New thinking needed on medical workforce

The AMA has released its updated Position Statement on Medical Workforce and Training 2019 to address the two most important issues affecting the sustainability of the medical workforce – capacity and distribution.

The number of doctors in Australia (2015) sits just above the Organisation for Economic Cooperation and Development (OECD) average at 3.5 per 1000 population (compared to 2.8 per 1000 in the UK and 2.6 per 1000 population in the USA).

AMA President, Dr Tony Bartone, said today that the health of communities relies upon care from a highly-skilled, well-trained medical workforce and a strong comprehensive primary health care sector.

“Over the past decade, the number of doctors in Australia has increased significantly, driven by a considerable rise in the number of medical schools and medical graduates,” Dr Bartone said

“But record growth in medical graduate numbers to well above the OECD average has raised concerns about a potential medical workforce oversupply in the years ahead.

“Notwithstanding this, distribution of the medical workforce remains an issue – both geographically and by specialty.

“Australia continues to rely heavily on overseas trained doctors to fill workforce gaps, particularly in rural and remote areas.

“Some medical specialties are in undersupply, with others in oversupply, especially in metropolitan areas.

“This is exacerbated by a shortage of vocational training places, increased competition for entry into vocational training, and exit block for employment of new Fellows.

“Delivering a medical workforce to meet future community requirements for health care requires a change in thinking.

“The focus of medical workforce policy and planning must shift from increasing medical school places towards giving medical students and postgraduate doctors more opportunities to train in rural areas.

“We also need targeted increases in postgraduate training capacity in the geographic areas and specialties where they are needed.

“And improving the distribution of the medical workforce is a priority.

“A well-distributed workforce, geographically and by specialty, is essential to meet the long-term healthcare needs of communities – where undersupply impedes appropriate access, and oversupply creates costly inefficiency.

“Medical workforce policy and planning must ensure there are enough doctors with the skills and commitment to provide care where it is needed most, particularly in underserved and rural and remote communities.

“This is an issue not only for general practice, but across all medical disciplines,” Dr Bartone said.

This Position Statement follows the AMA’s call for the Council of Australian Governments (COAG) to take greater responsibility to align government policy and medical workforce planning with the long-term health needs of communities.

This resulted in support from COAG to develop a National Medical Workforce Strategy.

Importantly, this Position Statement will inform AMA advocacy on the key tenets of a National Medical Workforce Strategy to be developed by the National Medical Training Advisory Network (NMTAN).

It gives the AMA a mandate to prosecute the case for the key issues that are impacting on medical workforce and training in Australia.

This includes calling on the Commonwealth to act in several areas, including:

  • regulating full fee paying domestic and international medical student numbers, and committing to no further increase in the total number of medical school places to address issues of oversupply;
  • accrediting all prevocational training positions to address issues of poor-quality training for prevocational doctors not in a College training program; and
  • creating training and employment opportunities to improve the distribution of the medical workforce in areas of unmet community need. A key consideration will be how to develop service networks, employment, and training models to meet the healthcare needs of communities, including the service requirements of hospitals, without creating training stresses.

The AMA Position Statement on Medical Workforce and Training 2019 is at https://ama.com.au/position-statement/medical-workforce-and-training-2019

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