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Information released from a national study tracking the preferences of Australia’s medical students over the past five years shows a swing towards careers in general practice.
The Medical Schools Outcomes Database (MSOD) and Longitudinal Tracking Project involves all medical schools in Australia and New Zealand and is also set to follow graduating medical students through their internships and into their chosen careers.
The project collects information from medical students on their educational and career intentions, to assist with medical workforce planning and evaluation of medical education programs.
For the past three years interest in becoming a GP has increased among first-year students, with general practice ranked the third-most-preferred career intention, after surgery and paediatrics.
Professor Justin Beilby, chair of the MSOD and Longitudinal Tracking Project board, says this is encouraging, given efforts in recent years to address Australia’s GP shortage.
“The Royal Australasian College of Physicians has recently commented that we need more general physicians who are able to coordinate the care of patients with very complex medical conditions,” he says. “This is in response to the increasing specialisation in medical care, particularly as our population ages, and medical care becomes more complex.”
Professor Beilby, who is also Executive Dean of the University of Adelaide’s Faculty of Health Sciences, says this coordination has traditionally and rightfully been done by GPs.
He says although the MSOD data shows the trend towards general practice is only slight at this stage – from 10.1 per cent of first year medical student preferences in 2006 to 10.4 in 2007 and 12 per cent in 2008 – it was a good start to addressing GP shortages.
“I think that GPs have been very good at marketing the benefits of their practice, lifestyle benefits and flexibility. Other areas of practice, such as pathology, may have to take a similar approach to attract students.”
The MSOD figures reveal that from 2006-2008 only one per cent of first year students hade a preference for a career in pathology, an area where there is already a national shortage of practitioners.
This is the first time longitudinal tracking data from the project has been publicly released. The students who participated in the study pilot in 2005 completed their degrees last year, so data now exists on how their career intentions changed throughout the course of their studies.
Professor Beilby says one of the benefits of the MSOD Project is that the student preference data can reveal areas where there may be a future skills shortage so that strategies can be developed to address these shortages.
The data can also be used to evaluate whether these strategies are working. For instance, he says the upward swing in 2008 first-year-student preferences for a career in gynaecology and obstetrics could be a response to both the ongoing need for skills in women’s health and delivering babies, but also in efforts to address professional indemnity issues for this specialist group.
Other data gathered for the project show:
Surgery and paediatrics are the top two ranking career preferences amongst commencing students: surgery was 19 per cent in 2006, 19 per cent in 2007 and 34 per cent in 2008 while paediatrics was 12 per cent in 2006, 11 per cent in 2007 and 14 per cent in 2008.
In 2008, 70 per cent of commencing students had not yet decided their specialisation.
“The MSOD will be a powerful tool that gives us the chance to compare different curriculum delivery models, planning and workforce innovations, to see if they are effective, and to see if student career intention translates into actual careers,” Professor Beilby says.
The MSOD project is a collaboration of Medical Deans Australia and New Zealand, the Commonwealth Department of Health & Ageing, National Health Workforce Secretariat, Confederation of Postgraduate Medical Education Councils, Federation of Rural Australian Medical Educators, Rural Undergraduate Support & Coordination, Australian Medical Students Association, Australian Rural Health & Education Network, National Rural Health Network and Australian Indigenous Doctors Association.
Demand for doctors is outstripping the supply of new graduates worldwide and it will deepen if enough clinical training places for Australia’s future doctors are not found, says incoming President of Medical Deans Australia and New Zealand Professor James Angus.
Professor Angus, who has been elected President of Medical Deans Australia and New Zealand – the body that represents the leaders of Australia’s 18 medical schools and two in New Zealand – said Australia can’t be complacent about training its medical workforce.
“Doctors are in demand everywhere, in every country,” Professor Angus said.
“We still don’t have enough clinical training places to train interns and specialists. Does Australia have a fully developed plan to leverage both public and private facilities for training? The answer remains “no”.
Professor Angus – also Dean of Medicine, Dentistry and Health Sciences at the University of Melbourne – takes up his two-year appointment as President at the Medical Deans’ Annual General Meeting in Canberra on Wednesday 17 June.
The Deans have been campaigning for several years for more facilities such as private clinics to be utilised as settings for students to train with real patients.
“We’ve got ageing populations demanding more from the health system, consumers expecting high quality, workforce maldistribution – rural needs versus metro bias, indigenous health, increasing specialisation. We have a lot of demand, especially for primary carers (general practitioners).
“If we are to meet it, we will still need to import doctors through migration and will have to hang on to as many of the domestic students we train here as we can. There are a lot of incentives for doctors to go to another country.
“This is a global problem. I understand every doctor who graduated in New Zealand last year found a job outside New Zealand.”
Professor Angus said doctors with families are not willing to work around the clock as in past generations, while safety limits on how many hours they can spend on the ward were also impacting on workforce planning.
He paid tribute to outgoing President Professor Allan Carmichael for encouraging governments to respond to the crisis in training facilities.
“Allan Carmichael did some very hard yards in getting everyone focused on the reality that you need more than a university to train doctors – you need hospitals, private facilities, specialist colleges – a big range of settings – and it all needs to be integrated, planned and funded.”
He said there has been a good deal of progress under successive Health Ministers but a major increase in medical school enrolments had added to the demand for clinical training places. “We need to keep looking hard at this,” he said.
“The Deans, governments and specialist Colleges have to work together, because it is going to compound as the population ages.”
Other issues Professor Angus intends to focus on during his two-year tenure as Medical Deans President are:
* Integration of medical training phases
* Exposure of all medical students to clinical research
* The role of the general practitioner as primary carer
* E-health and patient “ownership” of their health records
* Training an indigenous health workforce
* The Medical Schools Outcomes Database (MSOD) project
* Major government reviews including the NHHRC reforms
“Communication is crucial,” Professor Angus said. “If you can’t communicate, you can’t be a doctor.”
Biography of Professor James A Angus, BSc (Syd.) PhD (Syd.) FAA
James Angus was appointed Dean of the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne in July 2003.Before becoming Dean, he was Professor and Head of the Department of Pharmacology and Deputy Dean of the Faculty of Medicine, Dentistry and Health Sciences. At the University of Melbourne, Professor Angus has been President of the Academic Board (2000-2001) and Pro Vice-Chancellor (1999-2001).
Professor Angus was awarded the Gottschalk Medal of the Australian Academy of Science (1984), is a Fellow of the Academy (FAA) and has been a member of its Council. In 2003 he was awarded Australia’s Centenary Medal for contribution to Pharmacology and the Community. Professor Angus was a First Vice-President of the International Union of Pharmacology (IUPHAR) and was President of the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists.
His current roles include directorships of the Walter & Eliza Hall Institute, Bionic Ear Institute, Mental Health Research Institute, Melbourne Health, Centre for Eye Research Australia, Victorian Institute for Forensic Medicine, National Ageing Research Institute, and Victor Smorgon Institute at Epworth Pty Ltd. He serves the Australian Government as Chair Australian Health Information Council, and the Rhodes Trust, Oxford as the Honorary Secretary, Victorian Rhodes Scholarship. He served on the Council of Melbourne Grammar School (1991-9).
For further information and interviews please contact
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