Which would you rather?
By LAUREN POLLARD.
Imagine working, studying and training for 4+ years to become a doctor.
You want to work in Australia, you want to save lives, you want to ease pain and you want to become an integral part of the Australian health system. A system that is currently struggling to support itself. A system that is relying on the recruitment of 2500 foreign doctors each year.
Now, imagine graduating from your degree at one of Australia’s best universities and not being able to work because while the system is crying out for doctors: we don’t have enough intern places to do the final training for those who want to be doctors.
My 21-year old sister is a first-year medical student at the University of Sydney. Like so many other students, she has had to sacrifice so much in order to pursue her dream of one day being a doctor.
The hours are long, the training rigorous and the expectations placed upon them are excruciating. The thought of her jumping through all these hurdles only to be told ‘sorry’ at the end of 4 long years, is unimaginable.
And yet this is exactly what’s happening to 182 international students who have just finished their Australian studies to become medical professionals.
They’ve been trained to meet Australian standards and desperately want to work. Yet State and Federal governments are fighting over whose responsibility it is to fund their internship places – and without an internship these doctors cannot practice in Australia.
These students have paid hundreds of thousands of dollars to train in our prestigious hospitals and medical schools with the hope of working for the Australian health system. And now it looks like it might all have been for nothing.
How did this happen?
The intern crisis
Under the Howard Government in 2004, there was an increase in the number of medical students trained within Australia. Unfortunately, the lack of one single government body being responsible for medical training and funding across Australia has resulted in a health system that has not been prepared to deal with the increased numbers of graduates.
The increase in medical students without subsequent planning reflects a lack of understanding and foresight from all levels of government about the rigorous training a doctor must undergo to become qualified and skilled in their field. NSW Health Minister, Jillian Skinner went so-far as suggesting that these international students fund their own internships and pay to work in our hospitals.
As you can imagine, the issues surrounding this are complex and wide-reaching.
To meet the current demand, Australia is importing doctors from third-world countries in order to support our own health system. Importing doctors from these countries can potentially have devastating effect on their own struggling health systems. Not to mention, small rural towns are crying out for doctors…
And yet our governments are prepared to turn their backs on these students, who have studied here and want to work here and who desperately want to help.
If the issue isn’t addressed quickly the intern crisis is only going to grow. In the not-too-distant future, there is a genuine fear that our own domestic students won’t be able to access internships after graduation.
The fact is that Australia needs more Australian trained doctors.
It makes no sense that we’re importing more than 2,000 foreign-trained doctors per year into our health system, yet we’re sending the ones we’ve trained away because we can’t support the completion of their study.
We need these students just as much as they need us.
In trying to get this crisis resolved, a petition has been posted on change.org to try and raise awareness. There is a hashtag going around Twitter (#interncrisis) and a peaceful protest (Scrubs on the Street) took place in Sydney over the weekend.
Lauren is a 25 year old Communications student from Newcastle, NSW who has spent the past 7 years working for regional newspapers. When she’s not tweeting about the #interncrisis she enjoys binge reading, shopping too much and all things tween.
Comments
93 Comments so far
We need to separate medicine and the state.
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It is devastating after going for an undergrad in molecular bio then an M.D, then all the scut work, all the hours of sacrifice, all the sleepless nights, all the expensive licensing exams to be turned away year after year.
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As someone hoping to start med in a couple of years, this terrifies me :/
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I thought it was ok to do internships overseas? Or even a requirement?
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This article raises interesting issues. However there are several assumptions I want to challenge and bring a more balanced view to that raised in the article.
Firstly, we’ve had the phrase ‘doctor shortage’ for a while now. Casually throwing this term around is unacceptable. What kind of doctors? Not all doctors can do the same job. Take a brief stroll through an inner city suburb and you will see it packed full of GPs. True, we have a shortage in rural areas but this a function of med graduates to relocate to the underserved areas not because of a ‘shortage’. If you disagree then I am happy to look at evidence you can provide in an objective manner, so far I have seen NO statistics collected by reputable sources that says we have a shortage of doctors. In fact, we have one of the HIGHEST ratio of doctors to population. Most of the foreign doctors recruited overseas are FORCED to work in rural areas because local med grads don’t want to work there- this will continue whether we train another 180 interns or not.
Secondly, why should we pay for INTERNATIONAL STUDENT internships? Like you said, it is a training year. This means our TAXPAYERS are spending a lot of money training students who at the end of the year will jump at the chance to go back to US or Canada. I have asked many of these students and they are all desperately trying very hard to organize positions back home. For them, an Australian internship is only a backup plan. Only the ones who aren’t competitive to go home must rely on the goodwill of the Australian taxpayer to stay here. Do some research and you’ll find that foreign medical grads in US, Canada, Ireland, Singapore (all popular foreign medical training countries) DO NOT offer a GUARANTEED INTERNSHIP position and neither do we. It is explicitly written in the forms they sign when they accept entry into med school here.
Thirdly, and this is the most important point. We currently have a ‘crisis’ due to lack of internship positions, if we cede to pressure and allow all our international students to stay- imagine where the next bottleneck will be? That’s right specialist training. It is already so fierce that some med grads spend 5+ years working in a hospital before even BEGINNING their specialty training. If the governments have this much reluctance in increasing internship positions, what is the response going to be of the independent training colleges who have an entrenched interest in aritficially suppressing the number of trained specialists so there is less competiton? These international students will then end up competing with local students for what is already a very small pie of specialist positions.
Some food for thought. To the author, I applaud you for trying to bring forth issues regarding international med students- but please do your research and not just become a mouthpiece for international med students propaganda.
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Firstly: the shortage is based on a study conducted by the federal government’s Health Workforce Australia. The report “Health Workforce 2025″ is available online (link below) and there is a good summary of shortages on page 3.
https://www.hwa.gov.au/sites/uploads/health-workforce-2025-volume-1.pdf
Secondly: while an internship is indeed a training year so are the first 8 or so years (at least) of a doctor’s career, each of which is an integral part of the public health system (as you indicated in your third point). The HWA 2025 report found “bottlenecks, inefficiency and insufficient capacity in the training system, especially for doctors”. In addition to this it found a “high level of dependence on internationally recruited health professionals”; all of whom have to learn how our healthcare system functions, unlike the international students that are being turned away.
Thirdly: you are correct and once again this was noted in the HWA 2025 report.
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Its a problem for international student ‘For now’. This is just the beginning. Soon when medical graduate tsunami hit the shore. (or has it already?)
All medical graduates (including CSP, Full-fee paying domestic) will suffer from internship shortage.
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…and I’m naive on this but aren’t internships unpaid in all other industries, why are they paid in this case?
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They’re not the regular type of internship. It’s required to practice and it’s a full-time job. Kind of like an apprenticehip (in that you’re learning, but also getting paid because you progressively ‘do’ more).
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182 doesnt really sound like a large number to me. How many people are unemployed in Australia?
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and how many people are currently on waiting lists because they can’t see a Doctor?
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There is amedical training crisis affecting junior doctors overall. However, the availability of specialists itself is a small part of the issues driving waiting lists.
Waiting lists are not helped by stretching existing resources to include supervision of an excess of interns, or failing to consider the training needs of doctors in their subsequent years.
I trained at an Australian medical school, and have worked in public hospitals since this time. One factor that appears prominent for many international med students currently is that when they planned their studies some 5-6 years ago, the Australian dollar was performing poorly and therefore to study and live here appeared economical. This is no longer the case.
(I note that I am skiving on the internet as my first 2 patients booked for this morning did not attend!)
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Wait until we see the statistics on how many excellent, qualified teachers can’t get a job either
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I think a few people on here are missing the point.
Yes, it’s sad that these students can’t gain internships in Australia.
Yes, it’s true that in other fields a degree doesn’t equal employment.
The most important thing that we should take away from this article is that the Australian health system is struggling to support itself. We need doctors. All reports indicate that the best doctors to work in our hospital are the ones our Australian medical schools train. They work in our hospitals, they learn our systems and they meet our standard of training. In order for our system to have more of these Australian-trained doctors they an internship. No internship = no doctors. Our government has already invested roughly $75-80,000 per international student in order to train them to our standards. By not offering them an internship we’re effectively paying to train another Doctor who will go overseas for work. That’s cray-cray! We need these Doctors of the future to stay here and continue training here if we have any hope of meeting the predicted shortfall.
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Two points: (1) Its true there is an internship crisis. The problem though is whether we should be spending Australian tax payer money to train mostly international students. Australian students cannot pay their way into a medical degree in this country except at Bond. As a result there are plenty of Australians who go off to Ireland, the UK and other parts of the world to pursue their medical degrees. I would prefer that we give preference to our citizens with overseas medical qualifications before we start lending a hand to Canadians, even if they completed their degree here.
My second point which is neglected in this article is that there are people with far higher qualifications and sacrifice than made by med students who are unemployed. Our employment rates are amongst the best of all professions outside of dentists. We need to stop behaving like a bunch of spoiled privileged kids, that we mostly are. Studying is not an entitlement to a job in any other field.
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That is an incredibly small minded perspective for a med student to have. Domestic students can pay full fee in Australia not just at Bond, Notre Dame and Melbourne also charge full fee for some domestic places. I disagree that we should give preference to Australians with international degrees – Australian med schools are accredited to Australian standards and trained in our health system, surely grads from our own med schools should come before someone trained overseas. It is harder to ascertain the quality of training that someone has recieved at a foreign university. Tax payers should fund these places because they’ll be working in OUR hospitals, fixing OUR doctor shortage.
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A couple of points. Firstly, while an internship is a training position to some extent, it is first and foremost a job. My sister is currently completing her internship year and works 70 plus hour weeks, and has no time to attend any allocated teaching sessions. The funding goes towards employing people to do a tough but important job, often with minimal support. The “taxpayers” don’t pay interns out of the kindness of their heart, interns are, in fact, needed.
I’m not quite sure what you are suggesting with your second point, you would like to see full fee paying places brought back in undergraduate courses in public universities? In either case, I don’t see how you can justify giving preference to a student not smart enough to get a place at a local university over one trained in the Australian medical system. What kind of doctor would you want looking after you?
With regards to your final point, this entire issue is centred around the fact that med students HAVE to complete an internship year to be accredited, and without doing so there is ZERO possibility of them EVER finding a job. This is where the profession is different to others. Your argument may hold some weight if we had a surplus of doctors, but we don’t.
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“I don’t see how you can justify giving preference to a student not smart enough to get a place at a local university over one trained in the Australian medical system. What kind of doctor would you want looking after you?”
I think this sort of general mentality are why these international students can’t even practice back home. Majority of internationals that I know want to go back home to be with family and friends – staying here is a second option for them. Some come here to study because they want a change, but majority do so because they weren’t able to get into a medical school in their own home country. They are able to get into our schools because the MCAT requirements for entry are considerably lower than overseas. I don’t think your argument is valid here.
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The point I was trying to make was that these students are trained by accredited Australian universities which meet a required standard of teaching and prepare students to work in the Australian medical system. They are therefore the best qualified to work as interns in Australia. (There is recent data to support this, overseas trained doctors have significantly more complaints made against them locally trained ones)
https://www.mja.com.au/journal/2012/197/8/risks-complaints-and-adverse-disciplinary-findings-against-international-medical
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I think it’s highly misleading saying that there are greater complains with IMGs, as compared to Australian trained doctors. A proper perusal of that article shows that statement only involves a small cluster of countries. “IMGs from the 13 other countries examined were no more likely than Australian doctors to attract complaints.” So again, I still maintain that your original point is null and void. Your argument that they are therefore the best qualified to work in Australia is weak according to the article.
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Well I disagree. Who exactly do you consider to be better qualified?
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It’s pretty simple; whether or not they were ‘smart enough’ to get into med ‘back home’ is irrelevant. If they’re not good enough here, they fail.
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It’s the same deal for psychologists.
After 7 years of study, I’m a registered clinical psychologist, but jobs are thin on the ground. Many of my fellow grads are working temporarily in hospitality etc until the right job comes along.
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This issue is not exclusive to doctors. It has been the case with nearly every medical profession. I work in radiation therapy and our interns have been in a similar situation. When they began their study we were crying out for trained RT’s so the intake numbers were increased. Unfortunately by the time they were qualified the job vacancies had decreased.
The situation has begun to level out, but I find that there is an increasing reliance on qualified staff to train interns “on the job”. It seems that the graduates come out of university with very little useful skills
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Hope you know that the doctors need more training than technicians and your profession cant be compared to the doctors
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Rusden, the point made is still valid…
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This article said that Australia has been importing doctors from 3rd world countries.
So if the medical graduates come back to their countries to get internships and practical trainings for a couple years, what would be the chance for them to obtain Australian working visa to come back and be hired as a medical staff in an Australian medical institution? Or does Australian government only want to avoid funding medical internships/trainings by robbing experienced medical doctors from the underdeveloped countries?
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Imagine working, studying and training for 4+ years, balancing full-time uni with part- or full-time work: long hours at minimum wage. Imagine that during this time, you are on the receiving end of countless jokes and jibes about your chosen profession and passion, which you take in your stride time after time. Imagine that what you are good at has a graduating average of half that of other areas. Now, imagine that, instead of support, those jokes and jibes continue when you’ve graduated and are struggling to find meaningful employment. You’ve graduated from one of the world’s best universities with the oldest degree on record but can’t afford to spend months in unpaid internships or non-guaranteed “work experience” positions. You’ve got a first-class education, applicable skills and understanding, yet you can’t find a job. Neck up, med students. Welcome to the real world.
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I tend to agree! It’s not just medical students who can’t find employment or internships once they’ve graduated from university.
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The difference here is that our health system is in need of more doctors. In order for these graduates to be able to fill these positions, they need internships.
On average the government has invested up to $85,000 per international student to help fund their training. It’s a waste of tax payers money to not allow them to complete their training in Australia.
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They also have to go through long exams and most will have to re-dp internships and residency. So no, not less time.
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As an accounting graduate there was no guarantee of a job for me when I finished my degree, this goes for all people other than Medical Graduates, you get a job based on your ability and/or whether you are prepared to move to get what jobs are available.
I also work in the doctor training area in regional Australia and many Australian Graduates do not want to move from the Capital cities to take up the positions available.
On top of that if they do move to complete their training they are able to leave the regional area with a right to get a Medicare Provider No. in any location they wish.
Whilst I think there should and needs to be sufficient places for Medical Graduates this is not the only issue that needs to be addressed in order to solve the shortage of Dr’s in regional and remote areas.
So the problem may not be just the various Governments but also the graduates themselves. It would be interesting to see how many of the 182 do not have an internship because they chose not to move to fill a vacancy.
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Hi D,
0 of the 182 students do not have an internship because they choose not to move. If there were internships available, the vast majority of these students would move anywhere in Australia to get one. The fact is that currently, there is a national shortage of close to 200 places. Many of these students are hoping to work in rural areas when they finish their training, many as a result of increasing rural clinical schools and exposure during their degrees.
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As many of the comments state, an accounting degree is not comparable to a medical degree. You can get a job with an accounting degree. You can’t get a job without completing an internship after your medical degree. It’s quite true that there are places in rural Australia that need doctors and jobs go unfilled. These are not internship positions. I can tell with as a fact, that even the most remote hospitals have filled their places- Darwin is full. Alice Springs is full. Katherine is full. Hospitals that are accredited to take interns are all full. As a small aside, there is no medical school in the Northern Territory where these hospitals are located, so therefore all the interns accepted to these hospitals had to move to that state.
Rural Australian practices are not accredited to take interns and quite frankly, we’re talking about doctors without full registration, so quite frankly sending them out to these places would be completely inappropriate because they would not have even a fraction of the training required to practice in these areas.
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It is not just doctors. My daughter will be a registered nurse soon without a job. There is a chronic nurse/midwife shortage, but like with doctors, overseas nurses are hired, because no one wants to fund a grad year. There are very few graduate positions for them in Qld and I believe NSW is just as bad. I’m sure it goes across the board for health professionals. It’s a crying shame.
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It does seem a bit silly really to offer positions to people to study and not be able to provide internships. Intern years are carried out in hospitals. maybe if elements of the intern ear were in medical centres more positions could be offerered?
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lol irony – we’re not as judgmental as city people.. that in itself is a pretty judgmental view.
I have considered going rural as a nurse but I would miss my family and friends too much.
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Wa is funding all of it’s graduates and is taking a percentage of other states
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Can’t believe how sad this is. A country that allows its universities to open up spots for internationals to contribute so much to its economy, then turning the graduates away whom have spent 5-6 years studying to join a workforce that they say need people so badly.
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I’m fairly certain the Federal government has offered to pay for 100 of these places but none of the states will stump up for the other 82 between them?
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Correct – but the state governments aren’t prepared to cough up the 8 million to pay for the remaining 82 places. Ridiculous!
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I think one thing thats hard is that you can’t do alot of your training rural. I am actually bonded to go rural once Im fully done with my training (in about 15 years!!).
I came from a rural background and Im keen to go back but I have no choice but to train in the city – there just isnt the training positions rural.
But I would also agree – there is a weird stigma against rural (which I would agree is crazy!!).
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As a 3rd year medical student this is such a frustrating situation. My medical degree will be worth NOTHING without an intern year. You cannot work in the private sector, cannot work in the community – NOTHING without it. Its like telling everyone to leave before the final year of a degree!!
Sadly this wont just be an issue for intern year. In order to fully qualify you need further training (whether you want to be a GP, a cardiologist or a cardithoracic surgeon) so medical graduates are likely to face a bottle neck all the way along their training.
I have previously worked as a physio and have joked to my former boss that I may need physio work once I have my med degree!!
Sadly in the end its tough on medical graudates – but its also a big loss for the community who have invested alot of $$ in training these people.
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Love that Mamamia has this artible.
You cannot have doctors/specialist without interns. Interns can ONLY get jobs in public teaching hospitals Interns cannot work elsewhere and return to medical practice without de-skilling. Medical graduates are not like other graduates in other professions.
Oh, and there is also a little known fact that we are SHORT of doctors.
The system is simply failing us, regional, federal blah blah. We are seeing these graduates having to return to their country (where job opportunities are even harder for them as they did not graduate in that country and have to jump through further hoops) when we are having to wait forever to get to see a doctor, be it in ED, GP or specialist.
Medical training and studies are TOUGH. And most graduates will have sacrificed their lives to choose this field out of wanting to do good. I cannot imagine after all of that, and having to leave Australia, and float around to find a job.
Simply put, not enough is being done.
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So the real question is, why the bottleneck now when anyone looking at it (as has been said by quite a number of comments below) could see it coming?
On possibly a less life-threatening level, it’s the same with the recent baby boom, which has been in progress for a few years now. If you guess that most babies born this year will inevitably be entering an already full primary school a few years later, and that it takes a while to plan for, extend and/or build a new school, why don’t they get started earlier?
Are governments exempt from foresight?
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The employment of Interns in NSW hospitals is a NSW Government health responsibility; the commonwealth does not employ Dr’s or nurse perse. This is just a cynical exercise by the conservatives in blaming the federal Government is just ridiculous
Howard may have increased the Dr Intake but it was to little to late and I notice you didn’t say anything about that
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Fully appreciate the importance of the issues within this article and very much support this public discussion…however…my comment is to say I loved the the term “binge reading” in your bio! Haha I binge read all the time….stay up until 2am to finish the book I opened at 8pm as I just HAVE to have more!!
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Thanks Mez! I know exactly what you mean. I’m glad someone got what I meant when I used the term.
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I think that this article simplifies the problem simply to provoke reaction. Yes, there is a doctor shortage. Yes, there are medical graduates going without internships and yes, we are importing doctors. I think the fundamental part of the problem that you’ve failed to mention is that actually, the system shortage is of fully qualified and experienced doctors. You absolutely cannot throw an intern into an ED and expect them to safely perform. The whole purpose of an internship is that they get to practice their skill on living, breathing, complex cases that might fall dramatically short of the textbook ideal that they have learnt about in their theory classes. A similar situation with nurses occured in Queensland a few years ago. The government, with little foresight, opened up more nursing places in universities and dropped the fees. The problem was, the shortage was in experienced nurses, who could run shifts, take care of complex patients and act autonomously, not graduates who required their hands to be held as they found their feet. The result was a whole bunch of disappointed graduate nurses. The situation is slowly leveling itself out now, just as I imagine the intern crisis will. But to write this article, stamping your feet and screaming about poor the poor displaced interns without more deeply examining the mechanics behind the system is disengenious and sensationalist. Furthermore, point me in the direction of one other career where graduates come out and are not expected to fight for a job!
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Your comment is null and void, because it is obviously YOU that has no understanding. Of course doctors have to fight for jobs, just like everything else. The point is, you cannot do ANYTHING with a medical degree other than be a doctor. The other point is that you HAVE to work in a public hospital. If you could get your internship qualification by working in a private hospital and being paid by the private hospital, it wouldn’t be an issue, there would be jobs to compete for. So before you get on your high horse about ‘immature med students’, who for the most part are so much more mature than alot of their age category, maybe you should do some real research.
Likewise, you talk about needing specialists – you can’t ge specialists without having interns! Solving the intern crisis is just the first step – then we need more residents, registrars, training positions and so on. It doesn’t stop at internship.
I hope you never need a doctor, because you won’t be able to see one in 10 years. Fool.
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That’s a bit hostile, Sam. I think the original commenter had some valid points. He/she never actually called them “immature medical students” (that was something you paraphrased and put in quotes), but simply pointed out that no matter how many contact hours a medical student has in their training, they’re still not as qualified as a fully trained doctor, even if that fully trained doctor was trained overseas (this article had an interesting spin on the challenges faced by foreign doctors in Australia forever having their competence second guessed: http://www.theage.com.au/opinion/society-and-culture/the-days-of-the-male-anglosaxon-doctor-are-truly-over-20121018-27ttn.html ). The point of importing these doctors is a band-aid solution and serves an IMMEDIATE purpose of meeting an IMMEDIATE shortage. Taking on Australian-trained interns and importing foreign SENIOR doctors are not mutually exclusive options in addressing the issue, and for the author of this article to continue to suggest that importing fully trained doctors is the main problem is missing the scope of the issue. In the simplest terms the Australian healthcare system needs both of these things to happen, but is currently only addressing the short-term issue.
I’m a medical student at Sydney Uni too so please don’t think I’m downplaying your take on the level of maturity and hard work required of us in the course, but having government-appointed internships to call our own at the end of our degree is an exception, not the rule. I know plenty of brilliant people who can’t get work in their chosen field because of steep competition. Especially when hospital allocations are NOT merit based. It’s not that medically trained graduates CAN’T get jobs outside of medical practice, it’s that the privileged status of medical students means it’s considered HEINOUS that we don’t practice in our field.
TL;DR – Calling someone a fool doesn’t discount their argument. You should know better.
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I think you’ll find that as part of intern training, all interns in NSW are required to complete an ED term and required to safely perform. You may also be surprised to find that medical students have patient contact during their medical training e.g. University of Sydney has patient contact from first year, and third and fourth years see medical students solely at the hospital getting lots of hand-on experience on “living, breathing, complex cases”.
I agree that an intern is not as competent as a registrar or consultant, but changes need to be made for the long term. Making more internship places for these medical students allows more registrars and consultants later on down the track.
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To get a provoked action?
Try being a international medical graduate without a job and having to return overseas after 7 years of studies and 2 degrees.
- An intern who luckily got a job last year
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You make some good points however the fact is that nearly half of doctors that are “imported” have to work under supervision of a senior physician and therefore are not considered fully licensed – why not take an Australian trained student who speaks English, has had experience in the Australian healthcare system and has had access to arguably the best up to date medical training available in a supervised position?
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Don’t the experienced overseas doctors take a lot less time to train because they have the medical knowledge and experience, they just have to adapt to how we do it.
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Don’t you see, though? Of course the country isnt suffering from a shortage of interns per se, it is indeed suffering frmo a shortage of qualified doctors. But the whole point is that we can’t become qualified doctors without an internship….so in order to train the specialists of tomorrow, we need internships now. It’s just the way it works. These students aren’t throwing a tantrum because they feel they are entitled to a job when they graduate, medical students are well aware that so many professions don’t get this (trust me, many of us studied degrees prior to entering medicine and have worked in other areas). They are simply trying to raise awareness for the issue…losing 182 future specialists seems like a massive waste to me.
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There are little to no jobs for graduate nurses to fight for in Qld, despite a chronic, increasing shortage, worldwide.
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Public outrage about anything at all needs mass public exposure.
I hate to say this but you simply must go to “Current Affair”, Today Tonight”, the ABC, “The Project” – a real publicity blitz highlighting this problem.
The larger the public outcry the more something will be done – MAYBE.
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One of my doctors told me that this was a looming problem, 2 or 3 years ago. Appalling that nothing’s been done to fix it yet. As far as paying for their own internships (horrible idea), this is what many psychologists have to do to get registered, if they choose not to do postgraduate work – 2 years of having to pay somebody to supervise them. Ridiculous.
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There are a couple of aspects to this. I’m married to a cardiology fellow who’s been out of uni for nearly 10 years and we’ve had quite a few discussions about it.
When the announcement was made to open up med degrees to more students Hutch’s first response was that there would be a bottleneck at graduation as there simply aren’t jobs.
In order to be a capable doctor, you need to have a sufficient number of patients to learn from. The solution is not necessarily more training positions as it dilutes the learning opportunities for the junior medical staff. No one wants a consultant who doesn’t have the knowledge or experience to address and treat their patients’ conditions. We have quite a few friends whose specialties have taken them around Australia to do their training as staying home just isn’t sufficient exposure to different treatments or procedures. Medicine may be one of the most secure jobs once you’ve finished training, but you’ve got to get the right training in the first place.
It is also one of the rare professions where you are not actually qualified until you’ve done at least one intern year in a hospital I believe. These newly graduating students can not practice medicine until they do so.
Hutch is due to finish his fellowship in January and is currently looking at overseas studying options. If he is successful, he will be working for free for perhaps 12 months to get good quality experience in a foreign health system.
The breadth of specialties in medicine has meant that some positions are highly competitive, but others, such as rural general practice it is hard to find people willing to do so. There are plenty of incentives for drs to work in rural areas, but they have to want to, as well as be willing to uproot their family in the move. It comes down to the type of medicine you’ve chosen to pursue – Hutch couldn’t work in rural Australia in his area of specialty as there aren’t the jobs.
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I’m sorry, but the issue for me is that there is a need for doctors that the government should be funding, not that there are qualified doctors who claim they are entitled to have jobs. there are plenty of people who qualify in a range of professions or trades who’d love to have a job guaranteed, but would be laughed at if they said “I’ve qualified, now please provide me with a job.” By all means campaign for more doctors, but not for the right of graduates to have jobs provided automatically. What is really troubling is that these people want us to trust them with their lives when they don’t even have the maturity to see that is not how the real world operates.
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The difference between those situations is that in other fields, a lack of jobs usually means there are often of them. As in, lack of journalism jobs means there are enough journalists around. Or whatever.
But when we’re talking about doctors, there’s a lack of jobs… but a shortage of doctors.
Get what I’m saying?
Also, you can’t do anything with a medical degree unless you do an internship. It is completely useless. That is also very different to most other degrees. (I say most because i know some other degrees e.g. law, architecture etc need to do extra things too)
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Hi Fiona,
I’m not quite sure what you mean when you say that ‘there is a need for doctors that the government should be funding’? Isn’t that precisely what we’re advocating for?
Medicine works quite differently from other professions. In order for a graduate to be qualified they must complete an internship year, otherwise they are not qualified as a doctor. These positions are allocated by ballot, with no weighting given for better marks etc. From there they must go through their specialist training (up to 7 years after their internship) before they can work in private practice…they’re really not employable otherwise, and hence not much use.
The government did what was required and increased university places to train doctors, but now they have nowhere to go. We have well trained and enthusiastic young doctors who are desperately needed by the health care system, but aren’t able to get jobs due to issues at a government level; it has nothing to do with graduates not being good enough or feeling overly entitled or superior.
I think you’ll find the maturity of young doctors is far above that of our age-matched peers; we watch our patients suffer and die, we see a lot of horrible things other people will never have to face in their lives. The large majority of medical students are aware of how the ‘real world’ functions, which is why we want to be out there helping our fellow Australians.
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I agree Mel_89. I have witnessed for the last 10 weeks the dedication and professionalism of Doctors (interns, residents, registrars, fellows, consultants) in our public health system. They work in the ‘real world’ daily and long days at that.
Interns need well supported positions and mentors to enable them to develop into great Doctors. These positons need to be well resourced and funded in our public health system. As far as I’m concerned it is imperative.
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Couldn’t have said it better myself Mel!
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What is the problem here? An intern place needs “funding” ?!? To me that seems like an excuse – these interns are paid just a minimum wage as opposed to doctors on higher wages. Isn;t this the same as those qualified in other “trades”? A hairdresser would not get recognition until completing an apprenticeship – but the apprentices are paid a pittance and are often used as cheap labour…
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This is crazy – I know there is a shortage of doctors and we are having to import them, but I didn;t realise there was this bottle neck in the system with no internships to fully train our own doctors. Just ridiculous. Hope this is highlighted further in the media so that hopefully something is done to improve the situation.
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Something terribly sad about this is the level of ‘surprise’ from governments. Various medical bodies have been forecasting this issue for years. We know exactly how many medical school places there are, and how many intern jobs… it does not require an advanced degree to see that too many students going through for too few intern places is going to end in tears!
I feel very fortunate to have qualified some years ago, as I had no difficulty gaining an intern spot. However, job security is still an issue because of financial issues in Health. I have nearly finished my specialty training, and there is no guarantee that there will be a consultant physician job available for me when I do.
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I completely agree KJ. Have almost finished my specialty training and have no job security in my specialty in my state (Vic), so will be moving my family to Qld where I have been offered 5 different jobs.
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Wow, I’m sorry to hear you have to uproot your family. Great that you have your pick of jobs in Qld though.
I’m hoping to snatch the one and only job on offer in my state at the moment! I’ve discussed the possibility of moving my family also, but fingers crossed I don’t need to.
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QLD doesn’t have job security in all specialties. Cancer care services haven’t been expanded for 2 years, ED physicians, pathology, cardiology and psychiatry jobs are in very limited supply. I think it’s a disaster at both ends of the training spectrum.
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I agree, and it is only going to get worse. I look at all the fantastic registrars coming along behind me, and worry about them getting jobs.
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There isn’t a lack of interns though. Extra interns aren’t going to make waiting times less, it’s extra doctors training to be specialists or extra specialists. There are a limited number of places in training programmes. Many are already fiercely competitive and as more interns come through there will be even more people who cannot get into one.
We’re not “importing” 2000 interns from overseas each year. We’re getting 2000 fully qualified or at least fully registered (ie have completed their internship) doctors, who can actually be useful in a hospital and provide better care to Australians. We don’t need these extra interns. There’s already a bottleneck once you get past your internship, with people languishing as junior doctors because they cannot get into training.
It is awful for these students who can’t get internships here, but the fault lies with the universities and the recruitment organisations who got them here while alluding that it would be easy to get a job at the end. And, unfortunately, with themselves. They have to make a massive investment financially. The situation was very clear 4 years ago when almost all of them started. They should have known this coming in but they chose to gamble and hope they’d get a job at the end. Sadly it didn’t work.
I’m a doctor. I get it. It’s just not as clear cut as it seems.
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Do you honestly think a year 12 student (or whatever the person was) looked at the career in medicine & would have checked out their forecast internship place availability? People are just kids when they chose their career & think it’s safe to assume a job at the end of it. Obviously, the universities etc are the ones to fault, but not the students.
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Considering majority of medicine degrees in Australia are post-graduate, you’d hope that the new influx of potential students coming through would have thought about their job prospects first. IMG’s know what risk they’re taking by choosing to study here. If you don’t believe me, there have been mass posts on studentdoctornetwork warning about Australia’s impending tsunami for years!!! Not to mention the difficulty and stigma surrounding an IMG wanting to train back home.
We can blame the universities, but also, there is some fault with the students themselves. They willing went into the situation with blind faith, hoping for the best. Yes, the universities could have lied to them about the situation, but first and foremost universities are a business and will do what they can for your money. I feel a lot of international students come here to satisfy their desire to pursue med, without actually thinking about potential consequences.
the universities and students are equal to blame!
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I actually can’t believe you think the students are to blame
Don’t know where to start.
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well… considering they have to take out a $300K loan to study over here, you’d think they’d do better research about the situation.
simply put, when you go to take a mortgage out on a house, you’d want to inspect the house first and research the property and location… if you buy a dud house, and didn’t research first – who’s to blame? Yourself or the seller?
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Your point is valid, and international graduates are told that an internship isn’t guaranteed for them. But the universities distort this by saying “we have NEVER had a graduate not get an internship”
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Clara, I’m not sure what kind of specialist you are but sorry, interns aren’t “actually useful”?
Health care is a team effort and I bet if you work in a hospital, your intern does your discharge summaries and cannulas and your running around.
I’m a medical student, who is guaranteed an internship so no ulterior motive here but I find your comments disappointing. Even if you don’t work in a hospital you should remember doing the hard yards as an intern. They may not be fully trained and yes, we need specialists, but they still work hard and make huge contributions to the healthcare system.
Additionally the doctors we import are still not sufficient. The HWA2025 report pointed out that if we use every student we graduate and continue importing doctors at the current rate we will STILL be short by 3000 doctors. By 2025 these “interns” will be “specialists” and “useful”.
I understand your points about the fact that there are further training limitations down the track but if we want to fix the issues with the Australian healthcare system we need to start somewhere and this is the right way to go about it. Importing doctors just takes them from nations that need them and doesn’t solve the issue. We graduate 3500 students a year, we import 2500 and will still be short, something has to change.
Also I feel that although they weren’t guaranteed from what I’ve heard it certainly was not outlined to be as risky as it has turned out to be, I had friends told “but they have always found places in the past”. So I, for one, empathise with their cause.
I don’t think it is as clear cut as you put it either
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There is no clear cut explanation or solution to this problem.
I think what they meant was that an intern is not able to do what an experienced doctor can do. A lot of time and money and resources goes into hiring, training and supervising an intern.
No doubt they work their asses off and are hugely useful, but by the same token existing doctors are also working very hard and spending a lot of time to train them and look after them. Staff is the most expensive chunk of health care expenditure by far, so hiring more staff is more money spent.
It’s a fine balancing act that the government and universities seem incapable of getting right.
I’m a nurse and I think everyone working in hospital, especially in emergency, work their bums off and go above and beyond for the patients.
If it weren’t for a bunch of dedicated nurses, doctors, and other health care professionals, as well as cleaners, techs, volunteers etc who genuinely care and are excellent at what they do, our wait times would be astronomical. It’s the staff on the floor doing the best they can with what they are given that is keeping the health care system afloat.
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The supervision and training of interns is enormously time-consuming. There is a limit to the number of interns who can receive adequate training within the clinical resources of a hospital.
The more capable interns will function reasonably independently for the last few weeks of their rotation, before they move on and you start the intensive weeks again.
Yes, hospitals are based around the multidisplinary team, however the intern is predominantly there to learn.
To take the example of cannulation – there are so many interns, and only so many cannulas. To double the number of interns is to halve opportunities to practice this skill. Fewer opportunities for med students to have a turn.
In contrast, by the end of my intern year I would have placed more than 1000. Small consolation when I am called to cannulate a patient who has 6 bleeding holes (from the IV service, both interns) however continues to tolerate 5 students looking on!
But I digress.
I do feel for these students. In fact, I can relate as there are experienced doctors on training programs who don’t have a job in 2013.
Should we spend more of the health dollar on offering international students positions? It would be nice if we could, but I fear we risk stretching available resources to the point to the detriment of quality training.
Not every law graduate practices law. Not every medicine graduate goes on to clinical medicine.
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So great to see mamamia giving attention to this issue. It is something which affects all Austrlians, whether they want to accept it or not. Our population is ever-expanding and ageing every day, and with this expansion brings increased demand on our health system (which is already struggling). We NEED these doctors, whether they be Australian born or International born is completely irrelevant. Any doctor who has trained and studied in an Australian medical school should be kept within the Australian health care system. They are just as competent and qualified as everyone else, and to turn our backs on them is just apalling. It’s time for Jillian Skinner to wake up and realise this issue is not going to go away – if it isn’t fixed, it will get worse and each year we will lose more and more newly graduating doctors. I go to university with plenty of international medical students from all corners of the earth – America, Canada, England, Singapore, Lebanon – you name it. They all came here to study because of our great reputation and they want to stay here and practice as doctors. Lets give them a chance.
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I agree that international students deserve the chance to complete their internships, but not at the cost of local students. Try and see if as Australians, whether the Canadian or the American governments will enable to complete internships there.There is just no chance because the Canadian and American tax payer is not interested in training Australians. . All we have is Australia. The bigger issue really is the greed of universities to earn revenue from international fees, which translates to even greater competition for locals. Once international students complete their internship, they become eligible for Australian residency and eventually Australian citizenship. This just adds to even greater levels of competition for training spots, which are hard to come by as it is. While I think it is terrible that some international students may be denied the chance to complete their intern year, I think the fault really lies with the universities that bring them in.
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It is great to see this up on mamamia and some publicity getting out about this issue! I’m a first year student with Lauren’s sister Hannah, and know some of these soon to be unemployed students well. They will make fantastic doctors who I would be happy to be treated by and proud to call my colleagues, if only the appropriate state and federal ministers would come to their senses and rectify the situation. Please sign the petition and help us to help you!
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Absolutely crazy. And as a side issue, the supposed ‘nursing shortage’ across Australia is a myth. There are 50 nurses applying for every job. Only nurses with postgrad degrees have good flexibility in job offers. There might possibly be a shortage in 5-10 years when more current nurses retire … but then again, all the students without jobs will just fill them.
There isn’t a nursing shortage, there’s a lack of willingness to pay for the proper nursing staffing level.
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Actually, nursing is suffering the same as what has been described here for doctors. There is a shortage of clinically specialised nurses but the competition for graduate positions, which is needed to gain experience needed to get the jobs on offer, is fierce. The number of graduates each year far outweighs the number of graduate positions offered and, like doctors, without that graduate year you are unable to qualify and register as a nurse.Yes, this may change in some years as part of the workfore retires but it’s not a simple as the unemployed graduates filling the holes. Nurses with years of experience and specialised skills are going to be lost and it’s not as simple as sticking a graduate in their place.
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Actually, you will be able to register as a nurse without a graduate year, but finding a job in nursing is the hard bit. Employers want someone who has done a graduate year. Even then, the jobs just aren’t there. The staff who are, are just being worked into the ground.
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No there is a lack of money. The government mismanages their money to the point where they literally cannot afford enough nurses for adequate patient care. All the senior nurses are retiring so it’s a bottom heavy workforce, and the skill mix is going to be a big problem over the coming years.
There is a nursing jobs shortage. We don’t have enough nursing positions to cope with the patients.
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I’m a medical student in Victoria and I’m really glad you wrote this article and that mamamia chose to publish it. It’s a great injustice that our universities can expect international students to pay in excess of $200,000 for their medical degree which is absolutely useless without the final step which is an intern year. I’ve heard some people say that many students graduate with commerce or arts degrees and don’t find work in Australia and that international students shouldn’t expect to be employed here. The difference with a medical degree is that your degree isn’t worth the paper it’s printed on and you won’t be recognised as a doctor internationally unless you’ve completed an intern year to gain full registration. One of our biggest earners (at least in Victoria) is international students coming to Australia to study, it would also appear that it is one of our biggest scams.
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Hi Cathy,
If you haven’t already, you should sign the petition to the Victorian Minister for Health. Here’s a link!
http://www.change.org/en-AU/petitions/david-davis-prevent-the-loss-of-australian-trained-doctors
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Already have (and shared it on facebook) but thanks thinking of it!
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“The thought of her jumping through all these hurdles”
You jump through hoops, you jump over hurdles
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