Flinders Medical Students' Society

Internship Crisis 2014

FMSS Internship Crisis Postition Statement

Background

In order to register as a medical practitioner, Australian medical graduates need to complete an internship in an accredited hospital. These positions are funded by hospitals and coordinated by state-based training providers such as SA-IMET (South Australian Institute of Medical Education and Training). State-based training providers allocate intern positions according to a priority system that generally ranks Australian students above international students. In the past, sufficient intern training positions for all students has meant that the priority ranking has only been used to determine at which hospitals graduates will complete their internship. Due to a doubling of medical schools in Australia over the last 10 years, 2014 will see a predicted shortfall of almost 250 internships nationally. The priority ranking system threatens to severely disadvantage students in low priority groups (particularly international students) in their pursuit of an internship.

Issues

  • This 'crisis' has arisen because of a lack of workforce planning. Medical student places are funded by the Commonwealth government, whereas internship positions are funded by State governments (via hospital staffing budgets). A system that allows individual universities to determine the number of medical graduates when hospitals control the number of internships has resulted in fragmentation and a lack of coordination.
  • The priority ranking system was originally introduced as a way of determining which students go to which hospitals, not as a way of determining who will miss out on an internship, as it looks to do now.
  • International students in all other states are listed as the lowest priority for internship positions. They are also the students who graduate with the most financial debt, and are the most disadvantaged if they cannot register (and subsequently practice) as a doctor.

FMSS Position Statement

  1. FMSS feels that first and foremost, the excessive number of medical students must be addressed in order to ensure current students have sufficient job and career opportunities. An urgent cap should be placed on the numbers of medical students being produced by existing medical schools. The lack of internship positions in Australian and South Australian hospitals also needs to be addressed immediately.
  2. FMSS does not support any particular view on which group of students should be ranked higher in the priority ranking system. The issue of priority rankings, whilst significant in the context of the internship crisis, are secondary to the underlying problem – the lack of internship positions. The ranking system should only be used as a means of allocating students to hospitals, not to determine which students receive an internship position.
  3. Whilst international students have never been guaranteed an internship position by the Commonwealth government (as it does for Australian students), they come to Australia under the impression that there is the reasonable opportunity to obtain one. FMSS believes that all prospective international students should be explicitly notified of the current situation surrounding internships by the prospective medical school in order to make an informed decision.
  4. In the event that other states move to the system in Victoria, FMSS would advocate strongly that SA also adopts an allocation process that prioritises SA graduates (local and international) above interstate graduates to protect SA internship positions from the national shortage.
  5. Regardless of the method by which internships are allocated (merit, ballot system or other mechanisms), this process should be transparent and clear to students before they apply for internships.

Update 01/11/13: All Flinders Students Secure Positions.

After much hard work we have received conformation that all Flinders graduates have received internship positions for 2014. It is yet to be seen if the same can be said for other schools and states.

Update 29/08/13: AMSA Intern Crisis Phone Day.

A small dedicated group of students in every state spent the day calling almost every state and federal politician to alert them to the impending crisis. Overall the response from most politicians was positive, many followup meetings were arranged and AMSA is confident that the process has raised the profile of the Intern Crisis within the political community.

Update 22/08/13: The Liberal Party commits to an additional intern positions.

In the lead up to the election, the Liberal Party has committed to an additional $40M to fund 100 intern positions for the next 4 years. Read the full press release from the Liberals.

Update 20/06/13: Government report confirms medical training crisis.

The Australian Medical Students’ Association (AMSA) is calling on the Federal and State Governments to act on the current medical training crisis following the release of government numbers yesterday, that confirm the number of medical students graduating will increase again this year.

AMSA President, Mr Ben Veness said that the 16th report of the Medical Training Review Panel (MTRP), released today, shows that 3,556 medical students will graduate from Australian Universities in 2013, which is more than double the number of graduates in 2006. Only 3,201 internships are projected to be delivered by the states and territories in 2014.

AMSA predicts that the MTRP forecast will prove to be overstated and that the eventual gap is not quite as large as this, but that graduating students will nonetheless be left without a job.

“Last year, an eleventh-hour bail-out was required from the Federal Government to increase the number of medical internships in Australia and prevent the loss of young doctors overseas,” Mr Veness said.

“Our Governments must collaborate to prevent the same crisis occurring this year.

“The shortage of internships is just the tip of the iceberg, further shortages are predicted in specialty training positions.

“Doctors must complete an internship and specialty training, to be allowed to practice independently in Australia.

“If Australia doesn’t offer enough internships and specialty training positions, we’ll lose Australian-trained doctors overseas, and miss an opportunity to address our current doctor shortage.

“Rural and remote communities are sick of waiting for doctors.

“We don’t need new medical schools, we just need to employ and finish the training of these Australian-trained graduates.

“Private hospitals are keen to increase the number of interns working in their hospitals. If the governments engage them now, we could set up a sustainable medical training system that will ensure high quality doctors for all Australian communities.”

Read the full AMSA press release.

Update 23/04/13: Medical students call on governments to commit.

The Australian Medical Students’ Association (AMSA) was pleased to see the medical training crisis being discussed by Australia’s top politicians last night on ABC’s Q&A program, but is calling on all governments to agree to a practical long- term solution.

Federal Health Minister, Tanya Plibersek, and Federal Shadow Health Minister, Peter Dutton, were questioned directly on the medical training crisis in Australia.

AMSA President, Mr Ben Veness said today that both Ms Plibersek and Mr Dutton signalled a willingness to expand internships in private hospitals and other settings, but they stopped short of guaranteeing funding.

Read the full AMSA press release.

Update 12/03/13: Students seek a national solution to address training crisis.

The Australian Medical Students’ Association (AMSA) has called on the State and Federal Governments to address Australia’s medical training crisis and implement a National Intern Allocation System. An article published by the Medical Journal of Australia, yesterday, suggests that the States’ current methods of discriminating against interstate students in their internship allocations may be unconstitutional. AMSA (Acting) President, Mr Richard Arnold, said the article highlighted the need for the states to move towards a National Intern Allocation System.

Read the full AMSA press release.

Update 25/02/13: Students welcome private hospitals’ involvement in medical training.

The Australian Medical Students’ Association (AMSA) has welcomed the comments from private hospital representatives, at the National Medical Intern Summit on Friday, to support the training of Australia’s future doctors by increasing the number of internships in their hospitals.

At the Summit convened by the NSW Minister for Health and Medical Research, Mrs Jillian Skinner, in response to last year’s internship crisis, the CEO of Catholic Hospitals Australia, Mr Martin Laverty, said the hospitals were willing to expand the number of interns they employ after already identifying room for 70 internships last year.

Read the full AMSA press release.