A broader systems view is essential when discussing workforce and productivity. Australia has more practising surgeons than ever before and one of the highest numbers of doctors per capita in the OECD. Our health system was recently ranked number one globally in terms of outcomes. The real challenge is not workforce size, but distribution across regions and specialties.
The binding constraints on productivity in surgery and specialist care are not trainee numbers - they are theatre capacity, bed and ICU availability, nursing and anaesthetic workforce levels, diagnostics, digital maturity, and service planning. Australia does not have a shortage of doctors; it has a shortage of doctors in the right places, with significant maldistribution across regions and specialties.
Surgical training and Fellowship are public safety functions, not commercial processes. The internationally accepted model is profession-led and regulator-overseen… precisely the system in place in Australia to protect patients. Training positions are created, funded and put forward for accreditation by health services and government. RACS' role is to ensure these posts meet the standards required for safe, high-quality surgical training. We select candidates for the positions that exist; we do not set the number of posts. We are working closely with government and health services to expand rural training, and while there is more to do, meaningful progress is already being made through strengthened rural pathways and increased training places.
We acknowledge the community's concern about affordability and access, and share the expectation that the health system must continue to improve on both fronts. These pressures are felt acutely by patients and families. Affordability challenges reflect a complex mix of factors across the system, including long-term funding settings, rising costs of delivering care, infrastructure capacity and workforce distribution. The evidence shows these structural drivers, rather than the governance of specialist training, are the primary influences on access and cost.
Addressing the structural drivers of workforce distribution, strengthening primary care, infrastructure, funding models and coordinated planning will do far more to improve access and affordability than altering the role of specialist colleges in training or accreditation.
RACS remains committed to working with governments and health services to ensure safe, high quality and equitable surgical care for all Australians.
