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The intern crisis: A temporary reprieve?

On the first Friday in November, 116 careers were changed forever. One hundred and sixteen additional intern posts were found and funded, allowing 116 medical graduates to continue their medical training in Australia.

19 Nov 2012

On the first Friday in November, 116 careers were changed forever.

One hundred and sixteen additional intern posts were found and funded, allowing 116 medical graduates to continue their medical training in Australia.

After a hard-fought battle, the Federal Health Minister, Tanya Plibersek, deserves credit for her persistence in finally negotiating an agreement with the governments of Western Australia, Queensland, the Australian Capital Territory and the Northern Territory.

This must be seen as a victory for the federal and state branches of the AMA and the Australian Medical Students Association (AMSA).

Both organisations have run dogged, disciplined campaigns in the media - and behind the scenes - that have finally borne results. The medical students who were prepared to put a face to the crisis must also be given credit for the activism that brought a resolution to this crucial issue in medical training. 

Attention has to shift to the career prospects of the remaining unplaced graduates. Those states and territories that have participated in this agreement have benefited, with the Commonwealth funding at least two intern posts for every one that was locally funded. Simply put, the states yet to commit to the agreement are passing up an opportunity to gain a three-fold return on their workforce investment.  States must move beyond the bitter political point scoring that dominates their agendas on health care.

There are two very large, ‘elephants in the room’ that have yet to be acknowledged: medical graduate numbers are yet to peak, and internship is only the first year of a medical training pathway spanning many years.

Planning for future medical graduates has been remarkably absent from any discussion currently taking place.

No consideration has been given to next year’s graduates. Will we go through the same circus in the second half of next year?

Similarly, internship marks only the beginning of post-graduate training. Next year’s interns will need both prevocational and vocational training places in years to come, otherwise we can expect a counter-productive exodus of our trainees overseas. 

In an alarming development, we are already seeing hundreds of prevocational doctors ‘off-contract’ in both Victoria and Queensland.

This is at least partly due to a maldistribution of junior doctors, which has artificially brought forward the vocational training squeeze that is not due to hit until 2016.

We must be wary of short-term fixes that do not address this impending pipeline effect. Solutions will need to be strategic, flexible and responsive to local workforce needs.

There has been some progress. Health Workforce Australia has released the third volume of Health Workforce 2025, and the final instalment in its suite of medical workforce predictions looks at medical specialty workforce planning.

Included in the recommendations is a plan for a National Medical Training Advisory Network to develop policies to address these impending crises.

Similarly, the Federal Government’s willingness to engage stakeholders on medical training must also be applauded.

But there is a crucial question which remains to be answered: In the post-health reform era, to what extent will the states and territories co-operate, and will junior doctors yet again be the victims in another blame game?


Published: 19 Nov 2012