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Med grads face no-man’s land

By | Thursday, March 22nd, 2012
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Hundreds of international medical students could miss out on internships when they graduate next year due to a “tsunami” of domestic graduates and a shortage of clinical places.

A report on the impact of international medical students on Australia’s workforce needs has found that between 1996 and 2009, international medical students here grew from 960 to more than 3000. During that time, internships were available to virtually every international medical graduate who wanted one. In 2010, for example, 2380 domestic and international graduates applied for 2394 spots, the study shows.

In 2013, however, the situation is likely to change. Lead researcher Professor Lesleyanne Hawthorne, of the University of Melbourne, says the clinical infrastructure that provides the internships required for registration has not kept pace with a huge spike in domestic graduates, creating unprecedented competition for places.

“We’ve built 10 new medical schools in the past decade. What that means is there has been an enormous increase in domestic students studying medicine,” Hawthorne told Campus Review.. “A few years back it didn’t have any impact on international medical students because they were in the [internship] system. But NSW, where the largest number of medical schools has opened, is literally doubling the number of domestic students graduating within the current one-year period. It’s been referred to by some as the ‘tsunami’ of domestic graduates.”

Because states generally gave intern preference to domestic students, she said international students were panicked about 2013 placements. In addition to students from traditional source countries, this was the case for students from North America, whose numbers had grown rapidly since 2009 at the University of Queensland and University of Sydney, among other institutions, Hawthorne said.

“If Canadian students can’t do their internship here, they could be in a no-man’s-land — they can’t get full registration in Australia, nor is there a natural pathway back to Canada, because there isn’t a place for most of them there,” she said. “This is true for students from Malaysia, Singapore, etc. There’s a lot of anxiety amongst international students, who were very confident a few years ago that they had all options open to them.”

The research, which was conducted by teams from the universities of Melbourne and Queensland, found Australia imports about 15,000 medical migrants through various pathways every five years. On average, it takes five years for 53 per cent of these skilled migrants to obtain full-time employment as doctors. On the other hand, the study finds medical students who obtain their degree in Australia have much better outcomes. It shows Australia tripled retention of medically qualified international students between 2006 and 2010. The students were highly motivated to stay, with 78 per cent accepting an internship and then 99
per cent securing full-time medical work within four months of obtaining their qualifications.

Hawthorne said Australia was poised to lose a valuable cohort of up-and-coming doctors, which it had relied on to help address the practitioner shortfall that began about 15 years ago. “The real issue is going to be whether or not Australia wants to prioritise keeping international medical students who qualified in Australia to supplement the importation of foreign medical graduates,” she said.

Health ministers have set a goal that the nation’s demand for doctors, nurses and midwives be met with domestically trained professionals by 2025. Health Workforce Australia has been developing a national training plan to help meet that target, but it is yet to be released.

Meanwhile, Medical Deans Australia and New Zealand says it’s not really clear if international students will be included in the self-sufficiency mix. It argues they should be. “The issue for us as deans is that international students are a significant part of who we train,” Medical Deans president Professor Justin Beilby told CR. “They’re well trained, top quality, and some of them would make outstanding doctors. We believe they should be seriously considered in this discussion.”

Beilby said Health Workforce had been working with the Medical Deans to try to resolve the bottleneck. Places had been found for most international students in 2012, but he said solutions for 2013 and 2014 were lacking. “International students are not just in medicine, [but] medicine is part of the jewels in the crown. If we turn this off, what are the consequences for international students coming for other programs?” Beilby said.

James Churchill, president of the Australian Medical Students’ Association, said although international students may be the first group disadvantaged by the constraints in requisite internships, domestic students were worried, too. “The prospect for students who have paid so much for their medical degrees and then graduate from medical school and are not able to get an internship is a worrying thing,” said Churchill.

The report also unveils the source countries for international students who come to Australia to study medicine. Among the main ones in 2009 were: Malaysia (1134); Singapore (577); Canada (437); the USA (84) and the Republic of Korea (51). “By contrast, Australia’s dominant export education source countries, China and India, were the source of just 20 and 16 enrolments each — medical students from these countries being overwhelmingly Australian citizens or permanent residents (contributing 371 and 410 enrolments, respectively, in 2009),” the researchers write.

Since 1999, international medical graduates have been able to immediately migrate if enrolled as interns. “Should Australia fail to provide [postgraduate intern] places, these graduates seem certain to be recruited by external health jurisdictions, the New Zealand and Singaporean governments being cases in point. Further, the washback could negatively impact on future international medical student enrolments — a devastating prospect for the majority of Australian medical schools,” the report concludes.

The report, The early migration and career trajectories of international medical students qualified in Australia, is believed to be the first of its kind. The Medical Deans commissioned the research, which analysed comprehensive student survey data retained by the organisation.

Susan Woodward
Campus Review
19th March, 2012

Indigenous project reports now available

By | Monday, March 19th, 2012
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Medical Deans, in collaboration with AIDA, have recently completed two important projects:

1. Medical Deans – AIDA National Medical Education Review
2. Medical Deans – AIDA Capacity Building for Indigenous Medical Academic Leadership

The for the  both projects are now available.

Hospital intern plan risks exodus of foreign students

By | Wednesday, March 14th, 2012
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THE decision to guarantee internships in public hospitals only to domestic medical graduates risks forcing thousands of foreign students to leave Australia — while the nation imports thousands of overseas-trained doctors who are often less well-suited to Australian practice.

A report — called the first definitive analysis of medical students who have come to study in Australia — found that 79 per cent of the 546 overseas students secured an intern position in an Australian public hospital after graduating, allowing them to complete training and earn registration as doctors.

But it warns that this proportion is likely to fall given the steep rise in international enrolments, which went up by 223 per cent from 1999 to 2009 compared with the 52 per cent rise in domestic medical students.

The report, commissioned by Medical Deans Australia and New Zealand, representing the heads of the two countries’ medical schools, found that while hospital positions were sufficient to absorb nearly all the international students who remained in Australia in recent years, this was likely to change because of the Council of Australian Governments’ decision to guarantee internships only to domestic students.

Louis Landau, project director of the Medical Schools Outcomes Database, run by Medical Deans ANZ, said the study showed 60 per cent of foreign students were willing to work in under-resourced rural areas, and the fact they had trained in Australia meant they were more familiar with Australian practice and the health system while their English skills were also often better than recent older immigrants.

However, the sharp rise in medical school places — from 1100 a year to 3000, with rises to 3500 planned — meant it would be hard to absorb foreign students in the training system unless extra positions were opened up. “It’s not that we should have an open slather . . . it’s a matter of getting the balance right,” Professor Landau said.

  • Adam Cresswell and Julie Hare
    The Australian
  • March 14, 2012
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