate training in the health professions.
More medical specialists for Hunter
IN DEMAND: Dr Peter Chong and Dr Gary Avery in the Charlestown Private Hospital operating theatre. Picture: Phil Hearne TWO health specialists are calling for a Newcastle “medical revival” that would bring the range of health services up to the standard of Melbourne or Sydney. Plastic surgeon Dr Gary Avery and urologist Dr Peter Chong have both relocated to Newcastle to work in the public and private hospitals in recent years. The city has previously struggled to attract and retain surgeons across a number of specialties they feel, but the situation should, and is, changing – although they believe more government funding is needed. “As the city transforms and also more surgeons come out of training in Melbourne and Sydney and seek not only busy practices, but family-friendly lifestyles, I see that changing,” Dr Avery said. Completing surgical fellowships in New Zealand and Australia, Dr Avery moved to Newcastle in April with his family. He brings the tally of full-time plastic surgeons in the city up to three. Working in private practice in Charlestown, he also performs complex skin cancer removal, hand surgery and breast reconstruction at public hospitals. He said when there was so much on offer in Newcastle, the new trend of “drive in, drive out” surgeons wasn’t good enough. “I understand that some doctors probably think that because the area has been under-serviced that they can come up, operate and drive away, but I wouldn’t feel comfortable doing that to patients,” he said. “It might be different if there were no other options available to the community and it was a remote town, but surely Newcastle has enough going for it to commit to being here full time?” Dr Chong is also a relatively new addition to the region, previously living in Sydney and Canberra. He said Newcastle was being overlooked for important health funding from state and federal governments considering its rapidly growing population and economy.