Dr Bastian Seidel has warned of lobbying from drug companies eyeing new business opportunities. The forecast shortfall of training places suggests Australian medical students will increasingly struggle to find work. In its submission, the health department says the mismatch will emerge this year, run to an oversupply of trainee doctors for available training places of about 570 in 2018 and extend to an oversupply of about 1000 trainee doctors for available training places by 2030. The department's submission called for the removal of all medical occupations from the list including GPs, anaesthetists, neurologists, cardiologists and endocrinologists.

But in the annual review, which involves the Department of Education and Training providing advice to the Minister for Immigration and Border Protection, the government has so far decided against the recommendation to remove all medical professions from the list, instead making only minor exclusions. Lucky for Ms Ley the news broke in the silly season so she won't face a grilling in Parliament. Credit:Alex Ellinghausen The president of the The Royal Australian College of General Practitioners, Bastian Seidel, has urged the government to remove GPs from the skilled occupations list. He said getting overseas doctors to fill shortages in rural areas by requiring them to work there for a 7 to 10 year period was a short-term fix that treated overseas doctors like second-class citizens.

"I am quite positive that our Australian graduates can meet workforce needs in rural Australia," Dr Seidel said. "I think it is far more attractive now for Australian graduates to work in rural areas. "The priority is to expose Australian medical students early to rural areas. That's how we build capacity." 'Uncoordinated decision-making' The department's submission on doctors warned "unco-ordinated decision-making in the past has seen a boom and bust cycle in medical training and resulting doctor numbers".

The department has also warned that its future workforce modelling "provides enough evidence that there will be insufficient nurses to provide the future care required by all Australians". "It is for that reasons that we recommend that all nursing categories should be left on the Skill Occupation List," the submission says. A spokeswoman for the Federal Department of Health said the Skilled Occupation List identifies occupations that would benefit from independent skilled migration for the purpose of meeting the medium to long-term skill needs of the Australian economy. "Following the submission process, a number of changes were made to the 2016-17 SOL (Skilled Occupation List), which came into effect on 1 July 2016," the spokeswoman said. "These changes included flagging 15 health occupations, including medical specialists, for possible removal from the 2017-18 [skilled occupations list]. For now, these specialties remain on the [list] but have been flagged for review in future years.

"The process of updating the [list] for 2017-18 is now underway. The 2017-18 [list] will come into effect on 1 July 2017." A spokeswoman for the Minister of Health, Sussan Ley said the government has "noted and is further examining projections and estimates suggesting a looming oversupply of doctors". Specialties shortages "The medical workforce comprises a wide range of specialties and while there might be an emerging aggregate oversupply, there are some specialties where shortages persist especially in some regions, often in disciplines where need is increasing such as geriatrics, psychiatry and palliative care," she said. "The government is also mindful to ensure that rural and regional areas have adequate access to medical services."

A new report by the Australian Population Research Institute at Monash University echoes the department of health's warnings and is critical of the federal government's failure to remove medical professions from the skilled occupations list. The institute has repeatedly called for changes to Australia's skilled migrant program in order to provide more opportunities for citizens and permanent residents. The report by the institute's immigration expert Bob Birrell and country doctor Mike Moynihan says many overseas-trained doctors who have completed a compulsory period of service in rural and remote locations to fill doctor shortages eventually move to metropolitan areas. It says the use of migrants on 457 visas can only ever provide a short-term fix for rural doctor shortages. The report says employers sponsored 2320 overseas trained doctors on 457 visas in 2015-16, which is more than the 1529 training places for local graduates who began their careers as GPs in 2015.

Doctor makes the move Having completed his specialist GP training in the UK after doing his preliminary medical training in South Africa and Germany where he was born, Bastian Seidel arrived in Australia in 2007 on a skilled migrant visa. Dr Seidel, who has established his own medical practice in the Huon Valley in rural Tasmania where he plans to stay for the long term, says the majority of GPs in regional Australia are overseas trained. "When I started work in Huonville in 2008, no one wanted to work here," he said. "It was extremely difficult to get a qualified doctor here.

"So we trained our own doctors up. We got them very early as medical students and they are staying on." As the president of the The Royal Australian College of General Practitioners, Dr Seidel is now confronting a looming oversupply of GPs in Australia. He says the number of medical graduates has doubled in the past 10 years. The importation of overseas-trained doctors like himself provided a workforce solution when Australia could not train its own graduates quickly enough. Nor could it convince enough of them to work in understaffed rural areas. But Dr Seidel says that approach is short-sighted and the attitudes of Australian medical students have shifted over time, resulting in fewer workforce shortages in rural areas.

Now, a "different bottle neck" is emerging. A lack of training places for medical graduates wanting to specialise as GPs and other medical professions will be a limiting factor. "There are plenty of medical doctors out there already, they just need to be trained up to be specialists," Dr Seidel said. "Current evidence would suggest that general practitioners should be taken off the skilled occupations list. "I am quite positive that our Australian graduates can meet workforce needs in rural Australia."