Modelling shows the number of medical graduates is outstripping the number of postgraduate training positions in hospitals, explaining the Australian Medical Association’s concerns about a new medical school in Western Australia

Why is the head of Australia’s Medical Association slamming government funding for a new medical school?

This graph sums up part of the reason:

Modelling produced by the now-defunct HealthWorkforce Australia (HWA) in 2014 identified bottlenecks in the medical training system, particularly for doctors. After graduating, medical students work as interns in hospitals for a couple of years. Following this, they take up vocational training in a specific area, such as general practice or surgery.



The above graph shows the projected gap between the number of medical graduates who have finished their internships and want to undergo the training required to work as a doctor, and the number of advanced vocational training places available.



The HWA report suggested that if nothing was done, growth in the number of training positions would fail to keep up with growth in the number of students graduating from medical school, with a significant gap emerging by 2017. Under this business-as-usual scenario, there would be an undersupply of doctors by the early 2020s.



This is because the number of medical students has been increasing sharply since 2006, due to policies introduced earlier in response to a projected future shortage of doctors:



However, while the number of graduating medical students has increased, figures from the medical training review board show the number of training places for graduates have not increased at the same rate.

The number of medical graduates increased by 62.4% from 2007-11. Over the period from 2008-12 (the years differ due to changes in training programs), first year internships increased by 45.3%, and practitioners entering basic vocational training increased by 40.5%.



Apart from bottlenecks in the training pipeline, there are also specific specialities which are underrepresented. For example, from 2008-12 the number of emergency medicine trainees increased 150%, while those in radiodiagnosis only increased by 18%.



There is also a geographic disparity in the number of doctors in communities, with the gap between metropolitan areas and regional and remote areas increasing:

To address these issues HWA was coordinating the national medical training advisory network (NMTAN) and the production of a national training plan.

However, HWA was stripped of funding in the 2014 budget, and responsibility for the advisory network has been taken up by the Department of Health. This transition has apparently resulted in a significant delay in the process, according to people familiar with the situation.

A health department spokesperson provided the following response in a statement:

“The NMTAN is currently working on updating specialty projections for psychiatry, general practice and anaesthetics.”



“The department is also working with states and territories to develop agreed policy responses to the national medical workforce projections published in 2014, and other similar projections published for the nursing workforce and the oral health professions. These policy responses also involve education providers and employers of health workers.

“The department uses the projections to inform commonwealth health workforce policy and programmes. For instance, the minister for health recently announced that the Specialist Training Programme will be reviewed to align delivery of training posts from 2017 with the workforce projections that are now available, to ensure that this funding is supporting more training in specialties and geographic regions in undersupply, or projected to be in undersupply.”

Tony Abbott acknowledged the lack of training places was an issue, but said the expansion of the Midlands hospital in Perth would go some way towards addressing the problem.

“They’re [the AMA] absolutely right to be concerned about the subsequent clinical training places, and what we’ve done is work with the West Australian government to get a guarantee from the West Australian government that the clinical training places will be provided,” the prime minister said.