Are you ready for the Auditor - AMA WA

Continued from page 11
350
300
250
200
150
100
50
0
Fig. 2
Graph: Growth in graduates 2005-2012
Total WA Medical Graduate
(including International Graduates)
WA Medical Graduates
2005 2006 2007 2008 2009 2010 2011 2012
4. Dedicate adequate quarantined funding that is for
09 2010teaching 2011 and 2012 supervision purposes. Whilst some
funding has been provided, it remains insufficient.
The need for funding is compounded by the fact the
State Government has not committed to expanding or
funding additional places.
Curtin has advocated it needs a hundred students;
a number, apparently, based on the economics of
establishing a medical school and not the figure required
to meet future needs.
By 2015, UWA and UND will graduate in excess of
320 medical students each year. When these students
reach completion of their specialist training, around
the end of this decade, WA will be producing triple
the 2005 number of fully trained independent
medical practitioners.
Even when comparing 2010 to 2015, there may be an
additional 40 graduates from UWA and UND who will be
seeking intern positions, which is separate from the Curtin
proposal. These positions, and the required increase in
supervisors and training positions, will have to be funded
from somewhere.
Curtin’s proposal for 100 additional graduates, if
successful, raises questions as to whether WA health
can absorb this increase, as well as provide the required
funding and resources to ensure quality training. This is
the same as the total number of interns employed at Sir
Charles Gairdner, Osborne Park, Joondalup, Swan District
and Geraldton Hospitals. For 100 Curtin graduates to be
trained after graduation, WA would have to duplicate the
current number of such clinical opportunities; including
the additional positions, all the supporting facilities, and
appointment of senior staff to supervise. Funding would
also be a critical issue. Finally, would there be enough
patients for them to see?
The important issue remains “what is the required
number of medical students to meet future need and
how do we ensure a high level of training is preserved
and graduates have access to good careers?” – the
number of medical schools is really a secondary argument.
There has been no independent needs analysis –
this should be commissioned by the Department of
Health or by the Minister for Health’s office.
Need should prevail over politics. A proper business
case is required to determine the number of positions
required. The capacity, funding and resource needs of
the system; what will be the downstream effect, and; how
Total WA Medical Graduate
(including International Graduates)
medical graduates training and vocational needs will be
accommodated WA Medical Graduates needs detailed assessment.
Curtin’s proposal does not address the 12-plus years
needed to produce an independent practitioner. The
proposal only relates to the number of raw graduates, who
cannot practice independently.
A thorough analysis of the increases already in the
pipeline needs to be done as it is important to know the
downstream consequences, and whether any current
proposed increase in medical trainee numbers will
lead to access block to vocational training and career
opportunities.
In March this year HWA released a report, Health
Workforce 2025, Doctors Nurses and Midwives March 2012,
suggesting, based on various assumptions:
“Workforce shortages – highly significant in the
case of nurses (109,000 or 27%) and less so for
Doctors (2700 or 3% for doctors overall-more work
is required to quantify shortages at the individual
specialty level)” and goes on to note; “bottlenecks,
inefficiency and insufficient capacity in the training
system, especially for doctors.”
HWA also advocates workplace reform to boost
productivity; the full nature and consequences of which
are not clear. In essence, HWA asserts, one of the main
problem areas is resolving current training problems for
medical graduates brought about by the rapid expansion in
medical numbers, which are now starting to flow through
the system.
Comparison of raw numbers with medical school places
interstate is not appropriate. Most medical schools in other
states have a substantial number of fee-paying student
places, which are not accessible to Australian citizens.
To date, the debate does not appear to have taken into
account, for example, that by the end of this decade WA
will be producing over three-times as many fully trained
GPs and other specialists than in 2005 and medical
practitioners will be looking for jobs.
Do we need to increase graduate numbers at this
stage, and if not; when and how will we increase
these numbers? Should we first address the training
and downstream challenges, the recent increases
have placed on the system? We need to answer
these questions, as well as analyse the hard evidence to
determine how best to meet future requirements.
What do you think?
12 MEDICUS May