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Open Letter of Thanks to Professor Justin Beilby

By | Friday, August 1st, 2014
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1 August 2014

Professor Justin Beilby
Executive Dean
Faculty of Health Sciences
University of Adelaide
Australia 5005

justin.beilby@adelaide.edu.au

Dear Justin

 Thank you for your contribution to Medical Education

I write on behalf of the Executive of Medical Deans and the broader membership to offer our sincere thanks for the many many years of hard work and commitment to the medical education and training field.

There is no doubt that your efforts in this sphere will be sorely missed but we acknowledge that you will be continuing to make your contributions in other ways. And we know that the notions of ‘stop’ or ‘rest’ don’t come easily to Justin Beilby and we are all the worthy recipients of such leadership and drive. We wish you and your family some special quality time in the coming months and the opportunity to catch up on a few years of family news.

We will look with interest at the next phase of your life and the new contributions you will make to health and medicine in Australia and wish all the best in these endeavours.

Medical Deans, as an organisation, has benefited greatly from your leadership and like many others, we thank you and wish you well for the future.

Yours sincerely

Professor Peter Smith
President, Medical Deans Australia and New Zealand Inc

cc admin@medicaldeans.org.au

Federal MP supports Rural Clinical Schools

By | Tuesday, December 3rd, 2013
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On 2 December 2013, The Hon Dr Sharman Stone, Federal Member for Murray, introduced a motion in the House of Represetatives in support of Rural Clinical Schools and rural/regional training.

Of particular note is Dr Stone’s assertion that we are currently graduating enough doctors, and her call for more post graduate and vocational training places in rural and regional areas to address the mal distribution in the medical workforce.

To read Dr Stone’s motion, click here.

$8M windfall to boost internship program

By | Wednesday, August 14th, 2013
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The Commonwealth has announced $8M in funding to support new internships.

The Australian – 14 August 2013

The evidence is in – we need to put doctors where we need them, not new medical schools

By | Wednesday, August 7th, 2013
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Medical Deans is very worried about the impact of any proposed new medical school could have on the medical training system.

All governments agreed, in the establishment of Health Workforce Australia, that Australians deserved to have the best evidence available to help us determine how many doctors we need and where we need them.

We now have this evidence

In the past decade a range of initiatives has helped us double the number of medical graduates

The predicted supply of doctors should come close to meeting demand in the next year or so.

The training system now needs to support this expanded pipeline so we get high quality well trained doctors in places where we need them.

A recent Senate inquiry pointed out: “The current pressing issue is not student numbers, but the capacity in the system to adequately train those students all the way along a pathway from student to health professional who will work in rural areas.

We also know that there is still work to do to get doctors in places where patients need them whether that be rural Australia or the western suburbs of Sydney.

Figures for 2010 show that cities have an average of 219.5 specialists per 100,000 people compared with 85.5 for inner-regional areas, 47.6 for outer regions and 59.5 for remote areas. There are serious shortages in demand areas such as obstetrics and gynaecology, pediatrics and psychiatry.

All medical schools are working to achieve this goal.

The majority of the already 18 medical schools in Australia have rural and regional campuses to help train tomorrows doctors in these settings

For example, medical students at UNSW can undertake a significant part of their training at Coffs Harbour, Port Macquarie, Wagga Wagga or Albury and in the near future will be able to complete all six years of medicine in a regional area.

Other schools have focused on outer metropolitan settings where it has been traditionally difficult to recruit and retain doctors

All this has been done with large investments by governments in infrastructure and training

While on first glance a new medical school in a rural or regional setting may seem like a good idea, it ignores the current workforce evidence and the large number of current initiatives aimed at putting doctors where we need them

It also risks wasting large amounts of public money that could be diverted into better support and management of new graduates and doctors we have

Health systems are under increasing pressure and no government can afford to spend its health budget unwisely.

We can’t afford to be distracted by a debate over a new medical school that would take a decade to produce its first graduates and would swallow up large chunks of our limited resources – without addressing the real causes of the problem.

“If the number of medical students in Australia is further increased without extra investment in training infrastructure, it won’t increase the number of doctors serving our communities – it will just increase the number of unemployed doctors in our communities.”

Contacts:
Professor Judy Searle, CEO, 02 9114 1680
Professor Peter Smith, President, 02 9385 2451

Answer to rural GP shortage local interns

By | Thursday, July 25th, 2013
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RESIDENTS of regional towns and rural areas may find it hard to believe Australia is close to resolving its shortage of doctors.

But in the past decade a range of initiatives has helped us double the number of medical graduates and the supply of doctors should come close to meeting demand in the next year or so.

There are, however, still serious shortfalls in health services, with poorer outcomes and higher mortality rates to match. In some cases, local shortages of GPs and specialists are pushing residents to relocate to bigger towns and cities, eroding communities.

Why the steadily increasing cohort of medical graduates is not boosting numbers in regional areas is a complicated issue.

For example, the recent campaign by Charles Sturt and La Trobe universities for a $105 million medical school to serve Victoria and central and southwest NSW may seem, at first glance, like a good idea. In reality it does nothing to unpick the causes of the disparity or to solve it.

As such, we risk wasting large amounts of public money that could be diverted into better support and management of new graduates and doctors we have.

In recent years, Australia’s 18 medical schools have encouraged graduates to work in rural and regional areas. They have implemented policies to enrol a meaningful proportion of students from those areas – students presumed to be likely to want to go back home to practise.

Universities such as NSW and Sydney – with medical schools ranked in the world’s top 50 – also have invested in quality rural clinical schools.

For example, medical students at UNSW can undertake a significant part of their training at Coffs Harbour, Port Macquarie, Wagga Wagga or Albury and in the near future will be able to complete all six years of medicine in a regional area.

Graduates don’t lack the willingness or interest in practising outside cities.

UNSW takes 30 per cent of students from regional and rural areas, and of those students who train at our rural medical schools about 80 per cent would like to stay. So why don’t they?

The most significant barrier is a critical undersupply of rural placements for medical interns. While there are some places available for GPs, for the increasing number going on to train in other specialties the only option is to return to attachments at city hospitals.

This coincides with the life stage at which many young people find they want to settle down. So, despite their best intentions, most end up staying in cities – and rural Australia is, unarguably, all the poorer for it.

Figures for 2010 show that cities have an average of 219.5 specialists per 100,000 people compared with 85.5 for inner-regional areas, 47.6 for outer regions and 59.5 for remote areas. There are serious shortages in demand areas such as obstetrics and gynaecology, pediatrics and psychiatry.

A recent Senate inquiry pointed out: “The current pressing issue is not student numbers, but the capacity in the system to adequately train those students all the way along a pathway from student to health professional who will work in rural areas.

“There do not appear to be adequate systems that will support the internships, rotations or mentoring of the expanding number of medical students.”

Health systems are under increasing pressure and no government can afford to spend its health budget unwisely.

Instead, we should focus on what we can do.

Already some specialist medical colleges, such as the College of Physicians, are working to base some training places in regional areas. If more internships were in hospitals outside cities there would be the additional benefits of having more doctors with general qualifications on hand. This would alleviate the need to fly in doctors from as far away as New Zealand, which occurs regularly, just to keep regional wards and emergency services open.

We can’t afford to be distracted by a debate over a new medical school that would take a decade to produce its first graduates and would swallow up large chunks of our limited resources – without addressing the real causes of the problem.

Peter Smith is dean at UNSW Medicine and president of Medical Deans Australia and New Zealand
The Australian
July 24, 2013
http://www.theaustralian.com.au/higher-education/opinion/answer-to-rural-gp-shortage-local-interns/story-e6frgcko-1226683924425

Private student training ‘fantastic’

By | Thursday, June 6th, 2013
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PRIVATE hospitals are well placed to play an increasing role in medical student training, according to Professor Justin Beilby, president of Medical Deans Australia and New Zealand.

Professor Beilby, commenting on research published in the MJA that found overwhelmingly positive attitudes to medical student training at a Sydney private hospital, said the value of training medical students in both public and private environments was becoming obvious to all. (1)

“There is a growing momentum in Australia that we have this lovely option of training in private hospitals — it’s fantastic”, he said, adding that a training facility that opened last year at St Andrew’s Hospital in Adelaide had been a great success.

“As long as there is appropriate information provided to the patients who attend, the hospitals are very keen to be involved. I think that’s a reflection of realising the value for all society of training in both public and private environments.”

The research letter published in the MJA found that both patients and staff at the Sydney Adventist Hospital (SAH) were accepting of medical student involvement in care. It was the first private hospital in NSW to include a clinical school, opened by the Sydney Medical School in 2011.

A cross-sectional survey of 143 staff and 283 patients found 90% of patients would allow a student to be present during a consultation with a doctor, and 94% of staff would allow a student to watch their patient care. About half of patients and staff said they would like to have a medical student present.

The study authors said the results supported medical student teaching in private hospitals and noted that the privilege of having private health insurance did not reduce the responsibility to contribute to the training of future doctors. “Despite the limitations of this study, we have shown that patients and staff of a private hospital largely accept this responsibility.”

Professor Beilby said many clinicians in private hospitals loved to teach and there was a growing realisation that both the public and private hospital systems need to be involved in teaching.

“For years we have been teaching medical students in general practice — which has a private structure — so with the appropriate balance and the appropriate approvals, it can be done”, he said.

Michael Roff, CEO of the Australian Private Hospitals Association, said the research findings reinforced feedback to the association about other private sector training already occurring, such as registrar training. He noted that the private sector already provided more than 500 000 training days a year to both undergraduate and postgraduate health professionals.

Mr Roff said the sector had also demonstrated a willingness to become more involved in medical training last year when private hospitals agreed at short notice to take about 100 interns who were not able to be accommodated in the public system.

“There is probably capacity to increase that number. The issue is — and always has been —access to appropriate levels of funding”, he said. “If that funding is made available, we’ve seen that the private sector can step up to the mark.”

Late last month, the final report of the Review of Australian Government health workforce programs recommended that Health Workforce Australia engage more closely with the private health sector in developing and implementing health education training initiatives. (2)

Mr Roff welcomed the report’s recommendations. “The lack of coordination and the lack of funding are the two biggest barriers to the training role in the private sector expanding, as it will need to do if we are to maintain an adequate supply of health workforce into the future.”

1. MJA 2013; 198: 532-533
2. Australian Government 2013: Review of Australian Government health workforce programs

Nicole MacKee
Monday, 3 June, 2013
MJAInSight
https://www.mja.com.au/insight/2013/20/private-student-training-fantastic

Coalition divided over plan for new regional medical school

By | Wednesday, June 5th, 2013
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A FIGHT over a plan to create a new regional medical school could become a political issue after the Nationals signalled strong support for the proposal from Charles Sturt and La Trobe universities.

The established medical schools believe they have headed off the proposal, with Tony Abbott reportedly assuring the medical deans that, like Labor’s Health Minister Tanya Plibersek, he has no plans to back the idea.

But the Liberals’ Coalition partners, the Nationals, are backing the plan as a way to solve the chronic shortage of doctors in regional areas after strong growth in graduate numbers resulted only in more city-based doctors.

Coalition health spokesman Peter Dutton was non-committal, his office saying the opposition’s health policy would be announced closer to the election. But Medical Deans Australia and New Zealand president Peter Smith told the HES that one of his members had been told that the Opposition Leader was not interested in approving a new school. Mr Abbott’s office did not respond in time to queries from the HES.

“The model (proposed by CSU and La Trobe) is based on national and international evidence that supports rural training and is cost-effective by combining existing infrastructure and resources. In my view it deserves the government’s strong consideration,” Nationals senator and opposition regional education spokeswoman Fiona Nash said in a statement.

The Australian Medical Association opposes any new schools, given the near-term oversupply of graduates and shortage of internships.

Training spokesman Will Milford said he could yet have an open mind if a new school did not result in a net expansion of domestic places, but that would mean taking places away from existing schools and lead to them making up the shortfall by recruiting more international students.

Last week, Ms Plibersek said the government first wanted to ensure there was sufficient training capacity for internships before considering a new school.

La Trobe and Charles Sturt are arguing that a medical school located in the Murray-Darling area would effectively retain graduates in regional areas.

Many students have to travel to cities to do their initial study and proponents of the new school argue that they too often end up staying there.

Professor Smith said the problem was not at the undergraduate level, adding that the lack of internship places and specialist training opportunities in regional areas was driving doctors to the cities.

Last month, an independent review of health workforce programs by former NSW director general of human services Jennifer Mason said regional training pathways for doctors needed to be boosted urgently.

But she was agnostic on the merits of a new regional school, noting that while there were merits in keeping students in regional areas, the shortage of training places following the expansion of existing schools appeared a major issue.

“Further time and evaluation is needed to determine the true strength of arguments from both sides,” the review said.

Andrew Trounson
The Australian
5 June 2013

Latest publications on the MSOD Project

By | Tuesday, June 4th, 2013
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1. ‘Evidence-based medical workforce planning and education: the MSOD project’ – an editorial in MJA

2. ‘Utilisation of the healthcare system for authentic early experience placements’
http://www.rrh.org.au/publishedarticles/article_print_2328.pdf
3. ’International medical electives undertaken by Australian medical students: current trends and future directions’

4. Article

Demand rising for Australia-trained docs

By | Monday, February 25th, 2013
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FEDERAL Health Minister Tanya Plibersek says every medical graduate should get an internship given the unceasing demand for Australian-trained doctors.

“We’re going to have a huge need for doctors in the future, and doubling the number of medical students that we’re training will go some of the way in meeting that future demand,” Ms Plibersek told AAP outside the National Medical Intern Summit in Sydney on Friday.

“There will always be jobs for Australian-trained doctors. What we’ve got to make sure we do is place those interns so they get a little bit of experience before they’re off on their own.”

More than a quarter of doctors in Australia had come from overseas, she said.

“There’s nothing wrong with those doctors, but doctors who are trained in Australia are familiar with our medical system,” she said.

Ms Plibersek said there should be enough jobs for full-fee paying international students that train in Australia.

All Australian medical graduates found internships for 2013, but about 200 international students reportedly missed out.

“Those interns are valuable, and we should do our very best to keep them here in Australia,” Ms Plibersek said.

“We need to make sure that we’re training enough students. We need to make sure we’re training them in rural and regional areas as well.

“We need to make sure as we’re training specialists in the future that they’re not just sticking to our cities but also moving to the bush as well.”

The Australian
AAP
22 February 2013

Internships found

By | Monday, November 12th, 2012
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The current impasse regarding internships for international students in 2013 received a welcome boost last week with the announcement of 116 new intern posts in WA, ACT, NT and Queensland.

See the following links for announcements, media and details.

Ministerial Press Releases

The Sydney Morning Herald, 10 November 2012

Response from affected students

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